宋剑涛运用健脾益气法治疗儿童干眼经验  

SONG Jiantao's experience in treating children's dry eye with the method of strength⁃ening the spleen and tonifying Qi

作　　者：樊华 叶姗姗 王家宁 宋剑涛[1] FAN Hua;YE Shanshan;WANG Jianing;SONG Jiantao(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中国中医眼科杂志》2023年第6期552-554,共3页China Journal of Chinese Ophthalmology

基　　金：中国中医科学院科技创新项目(CI2021A02608);中国中医科学院眼科医院院内课题(202001)。

摘　　要：干眼为多因素引起的慢性眼表疾病,是由泪液的质、量及动力学异常导致的泪膜不稳定或眼表微环境失衡,可伴有眼表炎性反应、组织损伤及神经异常,造成眼部多种不适症状和(或)视功能障碍。儿童干眼临床上可表现为干涩、眼痒、畏光、眼疲劳、瞬目增多(>15次/min)等症状,因儿童干眼在临床缺乏关注,时常误诊为结膜炎,常采取局部抗炎疗法,收效甚微甚至加重病情。儿童干眼相关因素多以视频终端、屈光不正、角膜塑形镜的使用、睑缘炎、过敏性结膜炎、烟雾暴露、全身疾病和先天性疾病等为主。中医学认为,眼部疾病多与气血相关,目得血而能视,脏腑精气不及,则九窍不通。宋剑涛认为,儿童干眼的病因多为儿童形气未充,发育不足,脾气虚弱,气血生化乏源,不能上荣于目而致。临床上以益气健脾为治疗要点,在八珍汤的基础上进行加减,益气补血,荣养目珠,临床疗效甚佳。Dry eye is a chronic ocular surface disease caused by multiple factors,including tear film instability or imbalance of the ocular surface microenvironment due to the abnormality of the quality,quantity,and dynamics of tears.It can be accompanied by ocular surface inflammatory reaction,tissue damage and neurological abnormalities,resulting in a variety of ocular discomfort symptoms and visual dysfunction.In clinical practice,children's dry eye can manifest as dryness,itching,photophobia,eye fatigue,and increased blinking(>15 times/min).Due to the lack of clinical attention,children's dry eye are often misdiagnosed as conjunctivitis,and local anti-inflammatory therapy is often used,with little effect or even exacerbating the condition.The main factors related to children's dry eye are video terminals,refractive errors,the use of orthokeratology,blepharitis,allergic conjunctivitis,smoke exposure,systemic diseases,and congenital diseases.Traditional Chinese Medicine believes that the eye can see with blood and if the essence and Qi are insufficient,it can lead to obstruction of the nine orifices.Eye diseases are often related to Qi and blood.SONG Jiantao believes that the etiologies of children's dry eye are mostly due to insufficient physical and mental development of children,deficiency of spleen Qi,lack of source of generating and transforming Qi and blood,causing the inability to send nutrient upward to the eye.The key point of clinical treatment is to tonify Qi and strengthen the spleen.On the basis of Bazhen Decoction,it is added or subtracted to replenish Qi and blood,so as to nourish the eyes,with excellent clinical efficacy.

关 键 词：儿童干眼 八珍汤 健脾益气法 

分 类 号：R276.7[医药卫生—中医五官科学]