现代中医对近视病因病机认识的演变分析

Analysis on the evolution of understanding of the etiology and pathogenesis of myopia in modern traditional Chinese medicine

为了厘清现代中医眼科学界对近视病因、病机认识的发展过程及产生变化的影响因素,通过对统编《中医眼科学》第一版到第十版教材中近视章节的梳理,分析各版教材的理论框架和近视章节的主要内容和书写体例,探讨中医眼科学界对近视的认识特点。通过梳理发现,近期出版的教材与前期出版的教材相较而言,对这3种病因病机认识存在较大的差异。且《中医眼科学》教材中,未对"神光"这一重要概念进行明确的解释,造成一些学者从西医的角度理解这一概念,混淆了中医治疗近视的诊治思路。为此,建议后续的《中医眼科学》教材增加相应的内容,更加突出中医理论和中医认识该疾病的特点。

In order to clarify the development process and influencing factors of modern ophthalmology of traditional Chinese medicine(TCM)on the etiology and pathogenesis of myopia,this study teased the myopic chapters of Ophthalmology of TCM from the first edition to the tenth edition,analyzed the theoretical framework of each edition of textbooks,the main content and writing style of myopia chapters,and discussed the characteristics of myopia cognition in the field of Ophthalmology of TCM.The findings show that deficiency of heart yang,deficiency of qi and blood and deficiency of liver and kidney have gradually become the consensus of the etiology and pathogenesis of myopia from modern TCM’s perspective.However,there are great differences in the understanding of the three types of etiology and pathogenesis between the textbooks published recently and those published earlier.Moreover,the explanation of“shenguang”,an important concept,is not clear and adequate.As a result,some scholars understand“shenguang”from the perspective of Western medicine and unable to diagnose and treat myopia in TCM approach.Therefore,it is suggested that in the compilation Ophthalmology of TCM,textbook writers should highlight TCM theories and how TCM understand,diagnose and treat myopia by adding corresponding contents,which is significant not only in textbook compilation and teaching of TCM Ophthalmology,but also in understanding and clinical practice of myopia in TCM ophthalmology.