从“怪病多痰”论治年龄相关性黄斑变性伴视网膜色素上皮层脱离  

Clinical Treatment of Age-related Macular Degeneration with Pigment Epithelial Detachment from the Perspective of"Odd Diseases are Often Caused by Phlegm"

作　　者：吴建国[1] 韦东[1] 张玉平[1] WU Jianguo;WEI Dong;ZHANG Yuping(Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《中国中医眼科杂志》2025年第2期158-163,共6页China Journal of Chinese Ophthalmology

基　　金：中国中医科学院第三批优势病种项目(CACMS08Y0029);中国中医科学院西苑医院提升中医药临床循证证据级别研究专项(XYZX0202-13)。

摘　　要：年龄相关性黄斑变性(AMD)是威胁中老年人视功能的主要致盲眼病之一,在发展过程中可出现黄斑区色素脱失、玻璃膜疣、黄斑区脉络膜新生血管、视网膜色素上皮层脱离(PED)等眼底改变,从而导致视力下降甚至丧失。黄斑变性归属于中医学“视瞻昏渺”“视瞻有色”“视物异形”等范畴,中医学认为黄斑属脾,脾虚为本,或合并瘀、痰或湿为标,故发病为本虚标实之证。“痰”是人体之津液代谢失常所产生的病理产物,导致机体内水液停积、流溢而出为痰为饮,并进一步变生百病,又痰浊为患其质性黏腻,留伏遏阻,滞涩不去之象,其症状奇特、久治不效,属“怪病多痰”。故治疗上需四诊合参,调脏腑,施攻补,着重从老痰、顽痰论治,疗效颇丰。Age-related macular degeneration(AMD)is one of the major blinding eye diseases threatening the visual function of middle-aged and elderly people.During its progression,the disease may manifest as pigment loss in the macular area,drusen,choroidal neovascularization in the macular area,pigment epithelial detachment(PED)of the retina,and other fundus changes,leading to vision loss or blindness.Macular degeneration falls under the categories of"blurred vision""colored vision"and"distorted vision"in Traditional Chinese Medicine(TCM).According to TCM,the macula is associated with spleen,and spleen deficiency is the root cause,often accompanied by blood stasis,phlegm,or dampness as the manifestations.Therefore,the pathogenesis is characterized by deficiency in the root and excess in the manifestations."Phlegm"is a pathological product resulting from abnormal fluid metabolism in the human body,leading to fluid accumulation and overflow,which can further cause various diseases.Phlegm is sticky and turbid in nature,tending to linger and obstruct,causing persistent and peculiar symptoms that are resistant to treatment,which is why it is said that"odd diseases are often caused by phlegm".Therefore,in treatment,a comprehensive diagnosis based on the four diagnostic methods is necessary,with a focus on regulating the viscera,applying both attacking and nourishing therapies,and emphasizing the treatment of chronic and stubborn phlegm,which has yielded significant efficacy.

关 键 词：怪病多痰 黄斑变性 视网膜色素上皮层脱离 

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