| 引用本文: |
宋旭东, 余怡嫔, 李江伟, 彭俊, 彭清华.从水郁论治原发性开角型青光眼[J].湖南中医药大学学报,2025,45(8):1532-1536[点击复制] |
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| 从水郁论治原发性开角型青光眼 |
| 宋旭东,余怡嫔,李江伟,彭俊,彭清华 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药大学第一附属医院眼科, 湖南 长沙 410007) |
| 摘要: |
| 原发性开角型青光眼以小梁网阻滞、房水代谢异常引起眼压升高为发病的直接原因，神水瘀积属“水郁”范畴，与肺、脾、肾、肝功能异常息息相关，病机总结为邪犯肺郁，玄府闭塞；脾失健运，水湿上泛；肾失气化，主水无权；肝失疏泄，血瘀水停。根据形成水郁的不同病机，基于中医学调水在肺、制水在脾、主水在肾、疏泄在肝的理论基础，拟以宣肺利水、健脾运水、固肾培元、活血利水的治疗法则，使房水得利、水郁得消、气机得行、血运得通，以降低眼压，减轻原发性开角型青光眼视神经损伤。 |
| 关键词: 原发性开角型青光眼 玄府 水郁 宣肺 健脾 固肾 活血 |
| DOI：10.3969/j.issn.1674-070X.2025.08.020 |
| 投稿时间：2025-06-03 |
| 基金项目: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);国家自然科学基金项目(82274588);湖南省研究生科研创新项目(CX20240731);湖南中医药大学研究生创新课题(2024CX040) |
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| Treatment of primary open-angle glaucoma based on the theory of water stagnation |
| SONG Xudong, YU Yipin, LI Jiangwei, PENG Jun, PENG Qinghua |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Department of Ophthalmology, the First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Primary open-angle glaucoma（POAG） is directly caused by elevated intraocular pressure（IOP） resulting from trabecular meshwork obstruction and abnormal aqueous humor metabolism. In Chinese medicine, the stagnation of aqueous humor is categorized as "water stagnation", which is closely related to dysfunctions of the lung, spleen, kidney, and liver. The pathogenesis can be summarized as follows: pathogenic invasion leading to lung stagnation and obstruction of the "mysterious mansion（Xuanfu）";loss of splenic transportation causing upward movement of water-dampness; loss of kidney qi transformation resulting in impaired governance of water; loss of liver governance of free flow of qi causing blood stasis and water retention. According to the different mechanisms underlying water stagnation, and based on the Chinese medicine theories of water regulation by the lung, water restraint by the spleen, water governance by the kidney, and governance of the free flow of qi by the liver, the proposed treatment principles are: diffusing the lung and draining water retention, strengthening the spleen and facilitating water transformation,tonifying the kidney and nourishing the origin, and promoting blood circulation and water metabolism. These approaches aim to facilitate the outflow of aqueous humor, resolve water stagnation, restore the flow of qi, and improve blood circulation, thereby lowering the IOP and alleviating optic nerve damage in POAG. |
| Key words: primary open-angle glaucoma mysterious mansion（Xuanfu） water stagnation diffusing the lung strengthening the spleen tonifying the kidney promoting blood circulation |
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