老年性眼病的证治理论探析与临证举隅  

Theoretical discussion on the syndrome differentiation and treatment of age-related eye diseases with case examples

作　　者：郭承伟[1] GUO Chengwei(The affiliated Hospitai of Shandong University of Traditional Chinese Medicine,Jinan 250011,China)

机构地区：[1]山东中医药大学附属医院,济南250011

出　　处：《中国中医眼科杂志》2021年第9期613-617,共5页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金项目(81473734);山东省中医药科技发展计划项目(2019-0086)。

摘　　要：以中医经典理论为指导,结合临床实践,对老年性眼病的病证特点进行了全面阐释,并提出具体的证治法则。老年性眼病是以五脏为中心,以精气亏虚为主要特征的系统性衰老的眼部表现,因其具有早衰的生理病理基础而呈多发、早发的特点。本虚标实是老年性眼病的基本病证规律,正虚生邪、痰瘀(郁)络阻窍闭是其重要特征,临床上,"本虚"多以"邪实"等眼部病理改变的形式表现出来。临证在遵循祛邪扶正、标本缓急的原则基础上,把握老年性眼病治疗的整体观与系统观,坚持病证结合,处理好共性与个性关系,对不同的老年性眼病采取有针对性的治疗方案。同时,治病求本,首重肝肾以及祛邪为先在老年性眼病的辨治中占据主导地位;祛瘀通络,开窍明目是治疗老年性眼病的基本理念,须贯穿治疗全过程。在药物的选择上,应重视虫类和辛味药物使用。Guided by the classical theory of Traditional Chinese Medicine and combined with clinical practice,the syndrome charaterastics of age-related eye diseases were comprehensively discussed.Also,specific principles of treatment based on syndrome differentiation were put forward.Age-related eye diseases were regarded as ocular manifestations of systemic aging centered on the five visera and characterized by deficiency of vital essence which were also characterized by multiple-and early-onset because of the physiological and pathological basis of premature aging.Deficiency in vital essence and excess in symptoms were the basic features of age-related eye diseases,characterized by pathalogical factors generated due to insufficient vital essence,as well as collateral occlusion and orifical blockage caused by phlegm stasis.Clinically,deficiency in vital essence was presented in the form of excessive ocular pathological changes.On the basis of following the principles of supporting vital qi and eliminating pathogenic factors,grasping the holistic and systemic view of treating age-related eye diseases,adhering to the combination of disease and syndrome,as well as dealing well with the relationship between generality and individuality,those targeted treatment strategies should be chosen for different age-related eye diseases.Meanwhile,seeking the primary cause of the diseases,as well as eliminating pathogenic factors first with special attention paid to the liver and kidney,should play a leading role in the syndrome differentiation and treatment of age-related eye diseases.Removing blood stasis,dredging collaterals,opening orifices and brightening eyes were the basic principles,which must run through the whole process of treatment.While in the choice of medication,the use of insects and pungent herbs should be valued.

关 键 词：老年性眼病 正虚生邪 病证结合 通络开窍 祛邪为先 

分 类 号：R276.7[医药卫生—中医五官科学]