基于《眼科阐微》探讨归元剔络法治疗老年性眼病的学术思路

Exploring the Application of Guiyuan Tiaolou Method in the Treatment of Senile Eye Diseases Based on the Academic Ideas of Yanke Chanwei

《眼科阐微》开创了老年性眼病证治专论的先河,书中概括了老年性眼病的证候特征、阐释了病因病机、提出了治疗法则,其学术思想独具特色。在继承和发扬其学术思想的基础上,冯俊认为老年性眼病为本虚标实、脏窍同病之证,其中,脏腑为本,一身之元归脾肾;目为标,目中之元归气血;玄府-络脉为枢,标本联系剔络为要。所以,老年性眼病位在五脏和目窍,发病之本为脏腑虚损,尤责之脾、肾;发病之标为目窍,尤责之气血。本文提出归元剔络法可作为老年性眼病的治疗原则,以剔络开府、益气通窍的归元剔络方可作为治疗老年性眼病的核心方,临证中可根据其标本、虚实辨证加减。

Yanke Chanwei pioneered the specialized discussion on the diagnosis and treatment of senile eye diseases.The book summarizes the clinical features,interprets their etiology and pathogenesis,and proposes principles for treating these conditions.The academic ideas presented in the book are notably distinctive.Building upon and promoting these academic ideas,FENG Jun believes that senile eye diseases manifest as a combination of primary deficiency and secondary excess,with the organs and orifices sharing the same pathological patterns.Specifically,Zang-fu is considered the primary source,with the fundamental elements of the body converging in spleen and kidneys.The eyes represent the secondary manifestation,with their essential components converging in Qi and blood.The Xuan-fu and collaterals serve as the pivotal connection,emphasizing the importance of the relationship between primary and secondary manifestations.So,senile eye diseases are rooted in both the organs and orifices,with the underlying cause being the deficiency of Zang-fu,particularly spleen and kidneys.The manifest symptoms involve the orifices,particularly the disturbance of Qi and blood.The article proposes that the method of Guiyuan Tiaolou should be the fundamental principle for treating senile eye diseases.The core of treatment lies in the use of the Guiyuan Tiluo method,which involves clearing collaterals,nourishing Qi,and unblocking orifices.In clinical practice,treatment is adjusted based on differentiation of the primary and secondary manifestations,as well as consideration of deficiency and excess conditions.