风牵偏视病因病机探讨及临床应用  

Discussion on Etiology,Pathogenesis,and Clinical Application of Wind-induced Para⁃lytic Strabismus

作　　者：伍梅怡 李慧丽[2] 黎针宇 王辉武[3] WU Meiyi;LI Huili;LI Zhenyu;WANG Huiwu(Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]成都中医药大学,成都610075 [2]重庆市中医院,重庆400021 [3]重庆医科大学附属第二医院,重庆400010

出　　处：《中国中医眼科杂志》2024年第2期152-155,共4页China Journal of Chinese Ophthalmology

基　　金：重庆市中医院王辉武名老中医药专家传承工作室(cqzyymzygzs-009);重庆市2021年市级中医药重点学科[中医眼科学]。

摘　　要：风牵偏视相当于西医学的后天麻痹性斜视,是眼科常见疾病之一。本文通过梳理古代医药典籍及现代文献分析发现,该病发病原因主要与风、湿两邪有关。其中风邪可分为外风、内风致病,外风致病多由于正气不足或外风亢盛,内风致病则可能与肝阳化风、热极生风、血虚及血瘀生风相关。此外,外风、内风可相兼致病。湿邪所致本病也有内、外之分,外湿所致本病多因气候或居处潮湿、冒雨淋水等涉湿过度造成湿邪侵袭人体,内湿致病则多因中焦不运、水湿内停。风湿亦可相兼为病,常见风邪挟杂湿邪所致风痰结聚证型。该病治疗应在整体观念理论指导下,遵循治病必求其本原则,在遣方用药中重视立足病因病机,基于辨证论治选用方证对应的方剂能取得较好临床效果。Wind-induced paralytic strabismus,akin to acquired paralytic strabismus in Western Medicine,is a common ophthalmic disease.This study reviews ancient medical literature and modern literature analysis to determine that the disease is primarily related to two factors:Wind and dampness.Wind factors can be categorized into external and internal origins.External wind-related causes often arise from deficiency in one's righteous energy or excessive invasion of external wind.Meanwhile,internal wind-related causes might be associated with liver Yang transforming into wind,extreme heat generating wind,blood deficiency,or blood stasis generating wind.Additionally,external and internal wind can overlap and contribute to the disease.Dampness as a causative factor also has external and internal dimensions.External dampness causing this ailment is often due to excessively damp weather or living environments,exposure to rain,or excessive wetness.Internal dampness-related causes mostly stem from dysfunction in the middle burner or internal stagnation of water-dampness.Wind and dampness can also coexist in pathology,commonly seen in wind-phlegm accumulation resulting from a mix of wind and dampness.Treatment of this condition should adhere to holistic theoretical guidance,emphasizing the root cause in therapeutic principles.In prescription and medication,it is crucial to focus on the causative pathogenesis,selecting appropriate prescriptions based on syndrome differentiation to achieve better clinical outcomes.

关 键 词：风牵偏视 麻痹性斜视 病因病机 

分 类 号：R276.7[医药卫生—中医五官科学]