高健生学术思想及益气升阳举陷法治疗眼科疾病临床经验整理研究
|
摘要
[目的]总结高健生老师学术思想及益气升阳举陷法治疗眼科疾病的临床经验,在此基础上进行继承和发扬。
[方法]1.学习老师已经发表的论文和著作,整理学术思想。2.抄方学习,记录跟师过程中老师望闻问切的特点、就诊患者的病情、处方用药及复诊情况；尽量复原老师治病的思路,并对其运用益气升阳举陷法治疗眼病的经验进行总结。3.学习中医经典著作,并结合老师的学术思想和临床经验,灵活应用于临床实践中,并注意创新发扬。
[结果]
1.学术思想
1.1益气升阳举陷的诊治思路：将东垣“益气升阳”学说与张锡纯“升陷汤”的理论相结合,提出了“益气升阳举陷”法,治疗中焦气虚下陷,脾阳不升的眼病,临床效果较好。其特点为：①扩展益气升阳中的“益气”为补脾阳,温肾阳。常选用川草乌、附子、仙灵脾等,尤其是善散阴寒,温中止痛,暖脾止泻之川椒的应用,集温阳、通阳、引阳于一身。②重视升阳药,引经药的应用,不局限于升麻柴胡,包括一些祛风药在内如蔓荆子、防风、白芷、羌活等也作为引经药使用。③运用益精升阴法治疗眼科疾病时也加入一些益气升阳药,取肝肾俱在下焦,非风药行经不可也之意。
1.2益精升阴敛聚的诊治思路：创立益精升阴敛聚法——于补益肝肾处方中加入少许能够协助升运精、气、血上行清窍功能的佐使药物,促进补益肝肾药物上达头目。主要用于治疗视瞻昏渺、青盲等证属肝、肾,且精血亏耗、神光欲散的疑难眼病。
1.3老师非常重视中医眼科经典书籍的学习,并且深入探究,使中医眼科的学术内容更为丰富和严谨。如受《秘传眼科龙木论》中“仙灵脾”治疮毒入眼的启发,立法“益气固表,补肾托毒”治疗复发性单疱病毒性角膜炎；考证研究银柴胡的“明目益精”作用；辨误五风内障与青光眼;探究“六欲”的源流、含义等。
1.4重视玄府学说
细究“玄府学说”,用“热气怫郁,玄府闭密致使气液、血脉、营卫、精神不能升降出入”分析许多疑难内障眼病的病机并指导治疗,取得较好疗效,如高老师早年治疗的双眼急性横断性视神经炎、多发性硬化等疑难眼病。
1.5对中医唯物辩证思想和特有认知论的认识
高老师通过数十年的理论学习和临床实践,对中医学的哲学问题进行了较深入的思考和研究,初步勾画出了中医学辩证唯物论的思想体系,认为：“玄府”具有物质属性和时空变化的特点；中医的“神”具有物质属性和形神合一的特点；“天人合一,和谐共存”是中医的宇宙观；临床辨证论治是中医哲学思想的具体运用过程。
2.随机对照临床研究
川椒方是老师治疗过敏性结膜炎的经验方,采用随机对照的方法研究该方治疗过敏性结膜炎的疗效。样本数为60例120只眼,治疗组和对照组各30例60只眼,分别予川椒方和0.1%盐酸奥洛他定滴眼液,治疗3周统计疗效。结果,川椒方在改善眼痒、结膜充血、眼分泌物等方面均优于盐酸奥洛他定滴眼液。
3.临床经验
老师在治疗眼病时,善用温阳或升举阳气的药物。
3.1过敏性结膜炎：本质为“寒包火”,在祛风清热滋阴的同时,加用一味川椒,疗效明显。
3.2干眼症：审因论治,“因人而异”,对于久视伤血者,以补肝血、滋肝阴为主；而治疗更年期干眼症,以解肝郁、温肾阳为主。
3.3病毒性角膜炎：属于“本虚标实”之症,其治疗常以扶正为主,对于久治不愈者,采用益气固表、补肾托毒法治疗。
3.4糖尿病视网膜病变：辨证属于气阴两虚甚或阴阳两虚,据此创立了密蒙花方,可改善患者全身症状和眼底表现。
3.5重症肌无力眼肌型：从脾肾论治。在益气聪明汤或补中益气汤中加用鹿角霜、仙灵脾、附子、川草乌等温补肾阳之药。
3.6Meige综合征：常为精神过度劳累紧张耗伤脾胃所致,从脾胃论治,采用益气升阳举陷法,同时,常在方中加入温肾通络药物,如川乌、草乌、仙灵脾、蜈蚣、全蝎等。
3.7前部缺血性视神经病变：以气虚为主,治疗强调益气为重,同时养血通络。常用方剂补阳还五汤、血府逐瘀汤、参芪四物等,在此基础上加用虫类药物熄风通络。
3.8多发性硬化和视神经脊髓炎：为“本虚标实”之证,虚实夹杂,表现多样,五脏皆可受累,以肺、脾、肾为主。以玉屏风散结合分期治疗。
3.9视神经萎缩：治以“益精生阴敛聚法”。对于无证可辨者,予疏利玄府、升阴以养目(根据病机具体分析用药)；对于肝肾不足者,予补益肝肾中轻清之精血,使其上达头目。
4.发扬与创新
将经典学习与临床实践相结合,对某些疑难病的治疗取得了较好的疗效,并形成自己的经验；深入探究中医典籍,严谨考证,提出了自己的观点。
4.1用《伤寒论》“欲解时”理论指导治疗春季角结膜炎：受《伤寒论》“欲解时”、理论启发,将春季角结膜炎轻者归于“手太阴肺经”之病,重者“手太阴肺、足太阴脾”二经俱病。治太阴病“当温之,宜服四逆辈”,因此,对于病变较轻者,用川椒方；对于病变严重者,加用附子理中丸,在临床上取得较好效果。
4.2单疱病毒性角膜炎的时间治疗学：单疱病毒性角膜炎的复发常常在季节变化时发生,二十四节气中变化最大的有四个节气,即春分、秋分、冬至、夏至。《伤寒论》曰：“冬夏二至阴阳合也,春秋二分阴阳离也,阴阳交易,人变病焉”。复发的单疱病毒性角膜炎,在临床上控制病情后,让患者在二分二至服用玉屏风散,可增强正气,预防疾病复发。
4.3辨误“高风雀目”与“肝虚雀目”：“高风雀目”为原发性视网膜色素变性；“肝虚雀目”,儿童患病是由于维生素A缺乏,成人是由于肝虚。《秘传眼科龙木论》对两病的概念论述明确具体,而从元代以后一直到清朝多数医家对两病的概念论述不清,近代一些中医眼科教材及专著中,也有引用不当之处。提示阅读古代中医眼科著作,要认真思考,横向比较,在汲取其精华的同时,尽量减少错误。
[结论]高健生老师重视中医典籍的学习,不断总结临床经验,善于创新,采用“益气升阳举陷”、“益精升阴敛聚”方法,治疗包括眼表、视网膜、神经眼科在内的诸多疑难眼科疾病,取得较好疗效；同时还重视对中医方法论的探究。其治疗过敏性结膜炎的经验方(川椒方)经临床随机对照研究证实有效。通过师承学习,继承人的中医理论水平和临床疗效也得到了很大提高,并在学术上有所创新。
[Objective] To summarize, inherit and carry forward the academic thinking and clinical experience of Prof.Gao Jian-Sheng in eye disease.
