基于通下活血法治疗视网膜静脉阻塞性黄斑水肿  

Treatment of RVO-ME Based on Means of Activating Blood Circulation and Purgating Method

作　　者：马若楠 吴正正[1] 高明雪 那爽 刘思言 严京[1] MA Ruonan;WU Zhengzheng;GAO Mingxue(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：《浙江中医药大学学报》2023年第6期643-646,共4页Journal of Zhejiang Chinese Medical University

基　　金：北京市科技计划课题(Z211100002921024);中央级公益性科研院所基本科研课题(ZZ15-XY-CT-07)。

摘　　要：[目的]探讨通下活血法治疗视网膜静脉阻塞性黄斑水肿(retinal vein occlusion-macular edema,RVO-ME)的病因病机及核心概要,以拓宽临床诊疗思路。[方法]在结合既往医家诊疗思路的基础上,进一步总结临床经验。深入探讨RVO-ME病因病机,进而提出通下活血法在RVO-ME中的辨证应用,并附医案一则予以佐证。[结果]热毒和血瘀两种病理产物的生成是RVO的发病关键,血不利则水不行,进一步发展成RVO-ME。治疗上当以通下活血为法,通则热毒自除,活则血瘀自散,应根据疾病的发展阶段,灵活掌握通下与活血的治疗侧重。本文所附病案,临证以大黄牡丹汤治疗,体现了通下活血法的核心要义,取得了较好的临床疗效。[结论]通下活血法符合RVO-ME的病因病机,临床上依据该理论采用大黄牡丹汤治疗RVO-ME,有望拓宽本病的中医治疗思路。[Objective]To explore the etiology,pathogenesis and core summary of the treatment of retinal vein occlusion-macular edema(RVO-ME)with activating blood circulation and purgating method,so as to broaden the clinical diagnosis and treatment ideas.[Methods]On the basis of the previous medical thinking,the clinical experience was further summarized,the etiology and pathogenesis of RVO-ME were discussed in detail,and the application of activating blood circulation and purgating method in the syndrome differentiation of RVOME was put forward,and a medical case was attached to prove it.[Results]The formation of two pathological products heat toxicity and blood stasis,is the key to the pathogenesis of retinal vein occlusion(RVO).Poor blood flow can lead to a blockage in the circulation of water and eventually develop RVO-ME.When the the method of activating blood circulation and purgating is taken,the heat toxin is removed from the general,and the blood stasis is dispersed.According to the development stage of the disease,the treatment focus of activating blood circulation and purgating should be mastered flexibly.In the attached medical records,Dahuang Mudan Decoction was used to treat the clinical symptoms,which reflected the core meaning of activating blood circulation and purgating method and achieved good clinical efficacy.[Conclusion]Activating blood circulation and purgating method conforms to the etiology and pathogenesis of RVO-ME,according to this theory,treating RVO-ME with Dahuang Mudan Decoction in clinic is expected to broaden the traditional Chinese medicine treatment of this disease.

关 键 词：视网膜静脉阻塞 暴盲 黄斑水肿 热毒积瘀学说 通下活血法 大黄牡丹汤 

分 类 号：R273[医药卫生—中西医结合]