基于“伏毒损络”论治视网膜血管病  

Treatment of Retinal Vascular Diseases Based on Theory of“Hidden Pathogen Damaging Collaterals”

作　　者：王丹 郝晓凤[1] 谢立科[1] 孙梅 张孟姣 关小多 陈子扬 WANG Dan;HAO Xiao-feng;XIE Li-ke;SUN Mei;ZHANG Meng-jiao;GUAN Xiao-duo;CHEN Zi-yang(Eye Hospital China Academy of Chinese Medical Sciences,Beijing 100040)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《世界中西医结合杂志》2024年第8期1684-1688,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金(81603666);首都临床特色应用研究重点研发项目(Z181100001718183);首都卫生发展科研专项重点攻关项目(首发2014-1-4181);全国中医药创新骨干人才专项(202021);中国中医科学院眼科医院高水平中医医院领军人才项目(GSP5-83);中国中医科学院眼科医院高水平中医医院揭榜挂帅项目(GSP4-02-3);中国中医科学院中央级公益性科研院所基本科研业务"优势病种-医院制剂-新药"研发专项(ZZ15-XY-PT-09)。

摘　　要：视网膜血管病(Retinal vascular diseases,RVD)是包括糖尿病视网膜病变、视网膜静脉阻塞、视网膜动脉阻塞等在内的眼底血管性疾病的统称,常并发黄斑水肿和新生血管生成。RVD乃人体正气不足,脏腑功能失调,瘀、痰、湿、热等病理产物渐生,随气血游弋至目络并深伏于此,日久蕴结化毒,毒损目络所致。RVD之起病隐匿、发病严重、病因复杂、容易反复、顽固难愈的临床特点与中医“伏毒”致病特点相一致,“正虚毒伏”为发病之始,“伏毒损络”乃发病关键,“伏毒留恋”致后期反复发作。因此,治疗RVD当以“扶正祛邪、解毒通络”为治疗总则,并在疾病发展的不同阶段予以不同的祛毒之法。此外,可适当佐以虫类药、藤类药等引药入络,直导毒巢。Retinal vascular diseases(RVD)refer to a group of retinal vascular disorders,including diabetic retinopathy,retinal vein occlusion,and retinal artery occlusion,often accompanied by macular edema and neovascularization.RVD is attributed to a deficiency of vital Qi and dysfunction of the internal organs,which leads to the gradual accumulation of pathological products such as blood stasis,phlegm,dampness,and heat.These pathological factors circulate with the Qi and blood,eventually becoming lodged in the retinal collaterals.Over time,they transform into pathogens,damaging the retinal collaterals.The clinical characteristics of RVD,including insidious onset,severe progression,complex etiology,recurrent nature,and difficulty in healing,align with the traditional Chinese medicine(TCM)concept of“hidden pathogen”.The disease begins with“deficiency of vital Qi and hidden pathogens”,and the key to its progression is“hidden pathogens damaging collaterals”.In the later stages,the persistence of these hidden pathogens leads to repeated episodes.Therefore,the general treatment principle for RVD should be to“nourish vital Qi,dispel pathogens,detoxify,and unblock the collaterals”.Different detoxification methods should be employed at different stages of disease progression.Additionally,insect-based and vine-based medicines may be used appropriately and lead medicine into collaterals,targeting the pathogen sites.

关 键 词：视网膜血管病 伏毒损络 分期论治 引药入络 

分 类 号：R774[医药卫生—眼科]