彭清华基于“辛以润之”治疗干眼经验  

Professor PENG Qinghua's Experience in Treating Dry Eyes based on"Moistening with Acrid Medicinals"Theory

作　　者：吕怡 钟缘 彭俊[1,3] 彭清华(指导) LYU Yi;ZHONG Yuan;PENG Jun(The First Hospital of Hunan University of Chinese Medicine,Changsha,410000;Hunan University of Chinese Medicine;Hunan Provincial Key Laboratory for the Prevention and Treatment of Ophthalmology and Otolaryngology Diseases with Traditional Chinese Medicine)

机构地区：[1]湖南中医药大学第一附属医院,湖南省长沙市410000 [2]湖南中医药大学 [3]湖南省中医药防治眼耳鼻咽喉疾病与视功能保护工程技术研究中心

出　　处：《中医杂志》2024年第23期2399-2403,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82305037,82274588);国家中医药管理局人才支持项目-岐黄学者(国中医药人教函[2022]6号);国家中医药管理局中医眼科学重点学科建设项目(ZK1801YK015)。

摘　　要：总结彭清华教授基于“辛以润之”治疗干眼的经验。认为导致干眼“阴液亏虚”现象的根本原因为阳气不足,虚寒内生,阴液凝滞;阳气闭阻于内,阴液不行;阴枯液耗,虚阳上越。临证以“辛以润之”为根本治法,阳虚津凝者,以辛温之品温阳散寒,运行津液,使阴凝得化,常用药物有附子、干姜、细辛等;其中脾阳不足常用附子理中丸加减,肺阳不足常用小青龙汤加减,肾阳不足常用金匮肾气丸加减。阳郁津停者,以辛开之品透阳解郁,通滞行津,使阳气舒展,阴液流通,常用药物有麻黄、桂枝、柴胡等;其中阳郁肌表常用麻桂类方加减,阳郁于内常用四逆散加减。阴亏津竭者,在西洋参、南沙参、北沙参、玉竹等养阴生津药物或增液汤的基础上配合辛润之法,使阴阳互化而不燥,常用药物有人参、黄芪、肉苁蓉、肉桂等。This article summarized Professor PENG Qinghua's experience in treatment of dry eyes with princi⁃ples of"moistening with acrid medicinals".It is believed that the root cause of dry eyes with"yin fluids deficiency"phenomenon is that yang qi deficiency,deficient cold generating,and yin fluids stagnation;yang qi blocking inside,yin fluids fail to move;yin exhaustion and fluid consumption,deficient yang rising.In clinic,"moistening with acrid medicinals"could be the basic therapeutic methods.For patients with yang-deficiency and fluids-stagnation syn⁃drome,acrid and warm medicinals could be used for warming yang and dispersing cold,moving fluids,and transform⁃ing yin stagnation,commonly choosing Fuizi(Aconiti Lateralis Radix Praeparata),Ganjiang(Zingiber officinale Rosc),Xixin(Asari Radix et Rhizoma)and so on.If there is spleen yang deficiency,modified Fuzi Lizhong Pill(附子理中丸)could be used,if lung yang deficiency,modified Xiaoqinglong Decoction(小青龙汤)could be used,and if kidney yang deficiency,modified Jinkui Shenqi Pill(金匮肾气丸)could be used.For patients with yang-stagnation and fluids-retention syndrome,acrid and warm and opening medicinals could be used for expelling yang and resolving constraint,unblocking stagnation and moving fluids,to spread yang qi and free yin fluids,commonly choosing Mahuang(Ephedra sinica Stapf),Guizhi(Ramulus Cinnamomi),Chaihu(Bupleuri Radix)and so on.If there is yang stagnation in exterior parts,modified Mahuang Guizhi-Like Formulas(麻桂类方)were commonly used,and for yang stagnation inside the body,modified Sini Powder(四逆散)were commonly used.For patients with yin-deficiency and fluids-exhaustion syndrome,on the basis of tonifying yin and generating fluids medicinals like Xiyangshen(Panax quinquefolius L.),Nanshashen(Adenophorae Radix),Beishashen(Glehniae Radix),Yuzhu(Polygonati Odorati Rhizoma)or Zengye Decoction(增液汤),combined with the method of moistening with acrid medicinals,so yin and yang transforming with each other without dryness,an

关 键 词：干眼 辛以润之 名医经验 彭清华 

分 类 号：R276.7[医药卫生—中医五官科学] R249[医药卫生—中医学]