从络脉-气络理论探讨中心性浆液性脉络膜视网膜病变的证治  

Discussion on Syndrome Differentiation and Treatment on Chronic Central Serous Chorioretinopathy from Theory of Collateral Vessels-Qi Collaterals

作　　者：李丽英[1] 沈立台 陈强[1] 冯金红 陈宝珍[3] LI Liying;SHEN Litai;CHEN Qiang;FENG Jinhong;CHEN Baozhen

机构地区：[1]保定市第一中心医院,河北保定071000 [2]保定市徐水区中医院,河北保定072550 [3]河北大学医学部,河北保定071000

出　　处：《新中医》2022年第18期159-163,共5页New Chinese Medicine

摘　　要：通过对目内络脉的特点、目中真气及气络的生理、病理的阐述,探讨络脉病变与中心性浆液性脉络膜视网膜病变(CSC)之间的关系,认为CSC与络脉-气络密切相关。CSC的主要病机为正气亏虚,气络失和,气滞水停;气络失和,络脉郁滞可致CSC迁延;脾肾亏虚,络气乏源,气络不振易致CSC复发。急性期治以解郁和络、利水祛湿,可随证选用柴归汤、柴苓汤、柴胡三仁汤等;迁延期预防络积之变,可辨证选用苓桂术甘汤、真武汤等,还可加用子仁类药物以补益肝肾、活血明目;愈后防复发宜注意顾护脾胃、调畅情志。Through the description of the characteristics of collateral vessels in the eye and the physiological and pathological characteristics of the true qi and qi collaterals in the eye,this paper explores the relationship between collateral vessels lesions and chronic central serous chorioretinopathy(CSC). And it is believed that CSC is closely related to collateral vessels-qi collaterals. The main pathogenesis of CSC is the depletion of healthy qi,disharmony of qi collaterals and qi stagnation and water retention;disharmony of qi collaterals and constraint of collateral vessels may lead to a prolonged duration of CSC;depletion of the spleen and kidney,lack of collateral qi,and weak qi collaterals easily lead to recurrence of CSC. In the acute stage, Chaigui tang, Chailing tang and Chaihu Sanren tang can be used based on syndrome differentiation to resolve constraint and harmonize collaterals,and promote urination and dispel dampness.In the prolonged stage, Linggui Zhugan tang and Zhenwu tang can be used based on syndrome differentiation to prevent collateral accumulation, and also can be modified with seed kernel herbs to supplement and boost the liver and kidney,and invigorate blood and improve vision. After healing,special attention should be paid to the protection of the spleen and stomach and the adjustment of emotion.

关 键 词：中心性浆液性脉络膜视网膜病变 目络 络脉 气络 

分 类 号：R774.1[医药卫生—眼科]