基于“肝者,罢极之本”刍议近视  

Myopia Based on"Liver,the Basis of the Strike"

作　　者：周媛 颜家朝[2] 喻京生[2] ZHOU Yuan;YAN Jiazhao;YU Jingsheng(The First Clinical College of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China;The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一中医临床学院,长沙410208 [2]湖南中医药大学第一附属医院,长沙410021

出　　处：《中国中医眼科杂志》2025年第4期361-365,共5页China Journal of Chinese Ophthalmology

基　　金：国家基本中医药循证能力建设-中医眼科专病循证能力提升建设项目(2019XZZX-YK007);国家自然科学基金面上项目(82274583);湖南省“十四五”第一批中医药学科带头人培养项目(湘中医药综合处便函[2022]4号);湖南省自然科学基金面上项目(2022JJ30460);湖南省中医药管理局科研计划(D2022014)。

摘　　要：“肝者,罢极之本”源自《黄帝内经》,是对肝脏功能的高度概括,传统中医理论强调肝主藏血与疏泄的双重生理特性,通过调控目窍气血输布维系视觉功能。肝主筋,司运动,肝所主的“筋”系统在眼部具体体现为睫状肌及晶状体悬韧带等调节结构。近视的发生与肝密切相关,肝之功能可调节睫状肌痉挛及晶状体悬韧带松紧,耐受并消除其疲劳,实现双目视近、视远功能。肝气不足或疏泄失常时,可导致睫状肌持续痉挛与晶状体悬韧带张力失调,引起调节性视疲劳及屈光系统代偿障碍,此为近视形成的核心病机。据此理论指导下,本文分析近视的发病机制,探索其针对性的治则治法,提出三维调肝治法体系:一是补肝气,温肝阳;二是养肝血,舒肝气;三是滋肝阴,益肾精。本文为中医药干预近视提供新的理论依据,以期为临床中医药防治近视提供思路和参考。The statement"liver is the foundation of endurance to fatigue"originates from Huangdi Neijing,which profoundly summarizes hepatic functions.Traditional Chinese Medicine(TCM)theory emphasizes the dual physiological characteristics of liver in blood storage and regulation.By governing Qi and blood distribution in ocular structures,it maintains visual functions.Liver dominates tendons and controls movement,with its tendon system specifically manifested in ocular accommodation structures like ciliary muscles and suspensory ligaments.Myopia development closely relates to hepatic functions,as liver regulates ciliary muscle spasms and ligament tension,alleviating fatigue to achieve near-far vision adaptation.Hepatic Qi deficiency or dysfunctional regulation may cause persistent ciliary spasms and ligament tension imbalance,leading to accommodative asthenopia and refractive compensation disorders—the core pathogenesis of myopia.Guided by this theory,this paper analyzes myopia's pathogenesis and explores targeted treatment principles,proposing a three-dimensional liver-regulating therapeutic system:Reinforcing hepatic Qi and warming hepatic Yang;Nourishing hepatic blood and soothing hepatic Qi;Enriching hepatic Yin and supplementing renal essence.This framework provides novel theoretical foundations for TCM interventions in myopia,offering clinical guidance for prevention and treatment strategies.

关 键 词：罢极之本 肝 近视 

分 类 号：R778.11[医药卫生—眼科] R276.7[医药卫生—临床医学]