基于“少阳为枢”从时空论治葡萄膜炎

Treatment of Uveitis Based on the"Lesser Yang as the Pivot"Theory of Time and Space

葡萄膜炎是常见的致盲性眼病之一,其中医病机与少阳开升受阻,气机郁久化热密切相关,“少阳枢机不利”为其根本病机。本文基于《黄帝内经》天人相应观,临证“司天-司人-司病证”,将三阴三阳开阖枢之“少阳为枢”理论与《伤寒论》“少阳病欲解时”相结合,从时间与空间角度论治葡萄膜炎,以“和解少阳、调达枢机”为基本治法,运用小柴胡汤加减使气机调畅,阴阳调和,枢机得转,每多良效,为葡萄膜炎的中医治疗提供了新思路和新方法,拓宽了经方小柴胡汤的临床运用。

Uveitis is a common and potentially blinding eye disease.Its pathogenesis is closely related to the obstruction of the lesser Yang's upward movement,and the prolonged stagnation of Qi,leading to the transformation of heat.The fundamental pathogenesis of uveitis lies in the dysfunction of the lesser Yang pivot.This paper,based on the ancient Traditional Chinese Medicine(TCM)theory of the correspondence between heaven and man in the Huangdi Neijing,follows the clinical model of"commanding heaven-commanding man-commanding disease".It combines the theory of"lesser Yang as the pivot"from the Three Yin and Three Yang theory with the guidance provided in the Treatise on Febrile Diseases,emphasizing the importance of understanding the temporal and spatial dimensions in the treatment of uveitis.The basic treatment principle involves"harmonizing the lesser Yang and regulating the pivotal mechanism".The modified Xiaochaihu Decoction is employed to ensure the smooth flow of Qi,achieve harmony between Yin and Yang,and facilitate the rotation of the pivotal mechanism.This approach has shown significant efficacy in the treatment of uveitis,providing a new perspective and method for TCM in managing this condition and expanding the clinical applications of Xiaochaihu Decoction.