[Methods]1. Learn and investigate the published papers and books of Prof.Gao, systemized his acdamic thinking.2. Copy the prescription and take detailed notes for the treatment procedure of Prof.Gao, particularly focus on the diagnostic method, patient's condition, treatment principle, prescription and the following consultation of the patients.3. Study classic works of traditional Chinese medicine (TCM), and combine it with the academic thinking and clinical experience of Prof.Gao, then apply it into my clinic practice. In the way pay attention to innovation carry forward.
[Results]
1. Academic thinking
1.1Treatment theory of "Replenishing qi, Elevating yang, and Raising the dropping": By combining the treatment theory of "Replenishing qi, Elevating yang" from Li Dong Yuan and the theory of "Raise the dropping" from Zhang Xi Chun, the treatment outcome is very goodin the patients suffering from eye disease with pattern of qi deficiency and qi sinking at the middle burner (the portion between the diaphragm and the umbilicus housing the spleen, stomach, liver and gallbladder) and spleen yang failing to raise. The features of this treatment regiment are:(1)Enhance the effect of "replenishing qi" to supplement spleen yang and warm kidney yang by using Radix Aconiti Kusnezoffii, Radix Aconiti Lateralis Preparata, Epimedium davidii Franch and Zanthoxylum bungeanum Mazim. Among them, Zanthoxylum bungeanum Mazim can dissipate cold, warm the middle to reduce pain, and warm functional spleen to stop diarrhea. Since it can warm, unobstruct, and guide Yang, it plays very important role in treatment.(2)Pay attention to the application of medicinalswith effects of yang-upraising and channel-ushering, which include not onlyRhizoma Cimicifugae and Radix Bupleuri but also some wind-expelling herbal medicinalssuch as Fructus Viticis Simplicifoliae, Radix Saposhnikoviae, Radix Angelicae Dahuricae and Rhizoma Notopterygii.(3)Combining the method of "nourishing the original essence and upraising Yin" with "Yiqi Shengyang" to improve the therapeutic effect by regulating Qi.
1.2Treatment theory of "nourishing and constraining the original essence":Establish the treatment theory of ""nourishing and constraining the original essence" by combining drugs that can assist in upraising and regulating original essence, Qi and blood to reach the area near the eyes to enhance the treatment effects of drugs that can nourish the functional liver and kidney. This treatment regiment is applicable to patients who have eye diseases due to lack of Qi and original essence in functional liver and kidney.
1.3Dr Gao have accomplished extensive literature reviews for TCM classic works on eye diseases. By investigating published TCM studies from ancient times, he created a rigorous system to enhance the knowledge inheritance and many ancient methods were able to be preserved and implemented in the clinic for eye diseases. For instance, by investigating "Mi Chuan Yan Ke Long Mu Lun", he was inspired by the usage of Herba Epimediion visual disorders caused by pathogens infection. He has proposed and proved that treatment by nourishing healthy Qi, enhancing the epidermal barrier, nourishing kidney and expelling toxin in kidney is very effective on recurrent herpes simplex keratitis. He also investigated the origin and definition of "Six Emotions" from literatures; gathered evidence that Starwort Root has function of nourishing eyes and replenishing vital essences; corrected certain misunderstandings in the diagnosis and treatment of cataract caused by "Five Winds" and glaucoma from several literatures.
1.4Think highly of "Xuan Fu theory" in the treatment:In TCM theory,"Xuan Fu" is defined as invisible pores on human body. Once "Xuan Fu" is closed and there is stagnation of heat that is adverse to the eyes, it may cause a blockage of Qi, blood, or other essences of circulating systems. By further understanding the "Xuan Fu theory", we achieve excellence treatment outcome for patients who have visual disorders. Many difficult and complicated cases have been cured by Dr Gao using this theory such as acute cross-sectional polyneuritis and multiple sclerosis, etc.
1.5The understanding on Materialist Dialectics Thoughts and feature of cognition of TCM:Decades of clinical practice and investigation of TCM literature, has lead Dr Gao to outline and propose the "Materialist Dialectics Thoughts" entailed in TCM from the perspective of in-depth philosophy. He proposed that "Xuan Fu" has both physical nature and temporal and spatial variation."Shen" in TCM theory also has physical nature and the feature of "harmonization between soma and spirit"."Integration of Nature and Man" and "Harmonious Coexistence" is the cosmological concept of TCM; Clinical Syndrome Differentiation Thinking is the application of TCM philosophy.The application of "Deductive Thinking" skill in clinic practice will increase diagnosis accuracy and therapeutic effect.
2. Randomized controlled clinical trials
"Chuan Jiao Formula" is a clinical proven, effective experiential formula designed by Dr Gao for the treatment of allergic conjunctivitis. We investigated this formula by randomized controlled clinical trials in60patients (120eyes). Enrolled patients were randomly divided into Treatment group and Control group, each group has30patients (60eyes each)."Chuan Jiao Formula" was applied in Treated group,0.1%hydrochloride Olopatadine eyedrop was applied in Control group. All patients were treated for consecutively three weeks. The results showed that "Chuan Jiao Formula" was superior to0.1%hydrochloride Olopatadine eyedrop in reducing eyeitchingand conjunctival congestion. Less eye secretions was alsofound in the Treatment group.
3. Clinical Experience
Dr Gao is good at usingherbs that can upraise Yang or enhance Yang in the treatment of visual disorders.
3.1Allergic conjunctivitis:The cause and pathogenesis of the disease is due to attack of wind-cold when "Xuan Fu" closes and opens during season changing time, then the accumulation of wind-cold causing retention heat. By expelling wind, reducing heat, nourishing Yin and combing Zanthoxylum bungeanum Mazim, excellent treatment outcome will be achieved.
3.2Dry eye syndrome:Clinical Syndrome Differentiation Thinking was also applied when treating this disease. Thus the treatment principle varies from patient to patient. If dry-eye syndrome was caused by the long-term usage of eyes, drugs that can nourish and tonify the liver Yin, and/or improve blood circulation inside the liver will be prescribed. For climacteric dry-eye syndrome, drugs that can resolve depression caused by liver disorder and drugs that can enhance Yang in kidney were prescribed.
3.3Viralkeratitis:Patients of this type have a deficiency in Qi but the clinical syndrome shows excessiveness. Thus, the treatment principle will be focused on reinforcing the patient's healthy Qi and eliminating pathogens. For patientswith a long disease course, drugs that can nourish healthy Qi, enhance the epidermal barrier, nourish kidney and expel toxin in kidney will be prescribed.
3.4Diabetic retinopathy:The disease may be caused by both Qi and Yindeficiency, further a deficiency in Yin and Yang. Thus, we proposed to use formula that contains Flos Buddlejae to treat this type of disease. It showed that this treatment could improve both the systemic syndrome and fundus lesion.
3.5Ocular Myasthenia Gravis:The treatment principle is focused on the modulation of spleen and kidney function. By adding supplementary drugs such as Cornu Cervi Degelatinatum, Herba Epimedii, Radix Aconiti Lateralis Preparata and Radix Aconiti Kusnezoffii to the "Decoction of Yi Qi Cong Ming" and "Decoction of Bu Zhong Yi Qi", the Yang in kidney is nourished.
