基于元真通畅理论从少阴心肾论治DR

Treating Diabetic Retinopathy Based on the Theory of Yuanzhen Smoothness from the Perspective of Shaoyin Heart and Kidney

糖尿病视网膜病变(DR)是糖尿病微血管并发症之一。中医学认为本病为瘀、痰、水、湿、热等病理产物阻于视衣而目络不通;病络生成、视衣脱离则目失濡养、视衣不荣。本文基于元真通畅理论从少阴心肾的角度来分析DR的病因病机、病程变化及治疗,认为DR的发病原因是由于少阴枢折—水火不济致元阴亏损,君相不安致元阳虚衰、阴阳不相顺接致阴损及阳,元真失于通畅,发生一系列DR的眼底改变,并结合本团队的经验方进一步探讨充养元真、和畅少阴之法在DR中的应用,为DR的中医认识提供新的理论思路。

Diabetic retinopathy(DR)is one of the microvascular complications of diabetes.Traditional Chinese Medicine(TCM)believes that the disease is caused by the pathological products of blood stasis,phlegm,water,dampness,and heat obstructing the retinal vessels,leading to impaired circulation.This obstruction causes the retinal vessels to degenerate and detach,resulting in the loss of nourishment to the retina.Based on the Yuanzhen Smoothnes theory,this article analyzes the etiology,pathogenesis,progression,and treatment of DR from the perspective of Shaoyin heart and kidney.It suggests that the cause of DR is the disruption of the Shaoyin pivot,leading to a disharmony between water and fire,resulting in a deficiency of Yuanyin.This deficiency causes instability of the monarch and minister organs,leading to Yuanyang deficiency,and the lack of coordination between Yin and Yang,causing mutual damage.This disruption of Yuanzhen leads to a series of fundus changes characteristic of DR.Combining the experiences of our team,this article further explores the application of nourishing Yuanzhen and harmonizing Shaoyin in the treatment of DR,providing a new theoretical approach for the TCM understanding of DR.