目系病中医证治规律探究.pdfVIP

提 要 目的：通过对视神经炎、缺血性视神经病变以及视神经萎缩等常见目系病的文献 及临床回顾性研究，探讨目系病相关经络及脏腑病机特点，进而发现其证型规律及诊 疗思路。方法：1. 现代中医文献的回顾性研究：整理分析现代中医文献中上述常见 目系病的致病因素、辨证、用药及治疗结果。2. 中医临床病例的回顾性研究：收集 常见目系病的临床病例 61 例，分析并比较其病程、证型、用药特点、疗效差异，以 及证型与病程、证型与疗效的关系。结果：视神经炎早期病位在肝，主要表现为气机 失调，后期多表现为肝肾亏虚；治以疏肝解郁、和血理气、滋阴降火、补益气血，着 重调理肝肾，并注重理气化瘀；有外感者可应用解表药。缺血性视神经病变发病年龄 较大，多属本虚标实，与心、肝、肾功能失调有关；治疗重在活血化瘀，兼以滋补肝 肾，填精养血明目。视神经萎缩辨证可分虚实两方面，亦常见虚实夹杂；治疗中补益 药用量最大，兼有活血化瘀，着眼于“郁（瘀）”、“虚”两方面。视神经萎缩病程较 长，缺血性视神经病变与视神经炎病程无明显差别。各病相同证型间，病程无明显差 别。视神经萎缩疗效相对较差，缺血性视神经病变与视神经炎疗效无明显差别。各病 常见的相同证型间，疗效没有明显差别。结论：目系病与肝的关系最为密切，论治时 可在结合整体审因辨证和局部微观辨证的基础上，重视从经络脏腑的关系入手，早期 病在气在血者从肝心论治，虚者从肝肾论治，注重调理肝肾及心肾制化。对于有外邪 侵袭者，可从膀胱经论治。此外，开通玄府应贯穿于目系病治疗全过程。 关键词 目系病；证型；治疗思路；文献 The Study on TCM Syndrome and Treatment Regularity of Ocular Connectors Disease Specialty: Ophthalmology of Traditional Chinese Medicine Student: Han Guanyu Tutor: Prof. Lv lu Abstract Objective: Based on retrospective study of literature and clinical of the common ocular connectors diseases, such as optic neuritis, ischemic optic neuropathy and optic atrophy, explore the pathogenic feature of the meridian and viscera related to ocular connectors diseases, to find syndrome pattern rule and diagnosis treatment theory of the ocular connectors diseases. Methods: I. A retrospective study of contemporary literature: processing and analysis of the contemporary literature related to the pathogenic factors, differentiation, medicating and the therapeutic result of the common ocular connectors diseases. II. A retrospective study of clinical cases: analysis and comparison between the differences of the disease courses, syndrome pattern, feature of medicating, efficac