姚靖运用六经辨证治疗糖尿病视网膜病变的经验剖析

YAO Jing's Experience in the Treatment of Diabetic Retinopathy with Six-meridian Syndrome Differentiation Theory

糖尿病视网膜病变被认为是致盲的主要原因之一,是由于长期的高血糖刺激,导致视网膜组织缺血缺氧,造成血-视网膜屏障破坏及新生血管形成的糖尿病微小血管并发症。中医称之为“消渴内障”,其病因病机主要与脾肾两虚有关,姚靖将《伤寒论》六经辨证理论与临床相结合,认为该病应首辨阴阳、表里,明确其定性和定位,进而应用经方从该病六经归属进行治疗,将六经辨证的用药思想与疾病的辨证论治相结合,精准辨证,主张以全身证候所体现的六经归经为主要切入点,从而达到周身平衡,目病得缓。

Diabetic retinopathy(DR),known as"Xiaoke Mubing"in Traditional Chinese Medicine(TCM),is considered one of the leading causes of blindness.It arises from the prolonged exposure to hyperglycemia,which stimulates ischemia and hypoxia in retinal tissues,ultimately leading to the disruption of the blood-retinal barrier and the formation of neovascularization,both being microvascular complications of diabetes.The etiology and pathogenesis of DR in TCM are primarily attributed to the deficiency of both spleen and kidney.YAO Jing integrates the sixmeridian syndrome differentiation theory from"Treatise on Febrile Diseases"with clinical practice,advocating that the initial step in treating DR should be to differentiate between Yin and Yang,interior and exterior,thereby clarifying its nature and location.Subsequently,she applies classical prescriptions according to their respective(affiliation to one of the six meridians)in the treatment.By integrating the thought of syndrome differentiation and medication prescription based on the six-meridian syndrome differentiation with the syndrome differentiation and treatment of the disease,she advocates precise syndrome differentiation.She emphasizes that the main entry point lies in the six meridians manifested by the systemic symptoms,aiming to achieve whole-body balance and alleviate ocular diseases.