中医辨治糖尿病性眼底出血体会

Experience in TCM Syndrome Differentiation and Treatment of Diabetic Eyeground Bleeding

对糖尿病性眼底出血辨治、病因、病机、辨证分型、方药、治疗等作了详细的论述。病机分为气阴两虚,肝肾不足,瘀阻眼络三型,治疗以益气养阴,滋补肝肾,活血止血为原则。以活血化瘀为主,以止血为佐,治疗糖尿病性眼底出血的早期和后期,如果玻璃体、视网膜前新鲜出血者,才采用止血凉血为主,佐以活血为原则。并且论述了在临床中出血应该根据局部的检查,来判断新鲜出血或陈旧出血,出血的深浅、部位、性质、程度、针对不同的出血,随症加减用药。

The paper discusses in detail the syndrome differentiation and treatment, pathogens syndrome type classification, prescriptions and drugs of diabetic eyeground bleeding. The pathogenesis of the disease is divided into three types: deficiency of both qi and yin, asthenia of liver and kidney and blood stasis obstructing eyes. The therapeutic principles lie in benefiting qi and nourishing liver as well as promoting blood circulation and checking bleeding. Promoting blood circulation to remove blood stasis is the main principle, while checking bleeding is secondary. At the early and late stages of diabetic eyeground bleeding, checking bleeding and cooling blood are adopted as the main principles and promoting blood circulation as the secondary if the patients have fresh bleeding in vitreous body and retina. The thesis also puts forward that clinically local examination of bleeding should be carried out to determine whether the bleeding is fresh or old as well as the depth, location, nature and severity of bleeding, on the basis of which modification of administration adopted according the syndrome differentiation.