基于扶阳思想探讨眼肌型重症肌无力治疗思路  

Exploring the Therapeutic Approach for Ocular Myasthenia Gravis Based on the Yang-invigorating Theory

作　　者：王佳兴 杨玉霞[1] 王书臣 王莹[1] WANG Jiaxing;YANG Yuxia;WANG Shuchen;WANG Ying(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11期1056-1060,共5页China Journal of Chinese Ophthalmology

基　　金：第二批北京市石景山区名中医传承工作室项目(1021902)。

摘　　要：眼肌型重症肌无力(OMG)是重症肌无力最常见的类型,主要以横纹肌疲劳产生单侧或双侧上睑下垂、眼外肌麻痹为表现,属中医学“上胞下垂”“睑废”“睢目”等范畴。目前,中医学者多认为其病机为脾气虚弱、肌肉痿弱不用,临床多以补气升举为要法,对辛温助阳之品在治疗中的重要作用未予足够重视。扶阳思想最早起源于阴阳学说,其核心思想是重视维护机体阳气,强调“阳主阴从”的主导地位,用药以善用附子、干姜、细辛、肉桂等温热药物为特点。本文从OMG致病特点及发病机制等方面论述,以扶阳思想为辨证思路,治疗采用温清并用、温阳化气、温补脾肾、扶阳养阴并用等诸法治疗OMG,着重阐述温阳药物在OMG治疗中的重要作用和意义。Ocular myasthenia gravis(OMG)is the most common type of myasthenia gravis,mainly manifested by unilateral or bilateral ptosis and extraocular muscle paralysis due to striated muscle fatigue,which falls into the categories of"upper eyelid ptosis""eyelid paralysis",and"droopy eyes"in Traditional Chinese Medicine(TCM).Currently,most TCM scholars believe that its pathogenesis is due to spleen Qi deficiency and muscle atrophy,and clinically,tonifying Qi and lifting Yang are often considered the primary treatment methods.However,insufficient attention has been given to the significant role of pungent-warm Chinese medicines that assist yang in treatment.The Yang-Invigorating theory originated from the Yin-Yang doctrine,with its core idea emphasizing the maintenance of Yang Qi in the body and highlighting the dominant role of"Yang governs while Yin follows".Medication is characterized by the adept use of warm Chinese medicines such as Aconiti lateralis radix preparata,Zingiberis rhizoma,Asari radix et rhizoma,and Cinnamomi cortex.This article discusses the pathogenic characteristics and pathogenesis of OMG,adopting the Yang-invigorating theory as the dialectical thinking.Various treatment methods such as combining warming with clearing,warming Yang to transform Qi,warming and tonifying spleen and kidney,and combining Yang-invigorating with Yin-nourishing are used to treat OMG.It focuses on elucidating the important role and significance of Yang-warming Chinese medicines in the treatment of OMG.

关 键 词：眼肌型重症肌无力 扶阳思想 治疗经验 

分 类 号：R777.1[医药卫生—眼科] R276.7[医药卫生—临床医学]