运用升清降浊法辨治湿性年龄相关性黄斑变性

Using the Method of Ascending Clarity and Descending Turbidity to Treat Wet Age related Macular Degeneration

湿性年龄相关性黄斑变性(wAMD)是一种引起老年人严重视力下降的退行性病变,在中医学上属“视瞻昏渺”的范畴。临床多认为wAMD是由脾肾亏虚所致,病证多属本虚标实。脾肾气虚导致气机不畅、清阳不升、浊阴不降,津液输布障碍、血脉闭阻产生的痰、湿、瘀等病理产物瘀阻于脉道而发为本病。因此,治疗wAMD应着重以补益脾肾,调整气机、升清降浊为治则。在临床治疗本病时,注重运用升降理论,调补脾肾,调畅气机,畅达气、血、津液,常可达到脏腑清浊调和,目得所视。

Wet age-related macular degeneration(wAMD)is a degenerative condition that leads to severe vision loss,falling within the realm of Traditional Chinese Medicine's concept of"Shizhan Hunmiao".Clinically,it is widely believed that wAMD is caused by deficiency in spleen and kidneys,with symptoms often manifesting as deficiency in the root and excess in the manifestation.Spleen and kidney Qi deficiency results in impaired Qi circulation,failure of clear Yang to ascend,and turbid Yin not descending.This leads to the formation of pathological products such as phlegm,dampness,and stasis,obstructing the meridians and giving rise to this condition.Therefore,the treatment of wAMD should focus on nourishing spleen and kidney,regulating Qi circulation,and balancing the ascent of clear and descent of turbid.In clinical practice,we emphasize the use of the theory of ascending and descending,tonifying spleen and kidneys,regulating Qi circulation,and promoting the smooth flow of Qi,blood,and fluid to achieve harmony in the organs and clear vision.