冯俊运用剔络化瘀法治疗视网膜血管瘤样增生经验  

FENG Jun's Experience in Treating Retinal Angiomatous Proliferation with the Collateral-pruning and Blood-stasis-resolving Method

作　　者：杨桂萍[1] 冯俊[1] 杨二双 YANG Guiping;FENG Jun;YANG Ershuang(Eye Hospital,China Academy of China 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10期946-950,966,共6页China Journal of Chinese Ophthalmology

基　　金：国家中医药管理局眼体同调同治重点研究室;北京市石景山区名中医冯俊传承工作室(1021904)。

摘　　要：视网膜血管瘤样增生(RAP)属于湿性年龄相关性黄斑变性的一种特殊类型,其基本病变为新生血管形成。临床上往往采取对症治疗,但预后较差。冯俊深入研究古代医家的相关论述,结合多年临床应用经验,基于中医“络病理论”思想,阐述了络病与RAP的内在联系,提出了RAP属中医络病,认为“瘀阻脉络、水湿内停”为其主要病机,在治疗上采用剔络化瘀法,即应用虫类药与活血化瘀药物搜剔络脉、活血化瘀,兼顾利水渗湿,并调补全身气血,畅通眼底络脉,从而达到充养目系、固本明目之效。在其临床实践中该法疗效显著,为临床治疗RAP提供了新方法、新思路。Retinal angiomatous proliferation(RAP)is a special type of wet age-related macular degeneration,characterized by the formation of new blood vessels.Clinically,symptomatic treatment is often adopted,but the prognosis is generally poor.FENG Jun delved into the related discussions of ancient medical practitioners,combined with years of clinical application experience,and based on the theory of"collateral disease"in Traditional Chinese Medicine(TCM),explained the intrinsic connection between collateral disease and RAP.He proposed that RAP belongs to the category of collateral disease in TCM,considering"stasis obstructing the collaterals and internal retention of dampness"as its main pathogenesis.In treatment,he employed the collateral-pruning and blood-stasis-resolving method,using insectbased and blood-activating stasis-resolving medicines to prune the collaterals,activate blood circulation,and resolve stasis.Concurrently,he facilitated water drainage and dampness elimination,while adjusting and supplementing the body´s Qi and blood to unblock the collaterals in the fundus of the eye.This approach aims to nourish the eye system,consolidate the root,and improve vision.In his clinical practice,this method has shown significant efficacy,providing new methods and ideas for the clinical treatment of RAP.

关 键 词：视网膜血管瘤样增生 剔络化瘀法 经验总结 

分 类 号：R774.13[医药卫生—眼科] R276.7[医药卫生—临床医学]