吕海江运用开郁导滞法辨治前部缺血性视神经病变理论探微  

Theoretical Discussion of LYU Haijiang Using Kaiyu Daozhi Method to Differentiate and Treat Anterior Ischemic Optic Neuropathy

作　　者：娄彦蕊[1] 马宏杰 周尚坤 赵新 吕海江(指导)[1] LOU Yanrui;MA Hongjie;ZHOU Shangkun;ZHAO Xin;LYU Haijiang

机构地区：[1]河南中医药大学第三附属医院眼科,河南郑州450003 [2]郑州爱尔眼科医院眼科,河南郑州450004 [3]中国中医科学院望京医院眼科,北京100102 [4]河南省中医院眼科,河南郑州450053

出　　处：《新中医》2022年第22期171-176,共6页New Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教涵[2018]134号)。

摘　　要：吕海江教授认为,前部缺血性视神经病变(AION)的病位在目系,其病因病机为气血瘀阻,或痰热上壅,或气血亏虚等致目系络脉郁阻,玄府郁闭,神光受抑或湮灭。吕教授受中医玄府理论、络病理论、目病多郁理论及虫类药物应用思想的影响与启发,继承和发展了眼科名医张望之教授的“开郁导滞法”学术思想。结合多年的临证经验,吕教授认为AION早期宜用开郁导滞、通窍明目法治疗,其擅长在开郁导滞首施方的基础上辨证施治,合理配伍地龙、水蛭、僵蚕等虫类药以增强逐瘀通络通窍、畅达玄府之力;AION中晚期,吕教授常在开郁导滞、通络通窍的基础上合理配伍枸杞子等益肝肾明目之品,随症加减治疗,疗效颇佳。Prof. LYU Haijiang believes that the disease location of anterior ischemic optic neuropathy(AION) is in the eye connector. Its etiology and pathogenesis are constraint of collaterals,constraint and blockage of sweat pore, and depression or annihilation of eye spirit of the eye connector caused by constraint of qi and blood,phlegm-heat obstructing the upwards,or qi-blood depletion. Influenced and inspired by the theory of sweat pore,the theory of collateral diseases,the theory that eye diseases are often induced by constraint and the application idea of worm medicine in Chinese medicine, Prof. LYU inherits and develops the academic thought of “method of resolving constraint and removing stagnation”of Prof. ZHANG Wangzhi, a famous ophthalmologist. With the combination of many years of his clinical experience, Prof. LYU believes that AION should be treated by the methods of resolving constraint and removing stagnation as well as unblocking the orifices to to improve vision in the early phrase. He is good at syndrome differentiation and treatment based on Kaiyu Daozhi Basic Prescription,and reasonably combines with worm medicine like Pheretima, Hirudo and Bombyx Batryticatus to facilitate expelling stasis,unblocking the collaterals, unblocking the orifices, and smoothing sweat pore. In the middle and late phrases of AION,Prof. LYU often reasonably combines with herbs that can boost the liver and kidney and improve vision like Lycii Fructus based on the method of resolving constraint and removing stagnation as well as unblocking the collaterals and the orifices, and modifies them according to different symptoms,which achieved ideal curative effect.

关 键 词：前部缺血性视神经病变 开郁导滞法 开郁导滞首施方 名医经验 吕海江 

分 类 号：R774.6[医药卫生—眼科] R246.82[医药卫生—临床医学]