3.6Meige Syndrome:The spleen and stomach of the patient maybe in disorder due to over-work and/or over-stress, thus Meige Syndrome is developed. We propose to treat this type of patients based on theory of "Replenishing qi, Elevating yang, Raise the dropping". In the meanwhile, drugs that can warm kidney and relieve obstruction of collateral vessels, such as Radix Aconiti, Radix Aconiti Kusnezoffii, Herba Epimedii, Scolopendraand Scorpio will be added to improve the treatment outcome.
3.7Anterior Ischemic Optic Neuropathy:This type of visual disorders maybe caused by Qideficiency. Thus, we treat this type of patients by nourishing Qi, modulating blood circulation and relieving the obstruction of collateral vessels. The commonly prescribedformulas are:"Bu Yang Huan Wu decoction","Xue Fu Zhu Yu decoction","Shen Qi Si Wu decoction", etc. We also modify the formula with herbs that can extinguish wind and relieve the obstruction of collateral vessels from active components of insects or other animals.
3.8Multiple sclerosis and neuromyelitis optica:This type of patients also has a deficiency in Qi but the clinical syndrome may show excessiveness. The syndrome is hard to differentiate. It is easy to be misled when determining the status of Qi. Five vital organs may all be affected, mainly in the lung, spleen and kidney."Yu Ping Feng Power" is applicable to patients with this syndrome.
3.9Optic atrophy:The treatment theory is based on "Replenishing vital essence, tonifying kidney-Yin and aggregating Qi". For patients with unknown causes of this type of visual disorders, we focus on "Xuan Fu" to relieve the blockage and upraise Yin to nourish the eyes. Patients maybe treated in various ways depending on the syndrome and possible causes. For patients who have deficiency in kidney-Yin, we will prescribe drugs that can nourish kidney and liver. Thus, the blood and vital essences circulation will be improved to reach the eyes.
4. Innovation and development of treatment theory designed by Dr Gao
By collecting evidence from literature and by investigating ancient clinical cases reported, I proposed several novel treatment theories in the treatment of eye diseases. Until now, by combining my own experience from clinical practice and literature review, many difficult and complicated cases have been successfully cured. My novel treatment theories are as follows.
4.1Inspired by "Shang Han Lun", which proposed that treatment time is critical, such as "Yu Jie Shi" and "Yu Ju Shi", patients who had vernal keratoconjunctivitis were divided into two groups. For the patients who are in the early stage of vernal keratoconjunctivitis, they were diagnosed to have illness in "Shou Tai Yin Fei Jing"."Chuan Jiao Formula" was applied to this group of patients. Patients in the later stage of vernal keratoconjunctivitis were diagnosed to have illness in "Shou Tai Yin Fei" and "Zu Tai Yin Pi"."Fu Zi Li Zhong Pills" were prescribed to this group of patients. Both groups were treated with formulaswith warming functions because this type of eye disease was belong to "Tai Yin" illness. Excellent treatment outcome was achieved by this novel theory.
4.2Chronotherapy on herpes simplex keratitis:Herpes simplex keratitis normally occurs with seasonal rhythm. The24solar terms (i.e. Jie Qi in Chinese) provide a clear indication of seasonal changes. The great changes happen during4solar terms, they are the Spring Equinox, the Autumn Equinox, the Winter Solstice and the Summer Solstice. According to "Shang Han Lun", it is proposed that Yin and Yang are combined on the Winter Solstice and the Summer Solstice but dissociates on the Spring Equinox and the Autumn Equinox. During this four periods of time, diseases develop due to the seasonal change of Yin and Yang combination. Therefore, patients who have recurrent herpes simplex keratitis, were prescribed with "Yu Ping Feng Power" on these four solar terms once the disease was under(out of?) control.The healthy Qi will be enhanced and strengthened; it will prevent the reoccurrence of herpes simplex keratitis.
4.3Correcting the misunderstanding on "Gao Feng Que Mu" and "Gan Xu Que Mu":In modern clinical practice,"Gao Feng Que Mu" is treated as primary pigmentary degeneration of retina."Gan Xu Que Mu" is caused by the lack of vitamin A in children or liver deficiency in adult. There are specific and clear descriptions of these two diseases in "Mi Chuan Yan Ke Long Mu Lun". However, from the Yuan dynasty to the Qing dynasty, or even in modern times, the description and medical case records of these two diseases have become obscure and ambiguous. Misconceptions of these two diseases can be seen in many modern publications. Many citations areimproper. This indicates that critical thinking and cross comparison is required when reading and evaluating ancient literatures on TCM eye disease treatment theories.
[Conclusions]
By exploring extensive TCM classic works and journals, Dr Gao obtained in-depth knowledge of various treatment theories on visual disorders. Nowadays, by applying and practicing these theories acquired, his clinical experience is enhanced and continuously accumulated to make innovative treatment design possible. By using theories of "replenishing qi, elevating yang,and raise the dropping " and "Replenish vital essence, tonify kidney-Yin and aggregate Qi", we have cured many difficult and complicated cases including visual disorders on ocular surface, retina, and nervous system. By randomized controlled clinical trials,"Chuan Jiao Formula" has been proved to be clinically effective for the treatment of allergic conjunctivitis. By learning from my mentor Dr Gao, I have made great progress in the study of TCM theories. My diagnosis skill has also been improved through learning from Dr Gao and continuous practice in the clinic. I hasalso developed some new ideas to further improve therapeutic effectfor visual disorders.
