基于宏观与微观辨证相结合的“眼底脏腑辨证”探讨眼底视网膜病变

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摘要由于古代中医眼科医家无法窥见眼底，传统的宏观辨证及整体观念局限性较大，因此眼底病的中医药治疗效果往往不甚理想。随着现代视网膜成像技术及现代生物技术的飞速发展，医家能够清晰了解视网膜形态结构及功能的变化，使眼底病的微观辨证成为可能。传统宏观辨证与采用现代医学技术进行的微观辨证相结合的综合诊疗模式，有助于在中医眼科临床实践中把握核心病机，进行精准治疗。运用新的辨证论治方法，结合经典中医眼科五轮学说、六经辨证、“内五轮”假说等思路，基于宏观与微观辨证相结合的“眼底脏腑辨证”有望成为现代眼底视网膜病变的辨证体系，加深对眼底视网膜病变的理解、认识，并提高中医眼科医家的临床诊疗水平。

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	陆秉文1
	2 谢立科2 吴改萍2 赵健1 袁航2

关键词 ：宏观辨证, 五轮学说, 微观辨证, 六经辨证, &ldquo, 内五轮&rdquo, 假说, 现代视网膜成像技术, 眼底脏腑辨证, 眼底视网膜病变

Abstract：Because ancient traditional Chinese medicine (TCM) ophthalmologists are unable to see the fundus, traditional macroscopic syndrome differentiation and the holistic concept are greatly limited, so the curative effects of TCM therapies for retinal diseases are not ideal. With the rapid development of modern retinal imaging technology and modern biotechnology, ophthalmologists can clearly understand retinal morphological and functional changes, which makes it possible to differentiate retinal diseases microscopically. The comprehensive diagnosis and treatment mode of traditional macro-syndrome differentiation combined with micro-syndrome differentiation by modern medical technology is helpful to grasp the core pathogenesis and carry out precise treatment in the clinical practice of TCM ophthalmology. By using the new method of syndrome differentiation and treatment, combined with the classical ophthalmology five-wheel theory, syndrome differentiation of six channels theory and “inner five-wheel” hypothesis, the “fundus viscera syndrome differentiation” based on the combination of macro and micro syndrome differentiation is expected to become the modern syndrome differentiation system for fundus retinopathy, deepen the understanding of fundus retinopathy, and imove the clinical diagnosis and treatment level of TCM ophthalmologists.

Key words： Macro differentiation Five wheel-theory Micro differentiation Syndrome differentiation of six channels theory “inner five-wheel&rdquo hypothesis Modern retinal imaging technology Fundus viscera syndrome differentiation Fundus retinopathy

基金资助:中国博士后科学基金面上项目（2019M650987）。

通讯作者: 谢立科（1964.2-），男，硕士，主任医师；研究方向：中西医结合治疗玻璃体视网膜病及眼外伤病。

作者简介: 陆秉文（1988.1-），女，博士，博士后；研究方向：中西医结合治疗视网膜病及视网膜影像功能学分析。

引用本文:

陆秉文1,2 谢立科2 吴改萍2 赵健1 袁航2. 基于宏观与微观辨证相结合的“眼底脏腑辨证”探讨眼底视网膜病变[J]. 中国医药导报, 2021, 18(27): 134-137,145.
LU Bingwen1,2 XIE Like2 WU Gaiping2 ZHAO Jian1 YUAN Hang2. Investigation on the fundus retinopathy with “fundus viscera syndrome differentiation” based on the combination of macro and micro syndrome differentiation. 中国医药导报, 2021, 18(27): 134-137,145.

链接本文:

https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I27/134

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