从脾肾两经论治葡萄膜炎并发黄斑水肿
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摘要
葡萄膜炎并发黄斑水肿可以造成视功能不可逆性丧失,其病位在脾、肾,病变由阳入阴,虚实夹杂,病至太阴,脾气虚,水湿不能敷布转运而上泛于目,迁延日久,耗伤正气,传入少阴则阳气衰微、水停不化而出现黄斑水肿。应用"开导之后宜补论"的治疗原则,分经辨证论治,既可以避免激素、免疫抑制剂、生物制剂的毒副作用,又能对中医治疗葡萄膜炎并发黄斑水肿提供新的思路。
Macular edema(ME) with uveitis can cause irreversible loss of visual function. The disease is located in spleen and kidney. Its pathogenesis is that, with intermingled deficiency and excess, pathological changes are from yang to yin, which can cause spleen deficiency, so water and dampness cannot be transported and then spread over the eyes. Moreover, pathogenic factors prolong for a long time, damaging the vital qi. When Shaoyin is invaded, water stagnates with yang qi exhaustion and macular edema appears. Based on the principle of "better to adapt tonifying method after resuscitating and clearing", we treat the disease with syndrome differentiation of channels, which can not only avoid the toxic and side effects of hormones, immunosuppressants and biological agents, but also provide a new way of to treat the disease in traditional Chinese medicine.
Macular edema(ME) with uveitis can cause irreversible loss of visual function. The disease is located in spleen and kidney. Its pathogenesis is that, with intermingled deficiency and excess, pathological changes are from yang to yin, which can cause spleen deficiency, so water and dampness cannot be transported and then spread over the eyes. Moreover, pathogenic factors prolong for a long time, damaging the vital qi. When Shaoyin is invaded, water stagnates with yang qi exhaustion and macular edema appears. Based on the principle of "better to adapt tonifying method after resuscitating and clearing", we treat the disease with syndrome differentiation of channels, which can not only avoid the toxic and side effects of hormones, immunosuppressants and biological agents, but also provide a new way of to treat the disease in traditional Chinese medicine.
引文
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[2]罗旭昇,吴宁玲,郝进.黄斑水肿证治思考[J].中国中医眼科杂志, 2013, 23(1):49-51.
[3]刘新书,张美芬.葡萄膜炎继发黄斑水肿及其药物治疗[J].中华眼科杂志, 2015, 51(2):151-152.
[4]吴晓云.黄帝内经下册[M]. 2版.天津:天津古籍出版社,2007:549-681.
[5]陈达夫.中医眼科六经法要[M].成都:四川人民出版社,1978:1-9.
[6]周丹,刘利哲,张桐楠.基于“开导之后宜补论”治疗消渴内障的经验探析[J].中国中医眼科杂志, 2016, 26(1):61-63.
[7]苗喜云,张缠.郭会卿教授运用健脾除湿法治疗痹症的经验总结[J].中医临床研究, 2015, 7(4):66-67.
[8]吴瑭,温病条辨[M].徐淑楠,编著.石家庄:河北科学技术出版社, 1994:54.
[9]秦伯未.谦斋医学讲稿[M].上海:上海科学技术出版社,2009:78.
[10]蒋馨,沈涛,王宇珺.从“脾阴虚”理论浅析参苓白术散方义[J].亚太传统医药, 2015, 22(22):40-41.
[11]李萍,彭俊,周亚莎.彭清华辨治黄斑囊样水肿经验[J].中华中医药杂志, 2016, 31(11):4581-4583.
[12]韦企平.黄斑水肿从痰瘀论治浅谈[J].中国中医眼科杂志,2014, 24(3):214-216.
[13]鞠静,杜武勋.真武汤药效物质基础及温阳利水机制研究[J].吉林中医药, 2016, 36(7):719-723.
[14]李红果,魏丹蕾.猪苓汤与五苓散的方证病机及临床应用分析[J].上海中医药杂志, 2016, 50(5):24-26.