| 引用本文: |
钟缘, 吕怡, 汤钰, 彭俊, 杨毅敬, 周亚莎, 殷淑婷, 彭清华.彭清华教授基于“血不利则为水”分期论治原发性开角型青光眼经验[J].湖南中医药大学学报,2026,46(1):174-179[点击复制] |
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| 彭清华教授基于“血不利则为水”分期论治原发性开角型青光眼经验 |
| 钟缘,吕怡,汤钰,彭俊,杨毅敬,周亚莎,殷淑婷,彭清华 |
| (湖南中医药大学, 湖南 长沙 410208;湖南省中医药防治眼耳鼻咽喉疾病与视功能保护工程技术研究中心, 湖南 长沙 410208;湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| “血不利则为水”出自张仲景《金匮要略》，由此衍生的活血利水法被广泛运用于肾脏疾病、妇科疾病、水肿病、眼科疾病的治疗。彭清华教授认为，脉络瘀滞、玄府闭塞、神水瘀积是原发性开角型青光眼的核心病机，血瘀水停贯穿疾病全程，属气血水同病，但不同时期病机侧重不同，主张根据疾病分期论治：早期以“气不运”为主，重在疏肝活血利水，予以逍遥散加减；进展期以“水不利”为主，重在祛邪活血利水，予以温胆汤合五苓散加减；晚期以“血不利”为主，虚瘀并见，重在补虚活血利水，予以青光安颗粒剂或青光安Ⅱ号方加减。 |
| 关键词: 原发性开角型青光眼 “血不利则为水” 活血利水 《金匮要略》 青光安 |
| DOI：10.3969/j.issn.1674-070X.2026.01.025 |
| 投稿时间：2025-09-08 |
| 基金项目:国家自然科学基金项目（82274588，81874492，82575150）；国家中医药管理局人才支持项目-岐黄学者（国中医药人教函〔2022〕6号）；第七批全国老中医药专家学术经验继承工作项目（国中医药人教函〔2022〕76号）；湖南省自然科学基金高校联合基金重点项目（2025JJ90004）；湖南省重点研发计划项目（2024JK2122）；湖南省重点研发计划项目（湘科计〔2024〕21号）；中药粉体与创新药物省部共建国家重点实验室培育基地开放基金（23PTKF1001）。 |
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| Professor PENG Qinghua's experience in stage-based treatment of primary open-angle glaucoma based on the theory of "stagnant blood leading to water retention" |
| ZHONG Yuan, LYU Yi, TANG Yu, PENG Jun, YANG Yijing, ZHOU Yasha, YIN Shuting, PENG Qinghua |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Hunan Engineering Technology Research Center for Prevention & Treatment of Ophthalmology and Otolaryngology Diseases and Visual Function Protection with Chinese Medicine, Changsha, Hunan 410208, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| The theory of "stagnant blood leads to water retention" originates from Jin Gui Yao Lue (Essentials from the Golden Cabinet) by ZHANG Zhongjing. The blood-activating and water-draining method derived from this theory is widely applied in the treatment of renal, gynecological, edema, and ophthalmic diseases. Professor PENG Qinghua believes that the core pathogenesis of primary open-angle glaucoma lies in collateral stagnation, closure of the mysterious mansion, and accumulation of aqueous humour due to blood stasis. Blood stasis and water retention persist throughout the entire course of the disease, representing a concurrent disorder of qi, blood, and water. However, the emphasis of pathogenesis varies in different stages. He advocates for stage-based treatment: In the early stage, the main issue is "qi stagnation," with a focus on soothing the liver, activating blood, and draining water, using modified Xiaoyao Powder; in the progressive stage, the predominant problem is "water retention," with an emphasis on eliminating pathogenic factors, activating blood, and draining water, employing modified Wendan Decoction combined with Wuling Powder; and in the advanced stage, the main manifestation is "blood stagnation," characterized by a combination of deficiency and stasis. The treatment prioritizes tonifying deficiency, activating blood, and draining water, using Qingguang'an Granules or modified Qingguang'an II Formula. |
| Key words: primary open-angle glaucoma "stagnant blood leads to water retention" activating blood circulation and draining water Jin Gui Yao Lue (Essentials from the Golden Cabinet) Qingguang'an |
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