基于天癸理论探讨干眼的发病机制

The pathogenesis of dry eye based on Tian Gui theory

干眼是多因素导致的慢性眼表疾病,与下丘脑-垂体内分泌系统密切相关。天癸与下丘脑-垂体-性腺轴关联。基于天癸理论探讨天癸与目生理联系、天癸与干眼之间的病机联系,认为天癸衰少所致冲任虚瘀、目络阻滞是干眼发病的重要因素;天癸不足所致肝肾藏泄失衡为干眼的病机本质;天癸阴阳失衡所致目阴阳失调为病机关键。提出疏导冲任,活血化瘀为治疗干眼之要;补益肝脾肾,益源生癸为治疗干眼之本;药性相平,适配天癸阴阳为治疗干眼用药准则。以期基于天癸理论为干眼治疗提供参考与借鉴。

Dry eye,a chronic ocular surface disease caused by multiple factors,is closely related to the hypothalamus-pituitary endocrine system.Tian Gui(reproduction-stimulating essence)is associated with the hypothalamus-pituitary-gonad axis.Based on Tian Gui theory,this paper explores the physiological connection between Tian Gui and the eyes,as well as the pathological correlation between Tian Gui and dry eye.It holds that the important factor for the onset of dry eye is that the deficient Tian Gui fails to nourish the Chong and Ren meridians,thus leading to unsmooth flow in them and blood stasis which blocks the eye collateral eventually;the nature of its pathogenesis is the insufficient Tian Gui resulting in the imbalance of storing and discharging functions of the liver and kidney;the key is yin-yang imbalance of eyes caused by that of Tian Gui.As for the treatment,it is proposed to take smoothing the Chong and Ren meridians,and circulating blood and eliminating stasis as the key,tonifying the liver,spleen,and kidney to generate Tian Gui as the root,selecting Chinese medicines with proper natures of yin or yang to restore the yin-yang balance of Tian Gui as the guideline.This paper aims to provide ideas for the treatment of dry eye from the perspective of Tian Gui theory.