摘要
气、血、津液相互依存,通过“脏腑”功能而呈现的重要调节作用与“肝开窍于目”更为紧密。肝受血而能视,一旦气机受阻,目睛当先受损,导致眼底血症即眼底出血性病变。基于此理论,开展的多因性心、脑、肾“全身血脉瘀滞与眼底血症”“眼底血症与全身血脉瘀滞”双向性研究,证实气、血、痰、湿的“病-证”关系;利用眼科影像学技术及实验研究,证实了眼底血症核心病机为脉络瘀阻病,依次引起气滞血瘀致出血瘀血、痰湿内停致眼底渗出水肿,痰瘀互结致痰湿与瘀血交融“标志性”演变特点。通过对比性应用研究证实了益气活血法对早期糖尿病视网膜病变的优效性及健脾益肾、化痰利湿联合抗血管内皮生长因子对黄斑水肿中西融合疗效。综上研究,遵循了古人“气血”“脏腑”基础理论,为病证结合、精准辨病、量效参合诊疗模式提供了科学依据,为传承创新眼底血症诊疗体系开辟了更为宽广的诊疗措施。
Qi,blood,and body fluids depend on each other and exhibit significant regulatory effects through the functions of the"Zangfu"organs,particularly emphasizing the close relationship with"liver opening into the eyes".Liver governs vision through its blood supply,and when Qi mechanism is obstructed,eyes are the first to suffer,leading to fundus hemorrhagic disease.Based on this theory,bidirectional studies on"systemic blood stasis and fundus hemorrhagic disease"in the heart,brain,and kidney have been conducted,confirming the"disease-syndrome"relationship of Qi,blood,phlegm,and dampness.Utilizing ophthalmic imaging technology and experimental research,it has been demonstrated that the core pathogenesis of fundus hemorrhagic disease is blood stasis in the choroid,sequentially causing Qi stagnation and blood stasis leading to hemorrhage,phlegm-dampness retention causing exudation and edema,and phlegm-blood stasis interaction leading to the fusion of phlegm and blood stasis with"signature"evolutionary characteristics.Comparative application research has confirmed the superior efficacy of the method to tonify Qi and activate blood circulation for early diabetic retinopathy(DR),and the combined treatment of strengthening spleen,benefiting kidney,transforming phlegm,and eliminating dampness with anti-vascular endothelial growth factor(VEGF)for macular edema with integrated Traditional Chinese Medicine and Western Medicine.In summary,these studies adhere to the ancient theories of"Qi and blood"and"Zangfu"organs,providing scientific evidence for the combination of disease and syndrome,precise disease differentiation,and an integrated diagnosis and treatment model,thereby opening up broader diagnostic and therapeutic measures for the inheritance and innovation of the diagnosis and treatment system for fundus hemorrhagic disease.
作者
金明
JIN Ming(China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中国中医眼科杂志》
2024年第9期801-804,共4页
China Journal of Chinese Ophthalmology
基金
国家自然科学基金项目(82174440)。
关键词
眼底血症
中医眼科
传承与创新
fundus hemorrhagic disease
ophthalmology of Traditional Chinese Medicine
in-heritance and innovation