[方法]1.学习老师已经发表的论文和著作,整理学术思想。2.抄方学习,记录跟师过程中老师望闻问切的特点、就诊患者的病情、处方用药及复诊情况；尽量复原老师治病的思路,并对其运用益气升阳举陷法治疗眼病的经验进行总结。3.学习中医经典著作,并结合老师的学术思想和临床经验,灵活应用于临床实践中,并注意创新发扬。
[结果]
1.学术思想
1.1益气升阳举陷的诊治思路：将东垣“益气升阳”学说与张锡纯“升陷汤”的理论相结合,提出了“益气升阳举陷”法,治疗中焦气虚下陷,脾阳不升的眼病,临床效果较好。其特点为：①扩展益气升阳中的“益气”为补脾阳,温肾阳。常选用川草乌、附子、仙灵脾等,尤其是善散阴寒,温中止痛,暖脾止泻之川椒的应用,集温阳、通阳、引阳于一身。②重视升阳药,引经药的应用,不局限于升麻柴胡,包括一些祛风药在内如蔓荆子、防风、白芷、羌活等也作为引经药使用。③运用益精升阴法治疗眼科疾病时也加入一些益气升阳药,取肝肾俱在下焦,非风药行经不可也之意。
1.2益精升阴敛聚的诊治思路：创立益精升阴敛聚法——于补益肝肾处方中加入少许能够协助升运精、气、血上行清窍功能的佐使药物,促进补益肝肾药物上达头目。主要用于治疗视瞻昏渺、青盲等证属肝、肾,且精血亏耗、神光欲散的疑难眼病。
1.3老师非常重视中医眼科经典书籍的学习,并且深入探究,使中医眼科的学术内容更为丰富和严谨。如受《秘传眼科龙木论》中“仙灵脾”治疮毒入眼的启发,立法“益气固表,补肾托毒”治疗复发性单疱病毒性角膜炎；考证研究银柴胡的“明目益精”作用；辨误五风内障与青光眼;探究“六欲”的源流、含义等。
1.4重视玄府学说
细究“玄府学说”,用“热气怫郁,玄府闭密致使气液、血脉、营卫、精神不能升降出入”分析许多疑难内障眼病的病机并指导治疗,取得较好疗效,如高老师早年治疗的双眼急性横断性视神经炎、多发性硬化等疑难眼病。
1.5对中医唯物辩证思想和特有认知论的认识
高老师通过数十年的理论学习和临床实践,对中医学的哲学问题进行了较深入的思考和研究,初步勾画出了中医学辩证唯物论的思想体系,认为：“玄府”具有物质属性和时空变化的特点；中医的“神”具有物质属性和形神合一的特点；“天人合一,和谐共存”是中医的宇宙观；临床辨证论治是中医哲学思想的具体运用过程。
2.随机对照临床研究
川椒方是老师治疗过敏性结膜炎的经验方,采用随机对照的方法研究该方治疗过敏性结膜炎的疗效。样本数为60例120只眼,治疗组和对照组各30例60只眼,分别予川椒方和0.1%盐酸奥洛他定滴眼液,治疗3周统计疗效。结果,川椒方在改善眼痒、结膜充血、眼分泌物等方面均优于盐酸奥洛他定滴眼液。
3.临床经验
老师在治疗眼病时,善用温阳或升举阳气的药物。
3.1过敏性结膜炎：本质为“寒包火”,在祛风清热滋阴的同时,加用一味川椒,疗效明显。
3.2干眼症：审因论治,“因人而异”,对于久视伤血者,以补肝血、滋肝阴为主；而治疗更年期干眼症,以解肝郁、温肾阳为主。
3.3病毒性角膜炎：属于“本虚标实”之症,其治疗常以扶正为主,对于久治不愈者,采用益气固表、补肾托毒法治疗。
3.4糖尿病视网膜病变：辨证属于气阴两虚甚或阴阳两虚,据此创立了密蒙花方,可改善患者全身症状和眼底表现。
3.5重症肌无力眼肌型：从脾肾论治。在益气聪明汤或补中益气汤中加用鹿角霜、仙灵脾、附子、川草乌等温补肾阳之药。
3.6Meige综合征：常为精神过度劳累紧张耗伤脾胃所致,从脾胃论治,采用益气升阳举陷法,同时,常在方中加入温肾通络药物,如川乌、草乌、仙灵脾、蜈蚣、全蝎等。
3.7前部缺血性视神经病变：以气虚为主,治疗强调益气为重,同时养血通络。常用方剂补阳还五汤、血府逐瘀汤、参芪四物等,在此基础上加用虫类药物熄风通络。
3.8多发性硬化和视神经脊髓炎：为“本虚标实”之证,虚实夹杂,表现多样,五脏皆可受累,以肺、脾、肾为主。以玉屏风散结合分期治疗。
3.9视神经萎缩：治以“益精生阴敛聚法”。对于无证可辨者,予疏利玄府、升阴以养目(根据病机具体分析用药)；对于肝肾不足者,予补益肝肾中轻清之精血,使其上达头目。
4.发扬与创新
将经典学习与临床实践相结合,对某些疑难病的治疗取得了较好的疗效,并形成自己的经验；深入探究中医典籍,严谨考证,提出了自己的观点。
4.1用《伤寒论》“欲解时”理论指导治疗春季角结膜炎：受《伤寒论》“欲解时”、理论启发,将春季角结膜炎轻者归于“手太阴肺经”之病,重者“手太阴肺、足太阴脾”二经俱病。治太阴病“当温之,宜服四逆辈”,因此,对于病变较轻者,用川椒方；对于病变严重者,加用附子理中丸,在临床上取得较好效果。
4.2单疱病毒性角膜炎的时间治疗学：单疱病毒性角膜炎的复发常常在季节变化时发生,二十四节气中变化最大的有四个节气,即春分、秋分、冬至、夏至。《伤寒论》曰：“冬夏二至阴阳合也,春秋二分阴阳离也,阴阳交易,人变病焉”。复发的单疱病毒性角膜炎,在临床上控制病情后,让患者在二分二至服用玉屏风散,可增强正气,预防疾病复发。
4.3辨误“高风雀目”与“肝虚雀目”：“高风雀目”为原发性视网膜色素变性；“肝虚雀目”,儿童患病是由于维生素A缺乏,成人是由于肝虚。《秘传眼科龙木论》对两病的概念论述明确具体,而从元代以后一直到清朝多数医家对两病的概念论述不清,近代一些中医眼科教材及专著中,也有引用不当之处。提示阅读古代中医眼科著作,要认真思考,横向比较,在汲取其精华的同时,尽量减少错误。
[结论]高健生老师重视中医典籍的学习,不断总结临床经验,善于创新,采用“益气升阳举陷”、“益精升阴敛聚”方法,治疗包括眼表、视网膜、神经眼科在内的诸多疑难眼科疾病,取得较好疗效；同时还重视对中医方法论的探究。其治疗过敏性结膜炎的经验方(川椒方)经临床随机对照研究证实有效。通过师承学习,继承人的中医理论水平和临床疗效也得到了很大提高,并在学术上有所创新。
[Objective] To summarize, inherit and carry forward the academic thinking and clinical experience of Prof.Gao Jian-Sheng in eye disease.
[Methods]1. Learn and investigate the published papers and books of Prof.Gao, systemized his acdamic thinking.2. Copy the prescription and take detailed notes for the treatment procedure of Prof.Gao, particularly focus on the diagnostic method, patient's condition, treatment principle, prescription and the following consultation of the patients.3. Study classic works of traditional Chinese medicine (TCM), and combine it with the academic thinking and clinical experience of Prof.Gao, then apply it into my clinic practice. In the way pay attention to innovation carry forward.
[Results]
1. Academic thinking
1.1Treatment theory of "Replenishing qi, Elevating yang, and Raising the dropping": By combining the treatment theory of "Replenishing qi, Elevating yang" from Li Dong Yuan and the theory of "Raise the dropping" from Zhang Xi Chun, the treatment outcome is very goodin the patients suffering from eye disease with pattern of qi deficiency and qi sinking at the middle burner (the portion between the diaphragm and the umbilicus housing the spleen, stomach, liver and gallbladder) and spleen yang failing to raise. The features of this treatment regiment are:(1)Enhance the effect of "replenishing qi" to supplement spleen yang and warm kidney yang by using Radix Aconiti Kusnezoffii, Radix Aconiti Lateralis Preparata, Epimedium davidii Franch and Zanthoxylum bungeanum Mazim. Among them, Zanthoxylum bungeanum Mazim can dissipate cold, warm the middle to reduce pain, and warm functional spleen to stop diarrhea. Since it can warm, unobstruct, and guide Yang, it plays very important role in treatment.(2)Pay attention to the application of medicinalswith effects of yang-upraising and channel-ushering, which include not onlyRhizoma Cimicifugae and Radix Bupleuri but also some wind-expelling herbal medicinalssuch as Fructus Viticis Simplicifoliae, Radix Saposhnikoviae, Radix Angelicae Dahuricae and Rhizoma Notopterygii.(3)Combining the method of "nourishing the original essence and upraising Yin" with "Yiqi Shengyang" to improve the therapeutic effect by regulating Qi.
