基于六郁理论探析消渴目病的辨证论治  

Discussion on syndrome differentiation and treatmnet of diabetic retinopathy based on the theory of six stagnation

作　　者：王雨[1] 刘勇[2] WANG Yu;LIU Yong(Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学,济南250014 [2]山东中医药大学附属医院,济南250014

出　　处：《中国中医眼科杂志》2022年第4期305-308,共4页China Journal of Chinese Ophthalmology

摘　　要：消渴目病继发于消渴病,是眼科常见的致盲眼病。基于六郁理论,消渴目病的病机可以总结为在气血阴阳失调的基础上,气、湿、热、痰、血、食诸郁相继而生,兼杂为病,目失清阳而生诸症。在治疗上,气阴双亏,六郁继生者,以益气养阴,开郁行滞为原则,选择补阳还五汤加玄参、麦冬、川楝子为主方加减;脾肾阳虚,六郁为病者,以温补脾肾,固本行郁为原则,选择桂附八味丸为主方加减。同时注重开畅中焦气机,枢转脾胃升降功能,使气行则诸郁去,郁去则三焦通,以达气血周达,环流不息之效。六郁理论对消渴目病的遣方用药具有重要的指导意义,可以为消渴目病提供新的辨证思路。Diabetic retinopathy,which is secondary to diabetes,is a common eye disease in ophthalmology that can lead to blindness.Based on the theory of six stagnation,the pathogenesis of diabetic retinopathy can be summarized as follows:On the basis of the imbalance of Qi,blood,Yin and Yang,depression of Qi,dampness,heat,phlegm,blood and food occur one after another.These miscellaneous pathogenic factors lead to the development of eye diseases due to the loss of clear Yang in eyes.In terms of treatment,those who are deficient in both Qi and Yin and accompanied by six stagnation should follow the treatment principle of supplementing Qi and nourishing Yin to relieve depression and stagnation with the application of Buyang Huanwu Decoction plus Radix Scrophulariae,Ophiopogon japonicus and Szechwan Chinaberry.For the patients with deficiency of spleen and kidney Yang as well as six stagnation,Guifu Bawei Bolus is selected as the main formula based on the principle of warmly invigorating spleen and kidney thus strengthening resistance to relieve stagnation.At the same time,attention should be paid to regulate the stagnancy of Zhong Jiao,and pivot the lifting function of the spleen and stomach,so that when Qi flows,six stagnation will not be generated,and the Triple Energizer will be unblocked,which lead to continuous and unobstructed Qi and blood circulation.The theory of six stagnation has important guiding significance for the treatment of diabetic retinopathy,and can provide new ideas for syndrome differentiation and treatment for diabetic retinopathy.

关 键 词：六郁理论 消渴目病 辨证论治 

分 类 号：R276.7[医药卫生—中医五官科学]