庄曾渊治疗春季卡他性结膜炎的临床经验  

Clinical experience of ZHUANG Zengyuan in treatment of vernal keratoconjunctivitis

作　　者：王姝彦 张红[1] 张津京[1] 李佳贤 庄曾渊[1] WANG Shuyan;ZHANG Hong;ZHANG Jinjing(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中国中医眼科杂志》2020年第3期194-196,205,共4页China Journal of Chinese Ophthalmology

基　　金：北京中医药薪火传承“3+3”工程。

摘　　要：春季卡他性结膜炎属于中医“时复症”“痒如虫行症”,具有每年如期发作,易迁延不愈的特点,临床上治疗较为棘手。中医治疗本病有独特优势,庄曾渊教授根据本病的发病形式和临床特点,认为脾肺伏火、复感风热,内外合邪是本病重要病机,临床上多用清散脾肺伏火、疏散风热的方法治疗。庄曾渊认为本病发病时,风、热各有侧重,热重时结膜充血为甚,以清解合剂内清外散,重用石膏以清火,配伍辛散之药而清解,遵“火郁发之”之意;风重时眼痒为甚,以藁本乌蛇汤驱风除热,重在以大剂祛风药除眼部诸络之风,是“风去热自灭”之意。临证时还需根据不同病人的具体症状辨别兼加证型,随证加减,灵活处方。本文对其临床经验进行总结,并附有临床案例予以说明。Vernal keratoconjunctivitis(VKC)in Traditional Chinese Medicine belongs to seasonal eye disease and itching like insect crawling symptom,which has the characteristics of attack on schedule every year,easy to delay and not heal,and is more thorny to treat clinically.Traditional Chinese Medicine has unique advantages in treating this disease.According to the pathogenesis and clinical characteristics of the disease,Professor Zhuang Zengyuan holds that the fire hides in the spleen and lung,the wind and heat attack the body again,and the combination of internal and external pathogenic factors are the important pathogenesis of the disease.In clinic,the principle of clearing the spleen and lung to subdue fire and evacuating wind and heat is often used to treat vernal keratoconjunctivitis.Professor Zhuang Zengyuan thought when the disease attacked,the wind pathogen and heat pathogen had their emphases.If the heat pathogen was heavy,the conjunctival congestion was very serious,using Qingjie mixture to clear the inside and the outside.In this prescription,gypsum was reused to clear the fire and combined with Xinsan medicine to relieve it.It was the meaning of fire stagnation requiring dissipation.If the wind pathogen was heavy,the eye itching was very serious,using Gaoben Wushe decoction to expel the wind and heat.It was the meaning of wind removing heat and self-extinguish.In clinical practice,it was also necessary to distinguish and add syndrome types according to the specific symptoms of different patients,add and subtract with the syndrome,and make flexible prescriptions.This paper summarized the clinical experience and supplied two typical medical records of VKC.

关 键 词：春季卡他性结膜炎 时复症 中医眼科 临床经验 

分 类 号：R777.31[医药卫生—眼科]