谢立科疏肝养阴法治疗干眼临床经验

Experience of XIE Like Treating Dry Eye Disease by Soothing Liver and Nourishing Yin

干眼是眼科临床上常见的眼表疾病,其特征是泪膜稳态失衡,眼表可出现异物感、干涩感、烧灼感等症状。随着电子产品的普及,干眼的发病率呈逐年上升趋势,严重者可影响视力及人们的正常生活。现阶段干眼的治疗方法主要是人工泪液替代疗法,只能改善局部症状,不能长久使用。干眼属中医“白涩症”的范畴,中医药辨治干眼有悠久历史,疗效较好,现代各医家对干眼的病因病机有不同的见解,治疗上亦有不同,文章介绍谢立科教授多年来疏肝养阴法治疗干眼的临床经验。谢立科教授在前人认识以及自身30余年临床经验基础上,认为干眼病因病机多为气机郁滞,日久化火,津液亏虚不布,与肝脏密切相关,提出“郁”“虚”为本病主要病理因素,将干眼的病机概括为“肝郁阴虚”,并认为本病的发生与机体应激反应有相似之处,临床上,用自拟“逍生散方”治疗干眼,共奏疏肝养阴之功。此外,重视风药使用,常配伍防风、菊花、桑叶之品,同时将调畅情志贯穿疾病始终,为临床治疗干眼提供新思路。

Dry eye disease is a common ocular surface disease in Ophthalmology,which is characterized by the imbalance of tear film homeostasis.Patients with dry eye disease may have symptoms such as foreign body sensation,dryness and burning sensation.With the popularization of electronic products,the incidence of dry eye disease is increasing year by year,which can affect eyesight and people's normal life in severe times.At present,the treatment of dry eye disease is mainly artificial tears replacement therapy,which can only improve local symptoms,but can not be used for a long time.Dry eye disease belongs to the category of“white astringent disease”in traditional Chinese medicine.Traditional Chinese medicine has a long history in the treatment of dry eye disease,with good curative effect.Modern doctors have different views on the etiology and pathogenesis of dry eye disease,and the treatment is also different.This paper introduced professor XIE Like's clinical experience in the treatment of dry eye disease with the method of soothing liver and nourishing Yin for many years.On the basis of predecessors'knowledge and more than 30 years'clinical experience,Professor XIE Like thinks that the etiology and pathogenesis of dry eye disease are mostly stagnation of Qi,long-term change of fire,deficiency of body fluid,which are closely related to the liver,and puts forward“depression”and“deficiency”as the main pathological factors of the disease,summarizes the pathogenesis of dry eye disease as“liver depression and Yin deficiency”,and thinks that the occurrence of the disease is similar to the stress reaction of the body.In clinic,Xiaoshengsan(逍生散)is used to treat dry eye disease,which plays the role of soothing liver and nourishing Yin.In addition,we should pay attention to the use of wind medicine,often combined with Fangfeng(Radix Saposhnikoviae),Juhua(Flos Chrysanthemi)and Sangye(Folium Mori).At the same time,it will regulate the mood throughout the disease,so as to provide new ideas for the clinical treatment of dry eyes.