1.2Treatment theory of "nourishing and constraining the original essence":Establish the treatment theory of ""nourishing and constraining the original essence" by combining drugs that can assist in upraising and regulating original essence, Qi and blood to reach the area near the eyes to enhance the treatment effects of drugs that can nourish the functional liver and kidney. This treatment regiment is applicable to patients who have eye diseases due to lack of Qi and original essence in functional liver and kidney.
1.3Dr Gao have accomplished extensive literature reviews for TCM classic works on eye diseases. By investigating published TCM studies from ancient times, he created a rigorous system to enhance the knowledge inheritance and many ancient methods were able to be preserved and implemented in the clinic for eye diseases. For instance, by investigating "Mi Chuan Yan Ke Long Mu Lun", he was inspired by the usage of Herba Epimediion visual disorders caused by pathogens infection. He has proposed and proved that treatment by nourishing healthy Qi, enhancing the epidermal barrier, nourishing kidney and expelling toxin in kidney is very effective on recurrent herpes simplex keratitis. He also investigated the origin and definition of "Six Emotions" from literatures; gathered evidence that Starwort Root has function of nourishing eyes and replenishing vital essences; corrected certain misunderstandings in the diagnosis and treatment of cataract caused by "Five Winds" and glaucoma from several literatures.
1.4Think highly of "Xuan Fu theory" in the treatment:In TCM theory,"Xuan Fu" is defined as invisible pores on human body. Once "Xuan Fu" is closed and there is stagnation of heat that is adverse to the eyes, it may cause a blockage of Qi, blood, or other essences of circulating systems. By further understanding the "Xuan Fu theory", we achieve excellence treatment outcome for patients who have visual disorders. Many difficult and complicated cases have been cured by Dr Gao using this theory such as acute cross-sectional polyneuritis and multiple sclerosis, etc.
1.5The understanding on Materialist Dialectics Thoughts and feature of cognition of TCM:Decades of clinical practice and investigation of TCM literature, has lead Dr Gao to outline and propose the "Materialist Dialectics Thoughts" entailed in TCM from the perspective of in-depth philosophy. He proposed that "Xuan Fu" has both physical nature and temporal and spatial variation."Shen" in TCM theory also has physical nature and the feature of "harmonization between soma and spirit"."Integration of Nature and Man" and "Harmonious Coexistence" is the cosmological concept of TCM; Clinical Syndrome Differentiation Thinking is the application of TCM philosophy.The application of "Deductive Thinking" skill in clinic practice will increase diagnosis accuracy and therapeutic effect.
2. Randomized controlled clinical trials
"Chuan Jiao Formula" is a clinical proven, effective experiential formula designed by Dr Gao for the treatment of allergic conjunctivitis. We investigated this formula by randomized controlled clinical trials in60patients (120eyes). Enrolled patients were randomly divided into Treatment group and Control group, each group has30patients (60eyes each)."Chuan Jiao Formula" was applied in Treated group,0.1%hydrochloride Olopatadine eyedrop was applied in Control group. All patients were treated for consecutively three weeks. The results showed that "Chuan Jiao Formula" was superior to0.1%hydrochloride Olopatadine eyedrop in reducing eyeitchingand conjunctival congestion. Less eye secretions was alsofound in the Treatment group.
3. Clinical Experience
Dr Gao is good at usingherbs that can upraise Yang or enhance Yang in the treatment of visual disorders.
3.1Allergic conjunctivitis:The cause and pathogenesis of the disease is due to attack of wind-cold when "Xuan Fu" closes and opens during season changing time, then the accumulation of wind-cold causing retention heat. By expelling wind, reducing heat, nourishing Yin and combing Zanthoxylum bungeanum Mazim, excellent treatment outcome will be achieved.
3.2Dry eye syndrome:Clinical Syndrome Differentiation Thinking was also applied when treating this disease. Thus the treatment principle varies from patient to patient. If dry-eye syndrome was caused by the long-term usage of eyes, drugs that can nourish and tonify the liver Yin, and/or improve blood circulation inside the liver will be prescribed. For climacteric dry-eye syndrome, drugs that can resolve depression caused by liver disorder and drugs that can enhance Yang in kidney were prescribed.
3.3Viralkeratitis:Patients of this type have a deficiency in Qi but the clinical syndrome shows excessiveness. Thus, the treatment principle will be focused on reinforcing the patient's healthy Qi and eliminating pathogens. For patientswith a long disease course, drugs that can nourish healthy Qi, enhance the epidermal barrier, nourish kidney and expel toxin in kidney will be prescribed.
3.4Diabetic retinopathy:The disease may be caused by both Qi and Yindeficiency, further a deficiency in Yin and Yang. Thus, we proposed to use formula that contains Flos Buddlejae to treat this type of disease. It showed that this treatment could improve both the systemic syndrome and fundus lesion.
3.5Ocular Myasthenia Gravis:The treatment principle is focused on the modulation of spleen and kidney function. By adding supplementary drugs such as Cornu Cervi Degelatinatum, Herba Epimedii, Radix Aconiti Lateralis Preparata and Radix Aconiti Kusnezoffii to the "Decoction of Yi Qi Cong Ming" and "Decoction of Bu Zhong Yi Qi", the Yang in kidney is nourished.
3.6Meige Syndrome:The spleen and stomach of the patient maybe in disorder due to over-work and/or over-stress, thus Meige Syndrome is developed. We propose to treat this type of patients based on theory of "Replenishing qi, Elevating yang, Raise the dropping". In the meanwhile, drugs that can warm kidney and relieve obstruction of collateral vessels, such as Radix Aconiti, Radix Aconiti Kusnezoffii, Herba Epimedii, Scolopendraand Scorpio will be added to improve the treatment outcome.
3.7Anterior Ischemic Optic Neuropathy:This type of visual disorders maybe caused by Qideficiency. Thus, we treat this type of patients by nourishing Qi, modulating blood circulation and relieving the obstruction of collateral vessels. The commonly prescribedformulas are:"Bu Yang Huan Wu decoction","Xue Fu Zhu Yu decoction","Shen Qi Si Wu decoction", etc. We also modify the formula with herbs that can extinguish wind and relieve the obstruction of collateral vessels from active components of insects or other animals.
3.8Multiple sclerosis and neuromyelitis optica:This type of patients also has a deficiency in Qi but the clinical syndrome may show excessiveness. The syndrome is hard to differentiate. It is easy to be misled when determining the status of Qi. Five vital organs may all be affected, mainly in the lung, spleen and kidney."Yu Ping Feng Power" is applicable to patients with this syndrome.
3.9Optic atrophy:The treatment theory is based on "Replenishing vital essence, tonifying kidney-Yin and aggregating Qi". For patients with unknown causes of this type of visual disorders, we focus on "Xuan Fu" to relieve the blockage and upraise Yin to nourish the eyes. Patients maybe treated in various ways depending on the syndrome and possible causes. For patients who have deficiency in kidney-Yin, we will prescribe drugs that can nourish kidney and liver. Thus, the blood and vital essences circulation will be improved to reach the eyes.
4. Innovation and development of treatment theory designed by Dr Gao
By collecting evidence from literature and by investigating ancient clinical cases reported, I proposed several novel treatment theories in the treatment of eye diseases. Until now, by combining my own experience from clinical practice and literature review, many difficult and complicated cases have been successfully cured. My novel treatment theories are as follows.
