浅析“目得血而能视”理论在糖尿病黄斑缺血治疗中的应用  

Application of the Theory"Slight Obtained from the Sufficient Blood Supply of Eyes"in the Treatment of Diabetic Macular Ischemia

作　　者：岳冰洁 王建伟[1] 接传红[1] YUE Bingjie;WANG Jianwei;JIE Chuanhong(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》2024年第8期766-770,共5页China Journal of Chinese Ophthalmology

基　　金：中国中医科学院眼科医院中央高水平中医医院项目(GSP1-05);中国中医科学院眼科医院院级课题(202022)。

摘　　要：糖尿病黄斑缺血(DMI)是消渴病阴虚日久、损伤目络、伤及目窍引发的目系疾病,中医学将其归属于“消渴目病”“消渴内障”范畴。DMI是常见的由消渴病所致目系疾病中的眼底血络变证,临床主要表现为视物模糊、视力下降。金代医家刘完素提出“目得血而能视”理论,认为血液上荣于目,视物则明。故本文基于“目得血而能视”理论,以血为切入点,追溯“目”“血”“视”三者间的理论渊源,认为血液充盈,目窍得养,方能神光发越;同时结合DMI作为消渴病并发症的独特性,探讨其发病机制,学习古今眼科医家对消渴目病的诊疗思路,并提出滋阴与祛瘀并重的诊疗方案,力求达到血运通畅,目窍精微充盈,从而目病不生,目得血明的目的,为临床防治DMI,改善患者视力提供参考。Diabetic macular ischemia(DMI)is an eye disease caused by long-term Yin deficiency in diabetes,which damages the eye meridians and affects eye orifices.Traditional Chinese Medicine(TCM)classifies it under the categories of"diabetic eye disease"and"diabetic internal obstruction."DMI is a common ocular complication of diabetes,primarily manifesting as blurred vision and decreased visual acuity.JIN Dynasty physician LIU Wansu proposed the theory"slight obtained from the sufficient blood supply of eyes",suggesting that when blood nourishes the eye,vision is clear.Based on this theory,this paper takes blood as the starting point to trace the theoretical origins of the relationship between the eye,blood,and vision.It posits that when the blood is abundant,the eye orifices are nourished,enabling clear vision.Additionally,considering the unique characteristics of DMI as a complication of diabetes,the paper explores its pathogenesis,reviews the diagnostic and therapeutic approaches of ancient and modern ophthalmologists for diabetic eye diseases,and proposes a treatment plan that emphasizes both nourishing Yin and removing stasis.The goal is to ensure smooth blood circulation and full nourishment of the eye orifices,thereby preventing eye diseases and achieving clear vision.This provides a reference for the clinical prevention and treatment of DMI and the improvement of patients'vision.

关 键 词：目得血而能视 血 糖尿病黄斑缺血 消渴病 消渴目病 

分 类 号：R774.5[医药卫生—眼科] R276.7[医药卫生—临床医学]