基于“五轮八廓”学说治疗视网膜静脉阻塞之思路初探

A brief investigation on RVO therapies based on “five rings and eight regions” theories

视网膜静脉阻塞(RVO)是眼科临床常见的视网膜血管性疾病,由视网膜静脉血流阻塞所致,其继发的黄斑水肿(ME)已成为导致RVO患者视力受损的重要原因。保护患者黄斑区视功能对提高患者的治疗效果及生存质量具有重要意义。目前临床一线治疗方法抗血管内皮生长因子(VEGF)药物玻璃体腔注射虽短期疗效显著,但ME易复发,需多次反复用药,增加了患者的经济负担及手术风险,且治标而未治本。本文结合中医眼科传统"五轮八廓"学说,在传统中医理论基础上传承发展,从整体的角度看待视网膜血管病,创新提出"黄斑八廓"假说。借助现代眼科检测设备,从分析RVO继发黄斑周围区域视功能损伤的中医发病机理等方面,浅析基于脏腑辨证、生物全息律,个体化治疗RVO的思路。

Retinal vein occlusion(RVO) is a common retinal vascular disease in ophthalmology caused by obstruction of retinal veins. Macular edema(ME) secondary to RVO has become an important cause of visual impairment in patients with RVO. Thus, protecting the macular function of RVO patients is of great significance to improve the treatment effect and quality of life. Anti-vascular endothelial growth factor intravitreal injection is the current first-line clinical treatment method for ME secondary to RVO. Although it has a significant short-term effect, ME is prone to recur, thus repeated injections are required, which increases the economic burden and surgical risk of the patients. This therapy only treats the symptoms but not the root causes of RVO. This article combined the traditional "five rings and eight regions" theories of Traditional Chinese Medicine(TCM)in ophthalmology, inherited and developed the theoretical basis of TCM and raised the "eight regions of the macula " hypothesis creatively to investigate retinal vascular disorders from a holistic perspec-tive. With the help of modern ophthalmological imaging technologies, we analyzed the pathogenesis of retinal functional impairment in the macular area in RVO eyes and discussed the individualized treatment therapies based on syndrome differentiation of the viscera and the bio-holographic law.