4.1Inspired by "Shang Han Lun", which proposed that treatment time is critical, such as "Yu Jie Shi" and "Yu Ju Shi", patients who had vernal keratoconjunctivitis were divided into two groups. For the patients who are in the early stage of vernal keratoconjunctivitis, they were diagnosed to have illness in "Shou Tai Yin Fei Jing"."Chuan Jiao Formula" was applied to this group of patients. Patients in the later stage of vernal keratoconjunctivitis were diagnosed to have illness in "Shou Tai Yin Fei" and "Zu Tai Yin Pi"."Fu Zi Li Zhong Pills" were prescribed to this group of patients. Both groups were treated with formulaswith warming functions because this type of eye disease was belong to "Tai Yin" illness. Excellent treatment outcome was achieved by this novel theory.
4.2Chronotherapy on herpes simplex keratitis:Herpes simplex keratitis normally occurs with seasonal rhythm. The24solar terms (i.e. Jie Qi in Chinese) provide a clear indication of seasonal changes. The great changes happen during4solar terms, they are the Spring Equinox, the Autumn Equinox, the Winter Solstice and the Summer Solstice. According to "Shang Han Lun", it is proposed that Yin and Yang are combined on the Winter Solstice and the Summer Solstice but dissociates on the Spring Equinox and the Autumn Equinox. During this four periods of time, diseases develop due to the seasonal change of Yin and Yang combination. Therefore, patients who have recurrent herpes simplex keratitis, were prescribed with "Yu Ping Feng Power" on these four solar terms once the disease was under(out of?) control.The healthy Qi will be enhanced and strengthened; it will prevent the reoccurrence of herpes simplex keratitis.
4.3Correcting the misunderstanding on "Gao Feng Que Mu" and "Gan Xu Que Mu":In modern clinical practice,"Gao Feng Que Mu" is treated as primary pigmentary degeneration of retina."Gan Xu Que Mu" is caused by the lack of vitamin A in children or liver deficiency in adult. There are specific and clear descriptions of these two diseases in "Mi Chuan Yan Ke Long Mu Lun". However, from the Yuan dynasty to the Qing dynasty, or even in modern times, the description and medical case records of these two diseases have become obscure and ambiguous. Misconceptions of these two diseases can be seen in many modern publications. Many citations areimproper. This indicates that critical thinking and cross comparison is required when reading and evaluating ancient literatures on TCM eye disease treatment theories.
[Conclusions]
By exploring extensive TCM classic works and journals, Dr Gao obtained in-depth knowledge of various treatment theories on visual disorders. Nowadays, by applying and practicing these theories acquired, his clinical experience is enhanced and continuously accumulated to make innovative treatment design possible. By using theories of "replenishing qi, elevating yang,and raise the dropping " and "Replenish vital essence, tonify kidney-Yin and aggregate Qi", we have cured many difficult and complicated cases including visual disorders on ocular surface, retina, and nervous system. By randomized controlled clinical trials,"Chuan Jiao Formula" has been proved to be clinically effective for the treatment of allergic conjunctivitis. By learning from my mentor Dr Gao, I have made great progress in the study of TCM theories. My diagnosis skill has also been improved through learning from Dr Gao and continuous practice in the clinic. I hasalso developed some new ideas to further improve therapeutic effectfor visual disorders.
引文
[1]金.李东垣.脾胃论.文魁,丁国华整理.[M].北京：人民卫生出版社,2007.3,27.
[2]张年顺,吴少祯,张海凌.李东垣医学全书[M].北京：中国中医药出版社,2006.5.
[3]高健生,张凤梅,张殷健.论益气升阳举陷与益精升阴敛聚治法[J].中医杂志,2004,45(7)：485-487.
[4]张锡纯著.柳西河重订.医学衷中参西录[M].北京：人民卫生出版社,2007.319,338-342.
[5]祁宝玉.试论《原机启微》的学术思想渊源及影响[J].中国中医眼科杂志,1992,2(3)：179-181.
[6]明·王肯堂著,曹建辉,高慧筠,王赞春,等.证治准绳.眼目集[M].北京：中医古籍出版社,1993.14,106-107.
[7]明·傅仁宇原著,郭君双,赵艳.审视瑶函.北京：人民卫生出版社,2007.44-90.
[8]清·刘耀先著,韦企平,郑金生整理.眼科金镜[M].北京：人民卫生出版社,2006.189-194.
[9]亢泽峰,高健生,巢国俊,等.益气解毒方治疗复发性单纯疱疹病毒性角膜炎的临床观察[J].北京中医药大学学报,2004,27(1).74-76.
[10]李生绍,陈心智点校.黄帝内经灵枢[M].北京：中医古籍出版社,1997,121.
[11]李东垣著.文魁,丁国华整理.兰室秘藏[M].北京：人们卫生出版社,2007.34-35.
[12]李少芳,林卓鹏,林浩.针药结合治疗眼肌型重症肌无力100例疗效观察[J].新中医,2004,36(9)43-44.
[13]赵宜群,袁长新.中西医结合治疗重症眼肌无力27例疗效观察[J].甘肃中医,1998,11(4)：26.
[14]熊丹娟,熊棣书.中西医结合治疗眼型重症肌无力80例[J].湖南中医药导报,2001,7(6)：329.
[15]王宇,王红梅.补中益气汤治疗重症肌无力眼睑下垂36例[J].实用中医药杂志,1996,(4)：11.
[16]孙伯青.加味补中益气汤治疗眼肌型重症肌无力[J].甘肃中医,1996,9(6)：14.
[17]张洪.补中益气汤新用四则[J].实用中医药杂志,2003,19(8)：431.
[18]茅慧娟.补中益气汤治眼疾验案三则[J].上海中医药杂志,1995,(12)：31.
[19]李厚根.升阳益胃汤临证新用验案举隅[J].实用中医内科杂志,2002,16(3)：129.
[20]陈安颖.中药治疗儿童频繁瞬目112例[J].浙江中西医结合杂志.2008,18(9)：578.
[21]鞠景华,刘汉奎.药针并举治疗视力疲劳症20例观察[J].中医函授通讯,1996,(3)：27.
[22]刘自兰.益气聪明汤治疗眼疲劳[J].中西医结合眼科杂志,1994,(4)：242.
[23]杨宏斌.益气聪明汤在眼科的应用[J].北京中医杂志,1989,(4)：32-33.
[24]罗耀红.助阳活血汤加味治疗复发性单纯疱疹性角膜炎41例临床观察[J]..湖南中医学院学报,1998,18(1)：49-50.
[25]赵经梅.助阳活血汤治疗各类角膜炎28例[J].中医杂志,1984,(11).40.
[26]金京丽.补中益气汤在眼科临床的应用[J].长春中医药大学学报,2009,25(6)：856.
[27]王鑫.补中益气汤在眼科的应用[J].中外健康文摘,2009,8(17)：215-216.
[28]喻京生.补中益气汤加减在眼科临床的应用[J].辽宁中医学院学报,1999,1(1)：47.
[29]赵宏范.益气聪明汤加减治疗复发性中心性浆液性脉络膜视网膜病变58例[J].河南中医,2007,27(8)：38.
[1]杨薇,宋剑涛,高健生.益气升阳举陷法在眼科的应用[J].中国中医眼科杂志,2011,21(2)：114-117.
[2]谢立科,童绎,唐由之.视神经萎缩诊断与治疗[M].北京：人民军医出版社,2007.P163-224.
