基于目络学说对缺血性眼病病机和治疗的再认识

Recognition of pathogenesis and treatment of ischemic ophthalmopathy based on theory of eye collateral

在中医络病理论指导下,基于多年临床实践,提出了缺血性眼病的核心病机是“目络瘀阻”。“虚、瘀、毒、水”是缺血性眼病“目络瘀阻”病机演变过程中的基本要素,表现为络虚生瘀、瘀而生毒、毒邪伤络、饮生阻络、痰瘀互结的病机演变规律。其中正虚是缺血性眼病内在的发病基础,目络挛急是发病的始动因素,目络瘀阻贯穿疾病始终。本病的发病较为符合络病由气及血及络的发病规律。因此,依据缺血性眼病目络瘀阻病机特点,确立了“活血通络”为治疗大法,并创立了5个通络方剂。现将缺血性眼病的中医病机和治疗总结如下,对丰富其内涵、提高临床疗效具有重要意义。

Under the guidance of the theory of collateral of Traditional Chinese Medicine and based on clinical practice of many years,we proposed that the core pathogenesis of ischemic ophthalmopathy was“eye collateral stasis”.“Deficiency,blood stasis,toxin and water”are the basic elements in the evolution of pathogenesis of“eye collateral stasis”of ischemic ophthalmopathy,which are manifested in the law of pathogenesis evolution of collateral deficiency and blood stasis,blood stasis and toxin,toxin and pathogenic injury of collaterals,Yin and obstruction of the collaterals,phlegm and blood stasis.Among them,deficiency is the internal pathogenesis of ischemic ophthalmopathy,eye collateral contracture is the initial factor,and eye collateral stasis runs through the process of ischemic ophthalmopathy.The incidence of this disease is in accordance with the regularity of collateral disease which caused by Qi to blood and collaterals.Therefore,according to the characteristics of pathogenesis of“eye collateral stasis”of ischemic ophthalmopathy,we established the treatment principles of“promoting blood circulation and unblocking collaterals”,and originated five prescriptions for unblocking collaterals.This article is of great significance for enriching the pathogenesis and treatment of ischemic ophthalmopathy in Traditional Chinese Medicine and improving the clinical efficacy.