Graves眼病的“虚-瘀-毒”病机层次探讨

Discussion on Pathogenesis Level of"Deficiency-Blood Stasis-Toxin"in Graves Ophthalmopathy

Graves眼病是一种与甲状腺疾病密切相关的器官自身免疫性疾病,其发病机制目前尚未完全明确,现代研究多认为与细胞免疫、体液免疫、共同抗原-抗体反应以及球后成纤维细胞作用等密切相关,主要以激素冲击等免疫抑制剂治疗为主,存在不良反应较多、易复发、部分患者治疗无效等问题,严重者需放疗甚至手术。中医没有关于本病的专门记载,现代医家多将其归入“鹘眼凝睛”范畴,中医药治疗可改善患者症状、延缓病情发展、减轻激素治疗副作用,效果显著。但各医家对于本病的认识和相关治法各有所重,目前并无太多医家对Graves眼病进行明确的病机探讨。结合现代研究对于本病的相关认识及其病症特点来看,Graves眼病存在“虚-瘀-毒”的病机层次演变特点。

Graves ophthalmopathy is an organ autoimmune disease closely related to thyroid diseases.Its pathogenesis is still unclear.Modern studies believe that it is closely related to cellular immunity,humoral immunity,common antigen-antibody reaction and retrobulbar fibroblast function,etc.Immunosuppressants such as hormone pulse therapy are mainly used in treatment,but there are some problems such as adverse reactions,easy recurrence,ineffective treatment for some patients,etc.For severe cases,radiotherapy or even surgery is needed.There is no special record about this disease in traditional Chinese medicine,and modern doctors often classify it as"dove-like fixed eye".TCM treatment can improve patients’symptoms,delay the development of the disease and reduce the side effects of hormone therapy with remarkable effect.However,doctors have different understandings of this disease and related treatments.A few of doctors have made a clear discussion on the pathogenesis of Graves ophthalmopathy at present.According to the related understanding of this disease and its disease characteristics in modern research,Graves ophthalmopathy has the characteristics of"deficiency-blood stasis-toxin"in the evolution of pathogenesis level.