基于郁火理论探讨Graves眼病的病理改变  

Exploring the pathological changes of Graves' ophthalmopathy based on the theory of stagnation of fire

作　　者：王瑾琨 曹康迪 胡木 刘喜明[1] WANG Jinkun;CAO Kangdi;HU Mu;LIU Ximing(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中国中医眼科杂志》2023年第7期646-649,共4页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金面上项目(81774293);北京市科技计划研究项目(D08050703020803)。

摘　　要：Graves眼病是弥漫性毒性甲状腺肿最常见、最复杂的并发症,Graves眼病的基本病机为郁火之邪上炎眼目,因此郁火理论在Graves眼病病理改变方面有着重要应用。Graves眼病眼睑征乃脾营亏虚,中焦气机郁遏生火上炎所致;眼眶结缔组织增生乃痰浊湿滞,壅塞生火灼目所致;球结膜充血和水肿乃瘀血阻于眼络,郁热不得布散所致;泪膜功能下降,角膜炎症或溃疡穿孔乃肾阴不足,相火离位上扰所致;脉络膜及视网膜血流改变乃肝气怫郁于内,日久化火所致。基于郁火与眼部病理改变的理论联系,在治疗方面,可采用局部辨证与整体辨证相结合的方式,使用益营散火、化形解火、培肾透火、理气清火等治法,以达到疏解郁火,宣畅气机之效。Graves′ ophthalmopathy is the most common and complicated complication of diffuse toxic goiter,whose basic pathogenesis is that the evil of the stagnation of fire affects the eyes.Therefore,the theory of stagnation of fire has an important application in the pathological changes of Graves′ ophthalmopathy.The eyelid syndrome of Graves′ ophthalmology is caused by spleen deficiency and stagnation of Qi in the middle energizer,leading to the flaming-up of the fire.The proliferation of orbital connective tissue is caused by phlegm turbidity and dampness stagnation,and the congestion leads the generation of fire,burning the eyes.The bulbar conjunctival congestion and edema are caused by blood stasis obstructing the eye meridians,and the stagnation of fire can not be dispersed.The decreased tear film function,keratitis or ulcer perforation are caused by deficiency of kidney Yin and upward disturbance of ministerial fire.The changes in choroidal and retinal blood flow are caused by stagnation of liver Qi and the gradual transformation of fire over time.Based on the theoretical connection between stagnation of fire and pathological changes in the eyes,a combination of local and holistic syndrome differentiation can be used in the treatment,with the methods such as nourishing Ying to disperse fire,transforming and resolving fire,tonifying the kidney to penetrate fire,and regulating Qi to clear fire,in order to achieve the effect of relieving stagnation of fire and promoting the circulation of Qi.

关 键 词：GRAVES眼病 郁火 病理改变 火郁发之 

分 类 号：R276.7[医药卫生—中医五官科学]