浅述糖尿病视网膜病变视网膜激光损伤微观辨证  

Experience of microscopic syndrome differentiation in diabetic retinopathy with retinal laser damage

作　　者：蒲玟伶 刘志敏[5] 陈向东[5] 彭清华[1,2,3,4] 欧阳红波 PU Wenling;LIU Zhimin;CHEN Xiangdong(Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学,长沙410208 [2]湖南省中医药防治眼耳鼻喉疾病与视功能保护工程技术研究中心,长沙410208 [3]中医药防治眼病与视功能保护湖南省工程研究中心,长沙410208 [4]中医药防治眼耳鼻喉疾病湖南省重点实验室,长沙410208 [5]湖南中医药大学第一附属医院眼科,长沙410007 [6]安乡县第三人民医院,安乡415600

出　　处：《中国中医眼科杂志》2020年第12期894-897,共4页China Journal of Chinese Ophthalmology

基　　金：湖南省中医药管理局科研重点项目(201917);湖南省教育厅科学研究项目(19A362);湖南省中医药管理局科研项目(2017141);湖南省研究生科研创新项目(CX20190588);湖南中医药大学校级研究生培养质量工程项目(2018CX42);湖南中医药大学校级科研项目(2018XJJJ31);湖南中医药大学校级科研项目(2017029)。

摘　　要：糖尿病视网膜病变(DR)是眼科常见致盲眼病。目前,视网膜光凝术是公认的治疗DR的有效方法,但作为一种破坏性的治疗方式,会直接损伤视网膜,从而影响DR患者的视觉及生存质量。中医辨证论治在改善视网膜光凝术后患者全身症状、保护视功能、减少术后并发症等方面具有较大优势。由于眼科传统五轮辨证的局限性,DR视网膜激光损伤的辨证论治存在不全面、不系统等问题。本文基于中医辨证理论,将眼科现代仪器检查所获得的微观眼底表现进行分析辨证,辨明DR视网膜激光损伤与“火热、水湿、血瘀”之邪密切相关。在治疗上,注重微观辨证与整体辨证的关系,运用自拟丹黄明目汤治疗DR视网膜激光损伤,以达到养阴清热、活血利水之效,取得较好临床疗效。Diabetic retinopathy(DR)is a common cause of blindness in ophthalmology.At present,retinal laser is recognized as an effective method for treating DR.However,as a destructive treatment method,it can directly damage the retina leading to impairment of the vision and quality of life in patients with DR.Traditional Chinese Medicine(TCM)syndrome differentiation and treatment has great advantages in improving the systemic symptoms of DR patients undergone laser operation,protecting visual function,and reducing postoperative complications.However,due to the limitations of the five orbiculi syndrome differentiation,the syndrome differentiation and treatment of DR with retinal laser damage is incomplete and unsystematic.Under the guidance of TCM syndrome differentiation theory,this paper analyzes the microscopic fundus manifestations obtained by modern ophthalmology examinations,and identifies that DR with retinal laser damage was closely related to pathogen of fire heat,water-dampness,and blood stasis.In terms of treatment,we should take account of the relationship between the microscopic differentiation and the holistic syndrome differentiation,and use self-made Danhuang Mingmu decoction to treat DR with retinal laser damage and thereby achieved good clinical effects.

关 键 词：糖尿病视网膜病变 视网膜激光损伤 微观辨证 

分 类 号：R774.1[医药卫生—眼科]