[3]高健生,张凤梅,张殷建.论益气升阳举陷与益精生阴敛聚治法[J].中医杂志,2004,45(7)：485-487.
[4]高健生.导读《秘传眼科龙木论》[J].中国中医眼科杂志,2006,16(4).187-189.
[5]高健生,张丽霞.我国最早的白内障分类法及其临床意义[J].中国中医眼科杂志,2006,16(1).43-44.
[6]张凤梅,高健生,张丽霞.论我国第一部眼科手术著作《秘传眼科龙木论》[J].中华医史杂志,2005,35(3).179-182.
[7]康玮张丽霞高健生.庞赞襄用银柴胡治疗眼病之探讨[J].中国中医眼科杂志,2007,17(4).229-230.
[8]栾兆倩,高健生.《原机启微》《审视瑶函》中将“搏”讹误为“搏”之举证[J].中国中医眼科杂志,2008,18(2).95-96.
[9]刘绍燕,高健生,接传红,等.“强阳搏实阴之病”的探讨及意义[J].辽宁中医杂志,2009,36(5)：719-720.
[10]张殷建,高健生.《证治准绳》对原发性青光眼认识方面的贡献[J].中国中医眼科杂志,2004,14(1).40-41.
[11]接传红,高健生,宋剑涛,等.青风、绿风、黄风内障与闭角型青光眼的辨误[J].中国中医眼科杂志,2010,20(3).178-180.
[12]高健生,王辉.论“六欲”的医学含义及其在临床中的指导意义[J].中医杂志,2010,51(5).474-475.
[13]高健生,接传红,张丽霞,等.刘完素“玄府学说”及其对中医眼科学的指导意义[J].中医杂志,2008,49(7).584-587.
[1]Keane-Myers A. The pathogenesis of allergie conjunctivitis[J].Curr Allergy Asthma Rep,2001,1:550-557.
[2]Pelikan Z. Allergic conjunctivitis and nasal allergy[J]. Curr Allergy Asthma Rep.2010, 10(4):295-302.
[3]宋剑涛,杨薇,高健生,等.川椒方治疗过敏性结膜炎的临床观察[J].中国中医眼科杂志,2010,20(1)：17-19.
[4]李莹,张潇,吕岚,等.过敏性结膜炎的流行病学及奥洛他定滴眼液开放性多中心治疗的初步效果[J].眼科,2008,17(3)：166-170.
[5]Mc Gill JI, Holgate ST, Church MK,et al. Allergic eye disease mechanisms[J]. Br J Ophthalmol,1998,82(10):1203-1214.
[6]Niederkorn JY. Immune regulatory mechanisms in allergic conjunctivitis:insights from mouse models [J]. Curr Opin Allergy Clin Immunol,2008,8(5):472-476.
[7]李素毅.川椒方治疗小鼠变应性结膜炎的实验研究[D].北京：中国中医科学院,2011.
[1]宋剑涛,杨薇,高健生,等.川椒方治疗过敏性结膜炎的临床观察[J].中国中医眼科杂志,2010,20(1).17-19.
[2]宋剑涛,杨薇,高健生,栾兆倩.川椒在变应性疾病中的应用[J].四川中医,2010,28(3)42-43.
[3]尹连荣；高健生.自拟温肾逍遥汤治疗围绝经期干眼症的疗效观察[J].中国中医眼科杂志,2011,21(5).253-255.
[4]杨薇,宋剑涛,尹连荣,等.益气升阳举陷法治疗Meige综合征5例[J].中国中医眼科杂志,2010,20(6)：329-330.
[5]杨薇,童绎,高健生.前部缺血性视神经病变与腔隙性脑梗死的相关研究[J].中国中医眼科杂志,2008,18(3)：134-136.
[6]陈翠翠,高健生.高健生运用培正固本法治疗多发性硬化的临床经验[J].北京中医药,2010,29(1)：25-26.
[7]谢立科,童绎,唐由之.视神经萎缩诊断与治疗[M].北京：人民军医出版社,2007.163-224.
[1]张仲景述,王叔和撰次,钱超尘,郝万山整理.伤寒论[M].北京：人民卫生出版社,2007.19,85.
[2]杨薇,宋剑涛,高健生.高风雀目与肝虚雀目辨误[J].湖南中医药大学学报,2011,31(12)：5-7.
[3]接传红,高健生整理.秘传眼科龙木论[M].北京：人民卫生出版社,2006：29-30.
[4]金礼蒙.医方类聚：校点本,第四分册[M].浙江省中医研究院,湖州中医院,校.北京：人民卫生出版社,1981：126.
[5]傅仁宇,傅维藩.审视瑶函[M].郭君双,赵艳,整理.北京：人民卫生出版社,2006：210-212.
[6]倪维德.原机启微[M].薛己,校.上海：上海卫生出版社,1958：6.7.
[7]王肯堂.证治准绳·眼目集[M].曹建辉,高慧筠,王赞春,等编.北京：中医古籍出版社,1993：158-161.
[8]佚名氏.银海精微[M].郑金生整理.北京：人民卫生出版社,2006：69-70.
[9]黄庭镜.目经大成[M].李怀芝,郑金生,整理.北京：人民卫生出版社,2006：150-151.
[10]刘耀先.眼科金镜[M].韦企平,郑金生,整理.北京：人民卫生出版社,2006：70-74.
[2]张年顺,吴少祯,张海凌.李东垣医学全书[M].北京：中国中医药出版社,2006.5.
[3]高健生,张凤梅,张殷健.论益气升阳举陷与益精升阴敛聚治法[J].中医杂志,2004,45(7)：485-487.
[4]张锡纯著.柳西河重订.医学衷中参西录[M].北京：人民卫生出版社,2007.319,338-342.
[5]祁宝玉.试论《原机启微》的学术思想渊源及影响[J].中国中医眼科杂志,1992,2(3)：179-181.
[6]明·王肯堂著,曹建辉,高慧筠,王赞春,等.证治准绳.眼目集[M].北京：中医古籍出版社,1993.14,106-107.
[7]明·傅仁宇原著,郭君双,赵艳.审视瑶函.北京：人民卫生出版社,2007.44-90.
[8]清·刘耀先著,韦企平,郑金生整理.眼科金镜[M].北京：人民卫生出版社,2006.189-194.
[9]亢泽峰,高健生,巢国俊,等.益气解毒方治疗复发性单纯疱疹病毒性角膜炎的临床观察[J].北京中医药大学学报,2004,27(1).74-76.
[10]李生绍,陈心智点校.黄帝内经灵枢[M].北京：中医古籍出版社,1997,121.
[11]李东垣著.文魁,丁国华整理.兰室秘藏[M].北京：人们卫生出版社,2007.34-35.
[12]李少芳,林卓鹏,林浩.针药结合治疗眼肌型重症肌无力100例疗效观察[J].新中医,2004,36(9)43-44.
[13]赵宜群,袁长新.中西医结合治疗重症眼肌无力27例疗效观察[J].甘肃中医,1998,11(4)：26.
[14]熊丹娟,熊棣书.中西医结合治疗眼型重症肌无力80例[J].湖南中医药导报,2001,7(6)：329.
[15]王宇,王红梅.补中益气汤治疗重症肌无力眼睑下垂36例[J].实用中医药杂志,1996,(4)：11.
