基于“滋水涵木”理论探讨针刺治疗阴虚阳亢型视网膜中央静脉阻塞  

Acupuncture treatment of CRVO with the syndrome of yang hyperactivity due to yin deficiency based on the theory of"nourishing the water to culture the wood"

作　　者：陈士君 段雨佳 李甜甜 薛雨辛 陈渝璐 张楠[2] 杨迎新[2] CHEN Shijun;DUAN Yujia;LI Tiantian;XUE Yuxin;CHEN Yulu;ZHANG Nan;YANG Yingxin(Beijing University of Chinese Medicine,Beijing 100029,China;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;Capital Medical University,Beijing 100069,China)

机构地区：[1]北京中医药大学,北京100029 [2]首都医科大学附属北京中医医院,北京100010 [3]首都医科大学,北京100069

出　　处：《吉林中医药》2025年第3期256-260,共5页Jilin Journal of Chinese Medicine

基　　金：国家重点研发计划(2022YFC3502504);国家自然科学基金青年科学基金项目(82205196)。

摘　　要：视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)是一种以疾病的主要病理改变而命名的眼底血管疾病,属中医“暴盲”范畴。以“阴虚阳亢”为切入点探讨视网膜中央静脉阻塞的中医病因病机,强调此病与阴津亏虚之间的关系。肝肾之阴不足则水不涵木,虚火上炎扰动目窍,且血虚生风,风邪内作,风火相搏结攻冲于头,阻滞于目窍致眼目昏眩。治法上以“滋水涵木”为总则,滋肾阴使“龙潜海底,雷寄泽中”,避免出现血不循经、溢于络外的病理表现,从而减少诱发本病。治疗采用眼针与体针相结合,结合彭静山眼针“八区十三穴”理论与临床经验,选取眼部周边穴位睛明、攒竹、瞳子髎、丝竹空,配合太溪、三阴交、照海、申脉、肾俞、肝俞等穴随症加减,肝肾同治,调整患者阴阳失衡的状态,恢复眼底气血周流,达到祛瘀生新、发越神光的目的,以期为针刺治疗视网膜中央静脉阻塞提供新的思路。Central retinal vein occlusion(CRVO)is an ocular fundus vascular disorder named after its primary pathological characteristics.In traditional Chinese medicine(TCM),it falls under the category of"sudden blindness".This article delves into the etiology and pathogenesis of CRVO from the TCM perspective,with a focus on the concept of"yang hyperactivity due to yin deficiency",emphasizing the crucial link between this disease and the syndrome of yin deficiency and bodyfluids depletion.When a deficiency of yin occurs in the liver and kidney,the principle of"the water nourishing the wood"is disrupted,giving rise to deficientfireflaring up,which disturbs the eyes.Additionally,blood deficiency can generate the wind,and this internal wind pathogen,combined withfire,attacks the head and obstructs the eyes,resulting in symptoms such as dizziness and blurred vision.The overarching treatment principle in TCM for this condition is"nourishing the water to foster the wood".By replenishing yin of the kidney,the treatment aims to achieve a state where"the dragon hides at the bottom of the sea and the thunder rests in the marsh",effectively preventing the pathological phenomenon of blood notflowing along the meridians and overflowing outside the blood vessels,thus reducing the likelihood of inducing this disease.The treatment approach integrates ophthalmic acupuncture and body acupuncture,drawing on Peng Jingshan's theory and clinical experience of"eight zones and thirteen points"in ophthalmic acupuncture.Peripheral eye acupoints such as Jingming(BL1),Cuanzhu(BL2),Tongziliao(GB1),and Sizhukong(TE23)are selected,along with acupoints like Taixi(KI3),Sanyinjiao(SP6),Zhaohai(KI6),Shenmai(BL62),Shenshu(BL23),and Ganshu(BL18),which areflexibly adjusted according to specific syndromes.By simultaneously treating the liver and the kidney,this method effectively rectifies the yin-yang imbalance in patients,restores the normal circulation of qi and blood in the ocular fundus,and attains the goals of removing blood stasis,promoting the generatio

关 键 词：视网膜中央静脉阻塞 针刺 眼针疗法 滋水涵木 阴虚阳亢型 

分 类 号：R774.5[医药卫生—眼科]