活血化瘀法治疗视网膜静脉阻塞性黄斑水肿的研究简况  

The research status of the promoting blood circulation and removing blood stasis method in the treatment of retinal vein obstructive macular edema

作　　者：吴紫琼 辛瑞[2] WU Ziqiong;XIN Rui

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]天水市中医医院,甘肃天水741000

出　　处：《中医临床研究》2024年第30期35-39,共5页Clinical Journal Of Chinese Medicine

摘　　要：黄斑水肿是视网膜静脉阻塞(Retinal Vein Occlusion,RVO)的主要并发症之一,具有发病率高、症状出现较早的特点。该病的发病率在逐年上升,以视力的急剧下降为主要症状,严重影响患者的生活质量。临床上,西医对视网膜静脉阻塞性黄斑水肿(Retinal Vein Occlusion-macular Edema,RVO-ME)的原因尚不明确。有相关研究表明,RVO是血管性疾病的一种,其缺血缺氧、氧化应激、新生血管形成、血管通透性增加以及异常的免疫调节和炎症反应的出现均可因微血管功能的异常而发生。中医医家则从整体出发,辨证治疗、病证结合,认为RVO及其主要并发症黄斑水肿发生发展的关键因素是瘀血,临床运用中医活血化瘀法治疗RVO及RVO-ME已经取得良好疗效。瘀血存在于整个病程始末,因而中医强调活血化瘀是治疗RVO-ME的关键,可以有效改善视网膜出血的吸收、降低视网膜黄斑中心凹厚度、提高视力,且存在多靶点、不良反应少等优点,在临床实践中取得良好效果。本研究从活血化瘀的角度进一步研究RVO-ME的发病机制,以发挥中医药优势,在临床上选择更加有效的药物辨证分型治疗,提高患者生存率与生活质量。文章结合案例介绍活血化瘀法治疗RVO-ME的作用,为临床提供新思路、新方法。Macular edema is one of the main complications of retinal vein occlusion(RVO). It has the characteristics of high incidence and early symptoms. The incidence of the disease is increasing year by year, and the sharp decline of vision is the main symptom, which seriously affects the quality of life of patients. Clinically, Western medicine is not clear about the cause of retinal vein obstructive macular edema(RVO-ME). Relevant studies have shown that RVO is a kind of vascular disease, and its ischemia and hypoxia, oxidative stress, neovascularization, increased vascular permeability, abnormal immune regulation and inflammatory response can all be caused by abnormal microvascular function. Starting from the overall perspective, syndrome differentiation treatment, and combination of disease and syndrome, traditional Chinese medicine doctors hold that the key factors of RVO and its main complication of macular edema are due to blood stasis, and the clinical application of the promoting blood circulation and removing blood stasis method in the treatment of RVO and RVO-ME has achieved good results. Blood stasis exists in the entire course of the disease, so traditional Chinese medicine emphasizes that promoting blood circulation and removing blood stasis is the key to the treatment of RVO-ME, which can effectively improve the absorption of retinal hemorrhage, reduce the thickness of the macular fovea, and improve visual acuity. Besides, it has the advantages of multiple targets and fewer adverse reactions, and has achieved good results in clinical practice. This study further studies the pathogenesis of RVO-ME from the perspective of promoting blood circulation and removing blood stasis, gives full play to the advantages of traditional Chinese medicine, and selects more effective drug differentiation and type treatment in clinical practice, so as to improve the survival rate and quality of life of patients. This article introduces the effect of the promoting blood circulation and removing blood stasis method in the trea

关 键 词：视网膜静脉阻塞 黄斑水肿 活血化瘀法 瘀血 

分 类 号：R774.1[医药卫生—眼科]