皮质盲的中西医研究概况

Overview of Traditional Chinese Medicine and Western Medicine Research on Corti⁃cal Blindness

皮质盲(CB)是各种原因造成大脑枕叶皮质损害后导致的双眼失明。该病多属其他疾病的继发损害,成年人较为常见的原发病因有脑部疾病、各类操作手术等;儿童继发CB的原因多与控制不良的高热相关。因CB的发病机制尚不完全明确,故西医治疗主要以治疗原发病、扩张脑血管、营养神经、应用能量合剂联合认知感觉训练为主;中医治疗主要以“疏肝”为要,治疗上选择逍遥散化裁并联合针灸头部、体部辨证取穴。CB患者原发病各异、预后差异较大,临床上本病的诊治具有相当的难度,患者的心理上也会承受巨大的精神压力。基于此本文回顾了国内外文献及名家著作关于治疗CB的经验,现将关于CB的最新定义,病因,发病机制,诊断标准,中、西医的有效治疗方式作总结,以期为临床认识这一罕见疾病提供思路与诊疗方法。

Cortical blindness(CB)is a condition of bilateral blindness resulting from damage to the occipital cortex of the brain due to various causes.This condition is often a secondary damage caused by other diseases.In adults,common primary causes include brain diseases and various surgical procedures,while in children,uncontrolled high fever is a frequent secondary cause of CB.Since the pathogenesis of CB is not fully understood,Western Medical treatment primarily focuses on treating the primary disease,dilating cerebral blood vessels,nourishing nerves,and using energy mixtures in conjunction with cognitive and sensory training.Traditional Chinese Medicine(TCM)treatment emphasizes"soothing liver",often utilizing a modified version of the Xiaoyao Powder along with acupuncture on the head and body based on syndrome differentiation.The primary diseases of CB patients vary,and their prognosis differs significantly,making the diagnosis and treatment of this condition quite challenging in clinical practice.Patients also endure significant psychological stress.This article reviews domestic and international literature and the works of renowned experts on CB treatment.It summarizes the latest definitions,causes,pathogenesis,diagnostic criteria,and effective treatment methods from both TCM and Western Medicine perspectives,aiming to provide insights and therapeutic approaches for understanding this rare disease in clinical practice.