基于五轮八廓学说治疗视网膜静脉阻塞之思路初探

Abstract

視網膜靜脈阻塞（RVO）是眼科臨床常見的視網膜血管性疾病,由視網膜靜脈血流阻塞所致,其繼發的黃斑水腫（ME）已成為導致RVO患者視力受損的重要原因。保護患者黃斑區視功能對提高患者的治療效果及生存質量具有重要意義。目前臨床一線治療方法抗血管內皮生長因子（VEGF）藥物玻璃體腔注射雖短期療效顯著,但ME易復發,需多次反復用藥,增加了患者的經濟負擔及手術風險,且治標而未治本。本文結合中醫眼科傳統'五輪八廓'學說,在傳統中醫理論基礎上傳承發展,從整體的角度看待視網膜血管病,創新提出'黃斑八廓'假說。借助現代眼科檢測設備,從分析RVO繼發黃斑周圍區域視功能損傷的中醫發病機理等方面,淺析基于臟腑辨證、生物全息律,個體化治療RVO的思路。

Retinal vein occlusion (RVO) is a common retinal vascular disease in ophthalmol ogy caused by obstruction of retinal veins. Macular edema (ME) secondary to RVO has become an important cause of visual impairment in patients with RVO. Thus, protecting the macular function of RVO patients is of great significance to improve the treatment effect and quality of life. Anti-vas cular endothelial growth factor intravitreal injection is the current first-line clinical treatment method for ME secondary to RVO. Although it has a significant short-term effect, ME is prone to re cur, thus repeated injections are required, which increases the economic burden and surgical risk of the patients. This therapy only treats the symptoms but not the root causes of RVO. This article com bined the traditional 'five rings and eight regions' theories of Traditional Chinese Medicine (TCM) in ophthalmology, inherited and developed the theoretical basis of TCM and raised the 'eight regions of the macula' hypothesis creatively to investigate retinal vascular disorders from a holistic perspec tive. With the help of modern ophthalmological imaging technologies, we analyzed the pathogenesis of retinal functional impairment in the macular area in RVO eyes and discussed the individualized treat ment therapies based on syndrome differentiation of the viscera and the bio-holographic law.