味觉障碍是味觉感知功能异常的一种疾病。该文基于 《黄帝内经》 中的相关玄府理论及现代中医对玄府、心神与味 觉的认识，提出味觉障碍的核心病机在于邪阻玄府、心神不达。邪阻玄府，气血津液的流通受阻，神机的运转受到影响， 从而影响心神通达舌窍，进而导致味觉感知功能的异常。味觉障碍的具体发病机制如下：心气不和，血脉瘀滞而致玄府郁 闭；脾胃不和，水湿内停而致痰湿阻玄；肺气失宣，气机与津液代谢失常而致玄府闭阻；肝气郁结，疏泄失常而致玄府阻 滞；浊毒犯络，气血运行受阻而阻滞玄府；邪阻致虚，气血津液亏虚而致玄府失荣。治疗味觉障碍以“开玄达神”作为目 标，可通过调和心气、祛湿化痰、宣肺散寒、疏肝解郁、化浊解毒及扶正祛邪等开玄达神的方法，以流通气液、渗灌气血，助心神畅达于舌窍，从而改善味觉障碍。基于玄府理论探讨味觉障碍的病机及治疗，可为味觉障碍的辨证与治疗开拓新的 思路。

Taste disorder is a condition characterized by abnormal gustatory perception. Based on the relevant Xuanfu theory in Huangdi Neijing（The Yellow Emperor’s Inner Classic） and the interpretation of Xuanfu，heartspirit， and taste by modern traditional Chinese medicine’s practitioners， this article proposes that the core pathogenesis of taste disorder is due to the obstruction of pathogens in Xuanfu which causes the disorder of heartspirit. When pathogens obstruct the Xuanfu，the flow of qi，blood，and body fluids is impeded，and the mental activity is affected，thereby hindering the heart-spirit from reaching the tongue orifice and leading to abnormal taste perception. The specific pathogenic mechanisms of taste disorder are as follows：disharmony of heart qi and blood stasis of vessels cause Xuanfu blockage；disharmony of the spleen and stomach with internal retention of water-dampness leads to the obstruction of phlegm-dampness in Xuanfu；impaired diffusion of lung qi disrupting qi movement and fluid metabolism results in Xuanfu blockage；liver qi stagnation and abnormal conveyance cause Xuanfu obstruction；turbid toxins invading the collaterals and impeding the flow of qi and blood lead to Xuanfu blockage； deficiency resulting from obstruction and the insufficiency of qi， blood， and body fluids cause the malnourishment of Xuanfu. The treatment for taste disorders aims at unblocking the Xuanfu to ensure the normal function of the spirit，which can be achieved through the methods of harmonizing heart qi，eliminating dampness and resolving phlegm， diffusing the lung and dispersing cold， soothing the liver and relieving stagnation， resolving turbidity and detoxifying， and supporting healthy qi to eliminate pathogens. These approaches can promote the flow of qi and body fluids and the perfusion of qi and blood，which facilitate the smooth passage of heart-spirit to the tongue orifice， and then improve taste disorders. The exploration of the pathogenesis and treatment of taste disorders based on the Xuanfu theory will provide new perspectives for the syndrome differentiation and management of taste disorders.

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河北省自然科学基金项目（编号：H2022423369）；河北省政府资助临床医学优秀人才培养项目（编号：ZF2023159）；第五批全国 中医临床优秀人才研修项目（国中医药人教函 〔2022〕 1号）；河北省中医药管理局资助项目（编号：2022025）；国家中医药管理局梅建强 全国名老中医药专家传承工作室建设项目（国中医药人教函 〔2022〕 75 号）；国家中医药管理局全国名中医梅建强传承工作室建设项目 （国中医药办人教函 〔2022〕 245号）