李志英教授防治糖尿病视网膜病变的思路及经验

Professor Li Zhiying's thoughts and experience on prevention and treatment of diabetic retinopathy

糖尿病视网膜病变(DR)是糖尿病的常见眼部并发症及致盲性眼病,主要以视网膜血管源性改变为病理特征,眼底多表现为视网膜渗出水肿、新生血管、出血及增殖膜形成,严重威胁患者的视觉健康。随着近年来发病率的增加,如何有效的防治DR已成为眼科医生研究的热点和重点。虽然控制血糖、药物治疗、激光光凝和手术治疗是目前防治DR的主要方式,但也并不能完全控制DR的进展。及时有效的防治DR将能更早的挽救患者视力、降低致盲风险。李志英教授认为DR多属“气阴两虚,痰湿内生,脉络瘀阻”本虚标实之证,治疗过程中需分清标本缓急,同时根据中医整体观念,结合患者全身情况、居住环境及体质因素辨证施治,药食同疗,经多年临床观察,疗效显著。本文将详细介绍李志英教授对DR防治的诊疗思路及经验。

Diabetic retinopathy(DR)is a common ocular complication and blinding eye disease of diabetes mellitus.It is mainly characterized by retinal vasogenic changes.The fundus is characterized by retinal exudation and edema,neovascularization,hemorrhage and the formation of proliferating membrane,which seriously threatens the visual health of patients.With the increase of incidence in recent years,how to effectively prevent and treat DR has become the focus of ophthalmologists.Although the control of blood glucose,drug therapy,laser photocoagulation and surgical treatment are the main ways to prevent and treat DR at present,the progress of DR cannot be completely controlled.Timely and effective prevention and treatment of DR will save patients'vision and reduce the risk of blindness earlier.According to Professor Li Zhiying,DR is mostly the syndrome of"deficiency of qi and yin,internal phlegm and dampness,and obstruction of vessel and collaterals".In the treatment process,it is necessary to distinguish the root and the tip,the urgency and the mild.At the same time,according to the holism concept of traditional Chinese medicine,the patient's overall body condition,living environment and physical factors should be treated according to syndrome differentiation.This article introduces professor Li Zhiying's thoughts and experience on diagnosis and treatment of diabetic retinopathy.