王育良教授以“疏肝理气化瘀法”论治糖尿病视网膜病变思路探析

Exploration of Professor Wang Yuliang's Insights into the Treatment of Diabetic Retinoathy Using the "Soothing the Liver, Regulating Qi, and Resolving Stasis Method"

  • 摘要: 总结王育良教授应用“疏肝理气化瘀法”治疗糖尿病视网膜病变(Diabetic retinopathy,DR)的临证经验。王教授基于肝与目在生理上密切关联、病理上相互影响的理论基础,结合视网膜病变的病理特点,认为肝气郁滞是DR发生的始动因素,气滞血瘀、络脉瘀阻为DR的核心病理环节。气滞血瘀日久,化火伤阴,灼伤脉络,炼液成痰,导致肝肾阴虚、痰瘀互结、多重病理因素叠加。治疗应以“疏肝理气化瘀”之法贯穿始终,并根据DR不同时期的病机变化配合补益肝肾、凉血止血、化痰利湿等法,在疏肝理气的同时,祛除瘀、痰、热等邪实,从而恢复视网膜生理功能,为DR的临床诊治提供新思路。

     

    Abstract: This article summarizes Professor Wang Yuliang's clinical experience using the "soothing the liver, regulating qi, and resolving stasis method" in the treatment of diabetic retinopathy (DR). Based on the theoretical foundation of the close physiological connection and pathological influence between the liver and eyes, and incorporating the pathological characteristics of retinal disease, Professor Wang believes that liver qi stagnation is the initiating factor in DR, with qi stagnation and blood stasis, as well as obstruction of the collateral vessels, as the core pathological components of DR. Qi stagnation and blood stasis transform into fire over time, damaging yin, burning the collaterals, and transforming fluid into phlegm, leading to liver and kidney yin deficiency, the intertwining of phlegm and stasis, and the superposition of multiple pathological factors. Treatment should consistently adhere to the principle of "soothing the liver, regulating qi, and removing stasis". Based on the pathological changes of DR at different stages, treatment should incorporate liver and kidney tonification, cooling blood and stopping bleeding, and resolving phlegm and dampness. While soothing the liver and regulating qi, it can also dispel pathogenic factors such as stasis, phlegm, and heat, thereby restoring retinal function. This provides new insights into the clinical diagnosis and treatment of DR.

     

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