基于“气血水”理论对于糖尿病视网膜病变的初探  

A Preliminary Exploration of Diabetic Retinopathy Based on the Theory of"Qi,Blood and Body Fluids"

作　　者：于方海 梁凤鸣[1] YU Fanghai;LIANG Fengming(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,天津300381

出　　处：《中国中医眼科杂志》2024年第6期553-557,共5页China Journal of Chinese Ophthalmology

摘　　要：糖尿病视网膜病变(DR)是糖尿病的常见并发症,常致患者视瞻昏渺,严重影响患者生活质量。“气血水”理论与DR的联系是在气血与津液的生理病理联系上提出的。DR在肝、脾、肾三脏失调亏虚的病机基础上,气化不利,致血与津液失司,瘀血与病水互结,进一步阻碍气机,气、血、水搏结于目络,终成糖尿病性黄斑水肿。治疗上,气、血、水三者同调是治疗的关键,同时注重疏肝理脾,补肾填精等,调气重于黄芪、党参,注重添加风药,如防风、葛根等,血、水同治重用丹参、茯苓、泽兰之品,糖尿病病情日久应考虑精气不足,可予褚实子、茺蔚子等起填精明目之功。“气血水”理论可进一步完善中药在DR的应用。Diabetic retinopathy(DR)is a common complication of diabetes,often leading to blurred vision and significantly impacting patients'quality of life.The theory of Qi,blood and body fluids is proposed based on the physiological and pathological connections of Qi,blood and body fluids.DR,on the basis of the imbalance and deficiency of liver,spleen,and kidney,leads to poor Qi transformation,resulting in the disharmony of blood and body fluids,stasis of blood and accumulation of pathogenic water,further obstructing the flow of Qi.Qi,blood,and water stagnate in the eye collaterals,eventually leading to diabetic macular edema.In treatment,harmonizing Qi,blood and body fluids is key,while also focusing on soothing liver and regulating spleen,supplementing kidney and nourishing essence.Qi regulation is emphasized with medicines such as astragalus and codonopsis,wind-dispelling medicines such as ledebouriella,and blood and water regulation with medicines like salvia,poria,and coix seed.Due to the prolonged course of diabetes,deficiency of essence and Qi should be considered,and medicines like semen cuscutae and fructus cnidii may be used to replenish essence and improve vision.Therefore,the theory of"Qi,blood and body fluids"can further refine the application of Traditional Chinese Medicine in DR.

关 键 词：糖尿病视网膜病变 “气血水”理论 消渴目病 糖尿病性黄斑水肿 

分 类 号：R276.7[医药卫生—中医五官科学]