从伏邪理论探讨视网膜静脉阻塞继发黄斑水肿的治疗

Discussion on Treatment of Macular Edema Secondary to Retinal Vein Occlusion from Theory of Latent Evil

视网膜静脉阻塞可由多种外邪或内伤邪气侵袭导致脉络瘀阻,血溢脉外,其继发的黄斑水肿为常见并发症且易反复发作。视网膜静脉阻塞继发黄斑水肿(RVO-ME)是由外感或内生邪气侵袭,伏于体内,累及脾、肝、肾诸脏,以脾胃虚弱、肝肾亏虚等正气虚弱为本,痰湿、气滞、瘀血等积聚于黄斑为标,其本虚标实是伏邪的关键。因此基于中医整体观念辨证论治,结合八纲、脏腑、三焦辨证,从伏邪理论探讨RVO-ME的治疗,从健脾祛湿、疏肝养肝、益气活血、温补肾阳等方面论治,以期促进RVO-ME消退,减缓RVO-ME复发,提高患者视力和生活质量。

Retinal vein occlusion can be invaded by a variety of external evil or internal injury evil Qi,resulting in vein stasis and extravenous blood overflow.Its secondary is macular edema which is a common complication and easy to occur repeatedly.Macular edema secondary to retinal vein occlusion(RVO-ME)is invaded by exogenous or endogenous evil Qi,which lies in the body and involves spleen,liver and kidney.It is based on the weakness of healthy Qi such as deficiency of spleen and stomach and deficiency of liver and kidney.It presents as the accumulation of phlegm dampness,Qi stagnation and blood stasis in the macula.The key to subduing evil lies in the positive deficiency and the actual situation.Therefore,based on the overall concept of traditional Chinese medicine,combined with the syndrome differentiation of eight principles,Zang-Fu organs and triple energizer,this paper discussed the treatment of RVO-ME from the theory of underlying evil,and discussed the treatment from the aspects of strengthening spleen and removing dampness,soothing and nourishing liver,supplementing Qi and activating blood circulation,warming and tonifying kidney Yang,so as to promote the regression of RVO-ME,slow down the recurrence of RVO-ME and improve the vision and quality of life of patients.