关国华从气痰瘀论治中心性浆液性脉络膜视网膜病变经验  

GUAN Guohua’s Experience in Treatment of Central Serous Chorioretinopathy fromQi,Phlegm and Blood Stasis

作　　者：林楚妮 卢晓丽 唐露诗 刘求红[2] 俞晓艺[2] LIN Chuni;LU Xiaoli;TANG Lushi;LIU Qiuhong;YU Xiaoyi(The First Clinical Medical College of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《山东中医杂志》2023年第11期1215-1219,共5页Shandong Journal of Traditional Chinese Medicine

基　　金：关国华全国名老中医药专家传承工作室项目(批文号:国中医药人教教育便函[2018]74号);国家重点学科项目“中医五官科学”(编号:211020030106);广州中医药大学学科方向及团队建设项目“中医眼科学”(2019—2020年)。

摘　　要：基于气血津液辨证理论,关国华教授认为中心性浆液性脉络膜视网膜病变(CSC)主要致病因素有三:气、痰、瘀。三大致病因素在疾病发展的不同阶段表现各有不同:气为始动因素,在疾病早期表现为肝气郁、脾气虚;痰邪在疾病中期主要体现为痰浊阻滞、痰热内蕴;瘀邪在疾病晚期体现为目络瘀阻、痰瘀互结。本病总体病机为邪实闭阻目窍,玄府不利,使津液溢于脉外,导致水液积聚,治疗上以“治水先利窍”为原则,将利水之效寓于疏肝理气、健脾化湿、清热化痰、祛瘀通脉之法中;同时,关教授还提出早期治气、中期治痰、后期治瘀的分期辨治思路。Based on the theory of qi-blood-fluid syndrome differentiation,Professor GUAN Guohua believes the pathogenic factors of central serous chorioretinopathy(CSC)include qi,phlegm,and blood stasis.The three pathogenic factors have different manifestations at different stages of disease development.Qi is the initial factor which is mainly manifested as stagnation of liver qi and deficiency of spleen qi in the early stage.Phlegm is mainly manifested as phlegm turbidity obstruction and internal accumulation of phlegm-heat in the middle stage.Blood stasis is manifested as accumulation in eye collaterals and coagulation of phlegm and blood stasis in the later stage.The general pathogenesis of the disease is excess pathogens obstruct the eye orifices and collaterals,causing body fluid overflowing out of the veins and stagnating in the retina.Therefore,the reatment should be based on the principle of“treating water with benefiting the orifice as the first step”,combing excreting water with the methods of soothing liver and regulating qi,invigorating spleen and resolving dampness,clearing heat and resolving phlegm,removing blood stasis and dredging meridians.Meanwhile,Professor GUAN puts forward the idea on diagnosis and treatments for different stages:treating qi in the early stage,treating phlegm in the middle stage,and treating blood stasis in the later stage.

关 键 词：中心性浆液性脉络膜视网膜病变 气 痰 瘀 治水先利窍 分期论治 关国华 

分 类 号：R276.7[医药卫生—中医五官科学]