抑木扶土法治疗视网膜静脉阻塞继发黄斑水肿的理论及临床探讨
|
摘要
[目的]探讨抑木扶土法治疗视网膜静脉阻塞继发黄斑水肿(macular edema secondary to retinal vein occlusion,RVO-ME)的理论依据及临床疗效。[方法]根据RVO-ME病程迁延、反复发作的特点,通过"土虚木乘""木旺乘土"两个方面,阐述抑木扶土法治疗RVO-ME的理论依据,并阐明抑木扶土方——逍络方的组方意义,举病案佐证。[结果]RVO-ME与肝郁、脾虚有关,临床应用逍络方抑木扶土、活血化瘀治疗效果明显;通过案例证明逍络方能够减轻RVO-ME患者黄斑水肿,提高最佳矫正视力,且长期疗效良好。[结论]抑木扶土法治疗RVO-ME疗效明显,临床应用前景良好,为RVO-ME的治疗提供了新方法。
[Objective] To investigate the theoretical basis and clinical efficacy of method of restraining wood and supporting earth in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME).[Methods] According to the characteristics of RVO-ME prolongation and recurrent episodes,through the "Tuxu Mucheng" and "Muwang Chengtu" two aspects, the theoretical basis of restraining wood and supporting earth in RVO-ME was elaborated, and the significance of the Yimu Futu Prescription(Xiaoluo Prescription) was clarified, and two cases were presented as evidence. [Results]RVO-ME is associated with spleen deficiency and liver stagnation. Clinical application of Xiaoluo Prescription inhibits wood and promotes blood circulation and removes phlegm and blood stasis. In these cases, it was proved that Xiaoluo Prescription could reduce macular edema in patients with RVO-ME, improve best corrected visual acuity, and has good long-term curative effect.[Conclusion] Treatment of RVO-ME with method of restraining wood and supporting earth has obvious curative effect and good clinical application prospect, providing a new method for the treatment of RVO-ME.
[Objective] To investigate the theoretical basis and clinical efficacy of method of restraining wood and supporting earth in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME).[Methods] According to the characteristics of RVO-ME prolongation and recurrent episodes,through the "Tuxu Mucheng" and "Muwang Chengtu" two aspects, the theoretical basis of restraining wood and supporting earth in RVO-ME was elaborated, and the significance of the Yimu Futu Prescription(Xiaoluo Prescription) was clarified, and two cases were presented as evidence. [Results]RVO-ME is associated with spleen deficiency and liver stagnation. Clinical application of Xiaoluo Prescription inhibits wood and promotes blood circulation and removes phlegm and blood stasis. In these cases, it was proved that Xiaoluo Prescription could reduce macular edema in patients with RVO-ME, improve best corrected visual acuity, and has good long-term curative effect.[Conclusion] Treatment of RVO-ME with method of restraining wood and supporting earth has obvious curative effect and good clinical application prospect, providing a new method for the treatment of RVO-ME.
引文
[1]Wong T Y,Scott I U.Retinal-vein occlusion[J].N Eng JMed,2010,363(22):2135-2144.
[2]Campa C,Alivernini G,Bolletta E,et al.Anti-VEGF therapy for retinal vein occlusions[J].Curr Drug Targets,2016,17(3):328-336.
[3]田德禄,蔡淦,黄永生,等.中医内科学[M].上海:上海科技出版社,2006:236-237.
[4]太平惠民和剂局.太平惠民和剂局方[M].陈庆平,陈冰鸥,校注.北京:中国中医药出版社,1999:205-206.
[5]吴红梅,唐旭东,刘绍能,等.抑肝扶脾法改善腹泻型肠易激综合征患者生活质量的临床研究[J].中华中医药杂志,2016,31(8):3371-3374.
[6]罗静.抑木扶土法联合GP方案治疗晚期乳腺癌的临床研究[J].中医药导报,2016,22(24):32-34.
[7]邓雪.抑木扶土法治疗中青年顽固性失眠42例[J].实用中医内科杂志,2009,23(11):67.
[8]郑宏,王素梅.王素梅从肝脾论治小儿多发性抽动症经验[J].辽宁中医杂志,2017,44(11):2284-2285.
[9]龚晓薇,刘建忠,蔡建新,等.“抑木扶土”法治疗小儿功能性便秘举隅[J].湖北中医药大学学报,2017,19(2):98-100.
[10]李东垣.兰室秘藏[M].天津:天津科学技术出版社,2012:81-84.
[11]王慧博,韦企平.韦企平治疗视网膜静脉阻塞临床经验[J].北京中医药,2014,33(5):348-350.
[12]张硕,谢学军,罗国芬.陈达夫眼科六经辨证思维体系初探[J].四川中医,2000,18(4):1-2.
[13]Park S J,Choi N K,Park K H,et al.Nationwide incidence of clinically diagnosed retinal vein occlusion in Korea,2008 through 2011:Preponderance of women and the impact of aging[J].Ophthalmology,2014,121(6):1274-1280.
