国医大师唐由之运用参明汤治疗弱视的组方思路探讨

Exploring the Prescription Strategy of Using Shenming Decoction by the Eminent Chinese Physician TANG Youzhi for Treating Amblyopia

弱视为常见的儿童眼病,归属于中医学“视瞻昏渺”“目暗不明”等范畴。国医大师唐由之认为,弱视的病因病机为先天禀赋不足、后天摄养失宜,在治疗上以补养先、后天为主,在其经验方参明汤的基础上进行临证加减。参明汤的组方特色为:虚为病由,肾为虚本,重视补肾,填精益髓;幼科之要,调理脾胃,培土化源,健脾益胃;斡旋脾肾,脾肾互赞,相互资生,相得益彰;治法多变,不拘于补,补而不滞,静中有动;用药权衡,变通为要,四诊合参,中西并举。本文对唐由之诊治儿童弱视的学术思想进行深入分析,探讨其诊治依据和组方思路。

Amblyopia,a common childhood eye disease,belongs to the category of"dimness of vision"and"obscuration of sight"in Traditional Chinese Medicine(TCM).The renowned Chinese physician TANG Youzhi believed that the etiology and pathogenesis of amblyopia lie in congenital deficiency and postnatal improper nurturing.In treatment,the emphasis is on nourishing both congenital and acquired aspects.Based on his clinical experience,TANG Youzhi made modifications to Shenming Decoction,focusing on the principle of reinforcing kidney to supplement essence and marrow.The distinctive features of Shenming Decoction include:The disease originates from deficiency,with kidney being the root deficiency;Emphasizing tonification of kidney,enriching essence,and nourishing marrow;The essence of pediatric treatment lies in regulating spleen and stomach,nurturing the earth element,and enhancing spleen function to benefit digestion;Harmonizing spleen and kidney,mutually complementing each other,promoting mutual generation,and achieving mutual enhancement;The treatment methods are flexible,not confined to tonification,ensuring tonification without stagnation,maintaining dynamism within tranquility;Balancing medication selection,emphasizing adaptability,integrating the four diagnostic methods,and combining both TCM and Western Medicine.This article provides a detailed analysis of TANG Youzhi's academic thoughts on the diagnosis and treatment of amblyopia in children,exploring the rationale behind his treatment and the formulation strategy.