基于络病理论探讨祛积通络法治疗视网膜血管病变的应用  

Exploring the Application of Dispersing Accumulations and Promoting Collateral Cir⁃culation Method Based on Collateral Disease Theory in the Treatment of Retinal Vascular Diseases

作　　者：张孟姣 郝晓凤[1] 谢立科[1] 孙梅 苗梦璐 王丹 ZHANG Mengjiao;HAO Xiaofeng;XIE Like;SUN Mei;MIAO Menglu;WANG Dan(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12期1142-1145,共4页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金项目(81603666);北京市自然科学基金资助项目(7192235);首都临床特色应用研究重点研发项目(Z181100001718183);“优势病种-医院制剂-新药”研发专项(ZZ15-XYPT-09)。

摘　　要：视网膜血管病变(RVD)与冠状动脉粥样硬化性心脏病、糖尿病等疾病密切相关,可因眼部或全身血管因素导致血管炎症反应、视网膜缺血、缺氧,发生出血、渗出、水肿、新生血管等病变,形成RVD。其中,视网膜静脉阻塞和糖尿病视网膜病变因视网膜缺血、缺氧持续存在,故有反复发作、难以根治的缺点;视网膜动脉阻塞发病突然、进展迅速,存在治疗窗短、预后不佳的特点,严重影响患者视力及生活质量。五脏六腑之精华,上注于目而为明,气、血、津液凭借纵横交错的络脉以养目而视物,并排除代谢废物保持络脉通畅。然而,气滞、痰凝、瘀血、水湿等有形之积常聚于络脉,从而损伤络脉,导致RVD发生。治则当以祛积通络为法。本文基于络病理论探讨祛积通络法治疗RVD,辨证施治,祛除络脉积滞,使气血得畅、络脉得通、积聚得除,以期改善RVD患者视功能,提高其生活质量。Retinal vascular diseases(RVD)are closely associated with conditions such as coronary artery atherosclerosis heart disease and diabetes.RVD can result from vascular factors in eyes or throughout the body,leading to vascular inflammation,retinal ischemia,retinal hypoxia,and subsequent pathological changes such as hemorrhage,exudation,edema,and neovascularization.Conditions like retinal vein occlusion and diabetic retinopathy are caused by chronic retinal ischemia and hypoxia,making them difficult to cure with recurrent episodes.On the other hand,retinal artery occlusion manifests suddenly,progresses rapidly,has a short treatment window,and often leads to poor prognosis,severely impacting visual acuity and quality of life of patients.The essence of five viscera and six bowels ascends to nourish the eyes and allow vision.Qi,blood,and body fluids nourish eyes through an intricate network of collaterals,maintaining vascular patency and eliminating metabolic waste.However,tangible accumulations such as Qi stagnation,phlegm,blood stasis,and dampness often gather within these collaterals,damaging them and leading to RVD.The treatment principle should focus on dispersing accumulations and promoting collateral circulation.This article based on the collateral disease theory,explores the use of this approach in the treatment of RVD.Treatment is individualized based on syndrome differentiation,aiming to eliminate collateral blockages and restore the smooth flow of Qi and blood,resulting in improved visual function and enhanced quality of life for RVD patients.

关 键 词：络病理论 祛积通络法 视网膜血管病变 

分 类 号：R276.7[医药卫生—中医五官科学]