霍勤教授从肝论治视网膜静脉阻塞的临床经验

Clinical Experience of Professor Huo Qin in Treating Retinal Vein Obstruction from the Liver

霍勤教授认为,视网膜静脉阻塞(RVO)的基本病机是肝郁气滞、血脉瘀阻,提出从肝论治的学术思想;临床上从肝入手,将此病分早、中、晚、末四期分别论治,以疏肝解郁、活血通络作为基本治则,以自拟方柴归理血汤为基础进行化裁,灵活加减,多获良效。早期RVO考虑肝郁化热、迫血妄行,治宜清肝降火、凉血止血;中期考虑肝郁脾虚、血瘀水停,治宜疏肝健脾、活血利水;晚期考虑肝郁气滞、痰瘀交结,治宜理气化痰、祛瘀明目;末期考虑肝肾阴虚、气滞血瘀,治宜滋补肝肾、扶正散结。

Professor Huo Qin believes that the basic pathogenesis of retinal vein occlusion(RVO)is stagnation of qi due to depression of the liver and blood stasis.She proposed the academic idea of treating RVO from the perspective of the liver.The treatment starts from the liver,and the disease is divided into four stages:early stage,middle stage,late stage and terminal stage,and takes soothing the liver and relieving depression,and promoting blood circulation and unblocking collateral as the basic treatment principle.The self-made Chaigui Lixue decoction is the basic prescription with flexible addition and subtraction.At the early stage,Professor Huo considers that the liver depression changes into heat,forcing blood to act recklessly.Therefore,it is better to clear the liver to reduce fire and cool the blood to stop bleeding in this period.Liver depression,spleen deficiency,blood stasis and water stagnation are the causes in the middle period.Therefore,she advocates for that sooth the liver and invigorate the spleen,and promote blood and water circulation.At the late stage,she takes liver depression,qi stagnation,phlegm and blood stasis into account,so it is supposed to regulate qi and resolve phlegm,and remove blood stasis and improve eyesight.At the end of the period,liver and kidney yin deficiency,qi stagnation and blood stasis are considered,so it is proper to nourish the liver and kidney,and strengthen the body resistance and resolve masses.Many good results have been achieved in clinical practice.