陳向東教授運(yùn)用桂枝茯苓丸加味治療糖尿病黃斑水腫經(jīng)驗

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〔摘要〕 陳向東教授通過長期臨床經(jīng)驗結(jié)合微觀辨證理論得出，糖尿病黃斑水腫的病機(jī)特點為消渴耗氣，氣虛不運(yùn)，陽氣郁滯，血瘀視衣，病程日久，水濕停聚，痰濕內(nèi)生，痰瘀互結(jié)，發(fā)為水腫，故以“通陽解郁，活血利水”為治療原則，化裁經(jīng)方桂枝茯苓丸臨證加減，為治療糖尿病黃斑水腫提供新的治療思路。

〔關(guān)鍵詞〕 糖尿病視網(wǎng)膜病變；糖尿病黃斑水腫；微觀辨證；痰瘀互結(jié)；活血利水法；桂枝茯苓丸

〔中圖分類號〕R276         〔文獻(xiàn)標(biāo)志碼〕A          〔文章編號〕doi：10.3969/j.issn.1674－070X.２０24.06.017

Professor CHEN Xiangdong's experience in treating diabetic macular edema with modified Guizhi Fuling Pill

GUO Xinyi1， HUANG Longrong1， GUO Yonghong3， CHEN Xiangdong1，2*

1. The First Clinical School of Chinese Medicine， Hunan University of Chinese Medicine， Changsha， Hunan 410007， China;

2. Hunan University of Chinese Medicine， Changsha， Hunan 410208， China; 3. Hengyang Hospital of Chinese Medicine， Hengyang， Hunan 421000， China

〔Ａｂｓｔｒａｃｔ〕 Professor CHEN Xiangdong， based on long-term clinical experience and microscopic pattern differentiation theory， concluded that the pathogenesis of diabetic macular edema （DME） is characterized by qi deficiency， which is due to wasting thirst disorder， failing in transportation， stagnation of yang qi， blood stasis in the retina， retention of water-dampness in a prolonged disease course leading to endogenous phlegm-dampness， and， finally， intertwined phlegm and blood stasis. Therefore， taking "activating yang to relieve stagnation， and circulating blood and draining water retention" as the therapeutic principle， the classic formula Guizhi Fuling Pill is applied and modified according to different clinical conditions. This paper aims to provide a new therapeutic idea for the treatment of DME.

〔Ｋｅｙｗｏｒｄｓ〕 diabetic retinopathy; diabetic macular edema; microscopic pattern differentiation; intertwined phlegm and blood stasis; circulating blood and draining water retention; Guizhi Fuling Pill

糖尿病黃斑水腫（diabetic macular edema， DME）是造成糖尿病視網(wǎng)膜病變患者視力損害的最常見原因之一，75%糖尿病視網(wǎng)膜病變致盲患者合并有DME[1-2]。（剩余8731字）