基于络脉理论探析养阴清热、活血利水法治疗DR激光损伤  

Treatment of DR retinal laser injury by nourishing Yin,clearing heat,activating blood and diuresis based on collateral theory

作　　者：江婕妤 吕怡 刘志敏[1] 陈向东[1] JIANG Jieyu;LV Yi;LIU Zhimin;CHEN Xiang-dong(The First Affiliated Hospital,Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院,长沙410007 [2]湖南中医药大学,长沙410208

出　　处：《中国中医眼科杂志》2023年第5期468-471,共4页China Journal of Chinese Ophthalmology

基　　金：湖南省自然科学基金项目(2021JJ30520);湖南省中医药管理局科研项目(C2022003);湖南省教育厅科学研究项目(19A362);长沙市科学技术局基金项目(KQ2014226)。

摘　　要：糖尿病视网膜病变(DR)是临床上糖尿病严重并发症之一,严重影响糖尿病患者的生存质量。中医根据不同程度的症状将该病称为“视瞻昏渺”“云雾移睛”“暴盲”等,现代中医眼科学将其命名为“消渴内障”。本文以络脉理论为指导,通过对络脉生理病理以及与目关系的阐述,从理论和临床2方面确立了络脉在DR过程中的作用。针对DR患者在临床上进展至重度非增殖性糖尿病视网膜病变(NPDR)或增殖性糖尿病视网膜病变(PDR)行视网膜激光术后加剧阴虚内热、血瘀水停等病理特点,陈向东教授基于整体辨证与眼底微观辨证相结合的理念,提出“养阴清热、活血利水”的治疗方法,使亏虚之目络得以补、热灼之目络得以清,瘀滞之目络得以通,从而达到改善症状、降低血糖、提高视力、延缓病情进展的目的。Diabetic retinopathy(DR)is one of the severe complications of diabetes mellitus,which significantly affects the quality of life of diabetic patients.In Traditional Chinese Medicine(TCM),DR is referred to as"Dim Vision""Moving Clouds and Mists Before The Eyes""Sudden Blindness,"etc.Modern TCM ophthalmology named it"Xiaoke neizhang."This article aims to establish the role of meridians in DR based on the theory of meridians,by explaining the physiological and pathological changes of meridians and their relationship with the eyes.From a theoretical and clinical perspective,the article establishes the role of meridians in the process of DR.Professor Chen Xiangdong proposes a treatment method of"nourishing Yin,clearing heat,promoting blood circulation,and removing water retention"based on the holistic diagnosis and microscopic examination of the fundus.This method addresses the pathological features of aggravation of deficiency and internal heat,blood stasis and water retention after retinal laser treatment in patients with severe non-proliferative diabetic retinopathy(NPDR)or proliferative diabetic retinopathy(PDR).It allows the deficient meridians of the eye to be replenished,the meridians affected by heat to be cleared,and the meridians obstructed by blood stasis to be unblocked.This approach aims to improve symptoms,lower blood sugar,enhance vision,and slow down the progression of the disease.

关 键 词：糖尿病视网膜病变 视网膜激光损伤 络脉理论 养阴清热 活血利法 

分 类 号：R276.7[医药卫生—中医五官科学]