吕海江从“郁”分期论治原发性开角型青光眼  

Professor Lyu Haijiang′s Experience in Treating Primary Open-angleGlaucoma with Stages Based on "Depression"

作　　者：杨洁 吕海江[2] 王素萍[3] YANG Jie;LYU Haijiang;WANG Suping(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450008;Zhengzhou Second Hospital,Zhengzhou Henan China 450015)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第三附属医院,河南郑州450008 [3]郑州市第二人民医院,河南郑州450015

出　　处：《中医学报》2023年第4期771-775,共5页Acta Chinese Medicine

基　　金：吕海江全国名老中医药专家传承工作室建设项目{国中医药人教函[2018]134号}。

摘　　要：原发性开角型青光眼主要是由于眼内神水积滞所致。神水潴留责之于肝脾肾,病因病机本质在郁,总属本虚标实,而肝郁气滞是导致本病的关键。故应从郁论治,分期而治,病证结合,开郁导滞,才能玄府开、目郁解。早期患者因肝郁化火,损伤目络,而致玄府郁阻,以气郁、火郁为主,治以开郁导滞,通窍明目;中期患者因脾失运化,生湿聚痰,上犯于目,而致神光发越受阻,以湿郁、痰郁为主,主张开郁导滞,化湿明目;晚期患者因久病肝肾俱虚,目失濡养,以致神光发越无力,同时久病多虚多郁又多瘀,主张开郁导滞,补肾明目,兼顾活血化瘀。Primary open-angle glaucoma is mainly caused by stagnant Shen Water in the eye,for which the Liver,Spleen,and Kidney are responsible,and the essence of the etiology and pathogenesis lies in depression,which always belongs to deficiency in origin and excess in superficiality,in which Qi stagnation due to Liver depression is the key factor.Therefore,the treatment should be based on the depression with stages as well as combining disease and syndrome,resolving depression and dispelling stagnation to open the Xuanfu and relieve the depression.In the early stage,due to the Liver depression turning into Fire and damaging the eye meridian,Xuanfu stagnation is caused.It is dominated by Qi and Fire stagnation.The treatment is mainly to resolve depression and dispelli stagnation,unblocking stuffy orifices and improving eyesight.In the middle stage,due to the dysfunction of Spleen in transportation.With Dampness and Phlegm being accumulated,which injures the eyes,Shen light obstruction is induced.It is dominated by Dampness and Phlegm stagnation.It is advocated to treat by resolving depression and dispelling stagnation,removing Dampness and improving eyesight.In the advanced stage,due to prolonged illness,both Liver and Kidney are deficient.When the eyesloses moisture and nourishment,the Shen light gets weaker.At the same time,chronic illness causes deficiency,stagnation,and depression.It is advocated to treat by relieving stagnation,tonifying Kidney and improving eyesight as well as promoting blood circulation and removing blood stasis.

关 键 词：原发性开角型青光眼 青风内障 从郁论治 肝郁气滞 吕海江 

分 类 号：R249.27[医药卫生—中医临床基础]