[16]孙伯青.加味补中益气汤治疗眼肌型重症肌无力[J].甘肃中医,1996,9(6)：14.
[17]张洪.补中益气汤新用四则[J].实用中医药杂志,2003,19(8)：431.
[18]茅慧娟.补中益气汤治眼疾验案三则[J].上海中医药杂志,1995,(12)：31.
[19]李厚根.升阳益胃汤临证新用验案举隅[J].实用中医内科杂志,2002,16(3)：129.
[20]陈安颖.中药治疗儿童频繁瞬目112例[J].浙江中西医结合杂志.2008,18(9)：578.
[21]鞠景华,刘汉奎.药针并举治疗视力疲劳症20例观察[J].中医函授通讯,1996,(3)：27.
[22]刘自兰.益气聪明汤治疗眼疲劳[J].中西医结合眼科杂志,1994,(4)：242.
[23]杨宏斌.益气聪明汤在眼科的应用[J].北京中医杂志,1989,(4)：32-33.
[24]罗耀红.助阳活血汤加味治疗复发性单纯疱疹性角膜炎41例临床观察[J]..湖南中医学院学报,1998,18(1)：49-50.
[25]赵经梅.助阳活血汤治疗各类角膜炎28例[J].中医杂志,1984,(11).40.
[26]金京丽.补中益气汤在眼科临床的应用[J].长春中医药大学学报,2009,25(6)：856.
[27]王鑫.补中益气汤在眼科的应用[J].中外健康文摘,2009,8(17)：215-216.
[28]喻京生.补中益气汤加减在眼科临床的应用[J].辽宁中医学院学报,1999,1(1)：47.
[29]赵宏范.益气聪明汤加减治疗复发性中心性浆液性脉络膜视网膜病变58例[J].河南中医,2007,27(8)：38.
[1]杨薇,宋剑涛,高健生.益气升阳举陷法在眼科的应用[J].中国中医眼科杂志,2011,21(2)：114-117.
[2]谢立科,童绎,唐由之.视神经萎缩诊断与治疗[M].北京：人民军医出版社,2007.P163-224.
[3]高健生,张凤梅,张殷建.论益气升阳举陷与益精生阴敛聚治法[J].中医杂志,2004,45(7)：485-487.
[4]高健生.导读《秘传眼科龙木论》[J].中国中医眼科杂志,2006,16(4).187-189.
[5]高健生,张丽霞.我国最早的白内障分类法及其临床意义[J].中国中医眼科杂志,2006,16(1).43-44.
[6]张凤梅,高健生,张丽霞.论我国第一部眼科手术著作《秘传眼科龙木论》[J].中华医史杂志,2005,35(3).179-182.
[7]康玮张丽霞高健生.庞赞襄用银柴胡治疗眼病之探讨[J].中国中医眼科杂志,2007,17(4).229-230.
[8]栾兆倩,高健生.《原机启微》《审视瑶函》中将“搏”讹误为“搏”之举证[J].中国中医眼科杂志,2008,18(2).95-96.
[9]刘绍燕,高健生,接传红,等.“强阳搏实阴之病”的探讨及意义[J].辽宁中医杂志,2009,36(5)：719-720.
[10]张殷建,高健生.《证治准绳》对原发性青光眼认识方面的贡献[J].中国中医眼科杂志,2004,14(1).40-41.
[11]接传红,高健生,宋剑涛,等.青风、绿风、黄风内障与闭角型青光眼的辨误[J].中国中医眼科杂志,2010,20(3).178-180.
[12]高健生,王辉.论“六欲”的医学含义及其在临床中的指导意义[J].中医杂志,2010,51(5).474-475.
[13]高健生,接传红,张丽霞,等.刘完素“玄府学说”及其对中医眼科学的指导意义[J].中医杂志,2008,49(7).584-587.
[1]Keane-Myers A. The pathogenesis of allergie conjunctivitis[J].Curr Allergy Asthma Rep,2001,1:550-557.
[2]Pelikan Z. Allergic conjunctivitis and nasal allergy[J]. Curr Allergy Asthma Rep.2010, 10(4):295-302.
[3]宋剑涛,杨薇,高健生,等.川椒方治疗过敏性结膜炎的临床观察[J].中国中医眼科杂志,2010,20(1)：17-19.
[4]李莹,张潇,吕岚,等.过敏性结膜炎的流行病学及奥洛他定滴眼液开放性多中心治疗的初步效果[J].眼科,2008,17(3)：166-170.
[5]Mc Gill JI, Holgate ST, Church MK,et al. Allergic eye disease mechanisms[J]. Br J Ophthalmol,1998,82(10):1203-1214.
[6]Niederkorn JY. Immune regulatory mechanisms in allergic conjunctivitis:insights from mouse models [J]. Curr Opin Allergy Clin Immunol,2008,8(5):472-476.
[7]李素毅.川椒方治疗小鼠变应性结膜炎的实验研究[D].北京：中国中医科学院,2011.
[1]宋剑涛,杨薇,高健生,等.川椒方治疗过敏性结膜炎的临床观察[J].中国中医眼科杂志,2010,20(1).17-19.
[2]宋剑涛,杨薇,高健生,栾兆倩.川椒在变应性疾病中的应用[J].四川中医,2010,28(3)42-43.
[3]尹连荣；高健生.自拟温肾逍遥汤治疗围绝经期干眼症的疗效观察[J].中国中医眼科杂志,2011,21(5).253-255.
[4]杨薇,宋剑涛,尹连荣,等.益气升阳举陷法治疗Meige综合征5例[J].中国中医眼科杂志,2010,20(6)：329-330.
[5]杨薇,童绎,高健生.前部缺血性视神经病变与腔隙性脑梗死的相关研究[J].中国中医眼科杂志,2008,18(3)：134-136.
[6]陈翠翠,高健生.高健生运用培正固本法治疗多发性硬化的临床经验[J].北京中医药,2010,29(1)：25-26.
[7]谢立科,童绎,唐由之.视神经萎缩诊断与治疗[M].北京：人民军医出版社,2007.163-224.
[1]张仲景述,王叔和撰次,钱超尘,郝万山整理.伤寒论[M].北京：人民卫生出版社,2007.19,85.
[2]杨薇,宋剑涛,高健生.高风雀目与肝虚雀目辨误[J].湖南中医药大学学报,2011,31(12)：5-7.
[3]接传红,高健生整理.秘传眼科龙木论[M].北京：人民卫生出版社,2006：29-30.
[4]金礼蒙.医方类聚：校点本,第四分册[M].浙江省中医研究院,湖州中医院,校.北京：人民卫生出版社,1981：126.
[5]傅仁宇,傅维藩.审视瑶函[M].郭君双,赵艳,整理.北京：人民卫生出版社,2006：210-212.
[6]倪维德.原机启微[M].薛己,校.上海：上海卫生出版社,1958：6.7.
[7]王肯堂.证治准绳·眼目集[M].曹建辉,高慧筠,王赞春,等编.北京：中医古籍出版社,1993：158-161.
[8]佚名氏.银海精微[M].郑金生整理.北京：人民卫生出版社,2006：69-70.
[9]黄庭镜.目经大成[M].李怀芝,郑金生,整理.北京：人民卫生出版社,2006：150-151.
[10]刘耀先.眼科金镜[M].韦企平,郑金生,整理.北京：人民卫生出版社,2006：70-74.