基于“络病学说”探析视网膜动脉阻塞的诊疗

Diagnosis and Treatment of Retinal Artery Occlusion Based on Collateral Disease Theory

视网膜动脉阻塞(RAO)是眼科危急重症,主要表现为无痛性视力下降,发病率较高,预后不佳。目前,西医治疗RAO仍无法获得满意的疗效,中医治疗RAO具有独特的优势,而络病理论的发展又为该病的诊疗提供了新的视角。本文基于络脉与视网膜微小动脉解剖与功能的一致性,试将络病学说应用于RAO的诊疗,提出本病的发病基础为络虚不荣,病机关键为邪瘀阻络。在通络原则指导下,治疗上可应用辛味、虫类、藤类药祛邪通络,补益药通补络虚,辅以穴位针刺,为RAO的诊疗提供新思路。

Retinal artery occlusion(RAO)is a critical condition in ophthalmology,characterized mainly by painless vision loss,high incidence,and poor prognosis.Currently,Western Medicine is still unable to achieve satisfactory therapeutic effects in treating RAO.Traditional Chinese Medicine(TCM)has unique advantages in treating RAO,and the development of the collateral disease theory offers a new perspective on its diagnosis and treatment.This paper,based on the consistency between the anatomy and function of collaterals and retinal arterioles,attempts to apply the theory of collateral disease to the diagnosis and treatment of RAO.It suggests that the pathogenesis of this disease is rooted in collateral deficiency,with the key pathological mechanism being obstruction of collaterals by pathogenic factors.Guided by the principle of promoting collateral circulation,treatment may involve the use of pungent,insect,and vine medicines to dispel pathogenic factors and promote collateral circulation,as well as tonifying medicines to nourish and supplement collateral deficiency,supplemented by acupuncture at specific acupoints,providing a new perspective for the diagnosis and treatment of RAO.