基于“火郁发之”理论探讨扬刺法治疗泪小点区域睑腺炎的诊疗思路  

Discussion on the Diagnosis and Treatment of Meibomian Gland Inflammation in the Lacrimal Punctum Region Based on the Theory of"Huoyu Fazhi"Using the Yangci Method

作　　者：杜福生 段燕萍 普建萍 DU Fusheng;DUAN Yanping;PU Jianping(Anning First People's Hospital Affiliated to Kunming University of Science and Technology,Anning 650302,China)

机构地区：[1]昆明理工大学附属安宁市第一人民医院,安宁650302

出　　处：《中国中医眼科杂志》2024年第12期1161-1164,1172,共5页China Journal of Chinese Ophthalmology

基　　金：昆明市卫生健康委员会卫生科研课题项目(2023-08-01-001)。

摘　　要：睑腺炎为常见、易复发的眼科疾病,主要表现为以儿童和青少年多见的眼睑腺体的急性、化脓性、痛性、结节炎症病变。目前,西医治疗睑腺炎仍无法获得满意的疗效,尤其是近泪小点区域的睑腺炎,由于其解剖位置独特,化脓时若行肿块切开引流排脓术,容易影响泪小点的虹吸等功能,严重者可造成泪小点闭锁或者移位,引起泪小管损伤,出现泪溢等并发症。中医药治疗该病具有独特的优势,认为其病机为玄府闭塞、内有余邪、脾胃郁火,病机关键为郁火。基于“火郁发之”理论,运用扬刺法治疗泪小点区域睑腺炎,创伤小,能避开泪小点周围及泪小管,避免损伤泪小点及泪小管组织,标本兼治,起到宣通气血、解结散瘀、郁火透达外出的作用。本文旨在拓展针刺治疗睑腺炎的治疗思路与方法,充分发挥中医治疗本病的特色与优势,为治疗泪小点区域睑腺炎提供新的诊疗方案。Meibomian gland inflammation,a common and recurrent ophthalmic disease,primarily manifests as an acute,purulent,painful,nodular inflammatory condition of the eyelid glands,predominantly seen in children and adolescents.Current Western Medical treatments for hordeolum do not yield satisfactory results,particularly for meibomian gland inflammation near the lacrimal punctum.Due to its unique anatomical location,performing an incision and drainage procedure for a hordeolum in this area can easily affect the siphoning function of the lacrimal punctum.In severe cases,it may lead to closure or displacement of the lacrimal punctum,causing lacrimal canaliculus damage and complications such as epiphora(excessive tearing).Traditional Chinese Medicine(TCM)offers unique advantages in treating this condition,attributing its pathogenesis to the blockage of Xuanfu,internal excess of pathogens,and constrained fire in the spleen and stomach,with constrained fire being the key pathological mechanism.Based on the theory of"Huoyu Fazhi",the Yangci method is employed to treat meibomian gland inflammation in the lacrimal punctum region.This method causes minimal trauma,avoids the surrounding lacrimal punctum and canaliculi,and prevents damage to these structures.It effectively treats both the symptoms and root cause by promoting the flow of Qi and blood,resolving nodules,dissipating stasis,and allowing constrained fire to be released externally.This paper aims to expand the ideas and methods of acupuncture treatment for meibomian gland inflammation,fully utilizing the characteristics and advantages of TCM to provide a new diagnostic and treatment plan for meibomian gland inflammation in the lacrimal punctum region.

关 键 词：火郁发之理论 扬刺法 泪小点 刺络放血 睑腺炎 

分 类 号：R777.13[医药卫生—眼科] R246.82[医药卫生—临床医学]