[14]肖文峥,谢立科,谢万坤,等.视网膜静脉阻塞的中医病机与治疗研究现状[J].北京中医药,2012,31(10):798-800.
[15]陈直.养老奉亲书[M].陈可冀,李春生,评注.北京:北京大学医学出版社,2014:13.
[16]Winegarner A,Wakabayashi T,Fukushima Y J,et al.Changes in retinal microvasculature and visual acuity after antivascular endothelial growth factor therapy in retinal vein occlusion[J].Invest Ophthalmol Vis Sci,2018,59(7):2708-2716.
[17]Karagiannis D A,Karampelas M D,Soumplis V M,et al.Recurrence of macular edema in retinal vein occlusions after treatment with intravitreal ranibizumab(Lucentis)[J].Can J Ophthalmol,2011,46(6):486-490.
[18]Stanca H T,Manea G.Physiopathology of macular edema in central vein occlusion[J].Oftalmologia,2012,56(2):15-20.
[19]高丽萍.柴胡有效成分与药理作用探究[J].临床医药文献杂志,2017,4(70):13853-13854.
[20]Zheng Y Q,Wei W,Zhu L,et al.Effects and mechanisms of paeoniflorin,a bioactive glucoside from paeony root,on adjuvant arthritis in rats[J].Inflamm Res,2007,56(5):182-188.
[21]张钟媛.茯苓药理作用研究进展[J].继续医学教育,2015,29(5):108-109.
[22]杨娥,钟艳梅,冯毅凡.白术化学成分和药理作用的研究进展[J].广东药学院学报,2012,28(2):218-221.
[2]Campa C,Alivernini G,Bolletta E,et al.Anti-VEGF therapy for retinal vein occlusions[J].Curr Drug Targets,2016,17(3):328-336.
[3]田德禄,蔡淦,黄永生,等.中医内科学[M].上海:上海科技出版社,2006:236-237.
[4]太平惠民和剂局.太平惠民和剂局方[M].陈庆平,陈冰鸥,校注.北京:中国中医药出版社,1999:205-206.
[5]吴红梅,唐旭东,刘绍能,等.抑肝扶脾法改善腹泻型肠易激综合征患者生活质量的临床研究[J].中华中医药杂志,2016,31(8):3371-3374.
[6]罗静.抑木扶土法联合GP方案治疗晚期乳腺癌的临床研究[J].中医药导报,2016,22(24):32-34.
[7]邓雪.抑木扶土法治疗中青年顽固性失眠42例[J].实用中医内科杂志,2009,23(11):67.
[8]郑宏,王素梅.王素梅从肝脾论治小儿多发性抽动症经验[J].辽宁中医杂志,2017,44(11):2284-2285.
[9]龚晓薇,刘建忠,蔡建新,等.“抑木扶土”法治疗小儿功能性便秘举隅[J].湖北中医药大学学报,2017,19(2):98-100.
[10]李东垣.兰室秘藏[M].天津:天津科学技术出版社,2012:81-84.
[11]王慧博,韦企平.韦企平治疗视网膜静脉阻塞临床经验[J].北京中医药,2014,33(5):348-350.
[12]张硕,谢学军,罗国芬.陈达夫眼科六经辨证思维体系初探[J].四川中医,2000,18(4):1-2.
[13]Park S J,Choi N K,Park K H,et al.Nationwide incidence of clinically diagnosed retinal vein occlusion in Korea,2008 through 2011:Preponderance of women and the impact of aging[J].Ophthalmology,2014,121(6):1274-1280.
[14]肖文峥,谢立科,谢万坤,等.视网膜静脉阻塞的中医病机与治疗研究现状[J].北京中医药,2012,31(10):798-800.
[15]陈直.养老奉亲书[M].陈可冀,李春生,评注.北京:北京大学医学出版社,2014:13.
[16]Winegarner A,Wakabayashi T,Fukushima Y J,et al.Changes in retinal microvasculature and visual acuity after antivascular endothelial growth factor therapy in retinal vein occlusion[J].Invest Ophthalmol Vis Sci,2018,59(7):2708-2716.
[17]Karagiannis D A,Karampelas M D,Soumplis V M,et al.Recurrence of macular edema in retinal vein occlusions after treatment with intravitreal ranibizumab(Lucentis)[J].Can J Ophthalmol,2011,46(6):486-490.
[18]Stanca H T,Manea G.Physiopathology of macular edema in central vein occlusion[J].Oftalmologia,2012,56(2):15-20.
[19]高丽萍.柴胡有效成分与药理作用探究[J].临床医药文献杂志,2017,4(70):13853-13854.
[20]Zheng Y Q,Wei W,Zhu L,et al.Effects and mechanisms of paeoniflorin,a bioactive glucoside from paeony root,on adjuvant arthritis in rats[J].Inflamm Res,2007,56(5):182-188.
[21]张钟媛.茯苓药理作用研究进展[J].继续医学教育,2015,29(5):108-109.
[22]杨娥,钟艳梅,冯毅凡.白术化学成分和药理作用的研究进展[J].广东药学院学报,2012,28(2):218-221.