周剑基于“血不利则为水”论治RVO-ME  

ZHOU Jian's Treatment of RVO-ME Based on the Theory of"Blood Stagnation Leading to Fluid Accumulation"

作　　者：于欣宁 闫晓玲 周剑[2] 高妙然 杨国辉 YU Xinning;YAN Xiaoling;ZHOU Jian;GAO Miaoran;YANG Guohui(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078 [3]河南省中医院,郑州450002

出　　处：《中国中医眼科杂志》2024年第11期1047-1051,共5页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金项目(82274587)。

摘　　要：黄斑水肿(ME)是视网膜静脉阻塞(RVO)最常见的并发症,也是导致患者视力受损的主要原因,易反复发作,目前西医治疗的首选方案为玻璃体腔注射抗血管内皮生长因子(VEGF)药物,中西医结合治疗可减少注射药物的次数,并能减缓ME的复发。周剑基于“血不利则为水”理论,结合“血”与“水”的生理与病理关系,认为治疗RVO-ME应从“气”“血”“水”角度全面考虑,“利水”为治标,“活血”为治本,而治疗引起“血不利”的病因才是根本。本文总结其以活血利水法为主,结合理气、健脾、补气等治法辨证论治RVO-ME的经验,以期为临床治疗提供思路。Macular edema(ME)is the most common complication of retinal vein occlusion(RVO)and a major cause of visual impairment in the patients,often characterized by recurrent episodes.Currently,the preferred treatment option in Western Medicine is intravitreal injection of anti-vascular endothelial growth factor(VEGF)medicines.The integration of Traditional Chinese Medicine and Western Medicine can reduce the frequency of injections and delay the recurrence of ME.Based on the theory of"impaired blood circulation leading to fluid retention",ZHOU Jian,considering the physiological and pathological relationship between"blood"and"fluid",believes that the treatment of RVO-ME should comprehensively take into account the aspects of"Qi""blood"and"fluid"."Promoting diuresis"is a symptomatic treatment,while"activating blood circulation"addresses the root cause.Ultimately,treating the underlying causes of"impaired blood circulation"is fundamental.This article summarizes ZHOU Jian´s experience in treating RVO-ME with a focus on the method of activating blood circulation and promoting diuresis,combined with regulating Qi,strengthening the spleen,tonifying Qi,and other treatment principles based on syndrome differentiation,aiming to provide insights for clinical treatment.

关 键 词：血不利则为水 黄斑水肿 视网膜静脉阻塞 

分 类 号：R774.1[医药卫生—眼科] R276.7[医药卫生—临床医学]