中医药治疗视神经萎缩用药情况分析

Administration of Chinese medicinal in treatment of optic atrophy

目的探讨我院临床眼科专家治疗视神经萎缩(视瞻昏渺和青盲)的辨证处方规律。方法采用计算机信息技术,在遵循中医学及中药学理论基础上,对于2006年在我院住院治疗的视神经萎缩患者的中药汤剂处方进行分析,寻找用药规律,探究用药特点。结果我院治疗视神经萎缩处方用药以活血化瘀药、补气药、补血药位列前3,常配伍葛根、石菖蒲等通窍明目之品。常用方剂主要为四物汤、当归补血汤,其次是六味地黄汤、五子衍宗汤等滋补肝肾之方药及补阳还五汤、桃红四物汤等活血化瘀之方药。药性偏温,甘味药最多,正是补益药特征,而活血化瘀药味多辛苦。用药归经分析显示,视神经萎缩用药肝肾经最多,正是肝开窍于目、肝肾同源的印证。结论中医药治疗视神经萎缩在临床应用中有内在的规律,应善于挖掘以利于临床诊疗技术的提高。

Objective To investigate the laws of syndrome differentiation and formula administration in the treatment of optic atrophy by the ophthalmologists in the Eye Hospital of China Academy of Chinese Medical Sciences. Methods The formulas of Chinese medicinal decoctions were analyzed administrated in the patients with optic atrophy in 2006 by applying computer information technology based on TCM theory. The purpose was to find out the laws and characteristics of medicinal administration. Results The first three types of Chinese medicinal, used for treating optic atrophy, were medicinal with the actions of activating blood and resolving stasis, tonifying qi and tonifying blood, and they were commonly accompanied by Gegen （Radix Puerariae） and Shichangpu （Rhizoma Acori Graminei） for opening orifices and improving vision. The formulas used commonly included Siwu Tang, Danggui Buxue Tang, Liuwei Dihuang Tang and Wuzi Yanzong Tang with the actions of nourishing liver and kidney, and Buyang Huanwu Tang and Taohong Siwu Tang with the actions of activating blood and resolving stasis. The nature of these medicinal was warm, and the flavor was mainly sweet. The flavors of the medicinal with the actions of activating blood and resolving stasis were mainly pungency and bitterness. The analysis on medicinal meridian entry showed that the medicinal for optic atrophy mostly entered into the meridians of liver and kidney, which verified the theory of liver opening at eyes and homogeny of liver and kidney. Conclusion The treatment of optic atrophy with Chinese medicine has internal laws in clinical practice.