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中医药治疗糖尿病视网膜病变的研究进展 被引量:4

A review on treating diabetic retinopathy in traditional Chinese medicine
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摘要 糖尿病视网膜病变是糖尿病常见的微血管并发症之一,相当于中医学“视瞻昏渺”“雀目”等范畴,现代中医称之为“消渴目病”。糖尿病视网膜病变严重危害患者的身心健康,是造成失明的主要原因之一。对于糖尿病视网膜病变的防治是现代医学及中医学研究的热点及重点。现代医学对糖尿病视网膜病变的发病机制尚未完全阐明,其生理病理复杂,各种机制之间存在不可分割的相关性。目前认为与血管内皮生长因子上调诱发新生血管形成,氧化应激,炎性反应,血流动力学改变,血糖、血脂等代谢机制异常等因素有关。目前国内外治疗糖尿病视网膜病变除控制血糖外,尚无特别有效的药物和方法,西医多采用纠正代谢紊乱、视网膜激光光凝术、玻璃体切割术等治疗方式,但存在不良反应大、经济负担重等不足之处。近年来随着中医药事业的不断发展,中药治疗糖尿病视网膜病变的经验日益丰富,且具有个体化、整体观等优势。因此,文章从糖尿病视网膜病变的病因病机、辨证分型以及中医药治疗等方面进行探讨,并列举导师以经验方清肝明视汤治疗糖尿病视网膜病变验案一则,以期为糖尿病视网膜病变的治疗提供更多思路及方向,进一步推动中西医结合治疗糖尿病视网膜病变的发展。 Diabetes retinopathy(DR)is one of the common microvascular complications of diabetes,which is equivalent to“blind sight”and“birds’eye”in traditional Chinese medicine.It is known as“diabetes eye disease”in modern traditional Chinese medicine.DR is one of the main causes of blindness,which seriously endangers the physical and mental health of patients.The prevention and treatment of diabetes retinopathy is the focus of modern medicine and traditional Chinese medicine.Modern medicine has not fully elucidated the pathogenesis of DR,its physiology and pathology are complex,and there is an inseparable correlation between various mechanisms.Currently,it is considered that it is related to factors such as neovascularization induced by up regulation of vascular endothelial growth factor,oxidative stress,inflammatory response,hemodynamic changes,abnormal metabolic mechanisms such as blood glucose and blood lipid,etc.At present,there are no particularly effective drugs and methods for the treatment of DR at home and abroad except the control of blood glucose.Western medicine mostly adopts the treatment methods such as correcting metabolic disorders,retinal laser photocoagulation and vitrectomy,but there are many shortcomings such as large adverse reactions and heavy economic burden.In recent years,with the continuous development of traditional Chinese medicine,the experience of treating DR in traditional Chinese medicine has become increasingly rich,and it has the advantages of individualization,holistic view and so on.Therefore,this paper discusses the etiology,pathogenesis,syndrome differentiation and TCM treatment of diabetic retinopathy,and lists an empirical case of the treatment of diabetic retinopathy with the Qinggan Mingshi decoction(清肝明视汤)by the mentor,with a prospect of providing more ideas and direction for the treatment of diabetic retinopathy,and further promote the development of the integrative medicine in the treatment of diabetic retinopathy.
作者 刘梦伟 鲍新颖 王烁 王元松 王晓蕴 张忠勇 LIU Mengwei;BAO Xinyin;WANG Shuo;WANG Yuansong;WANG Xiaoyun;ZHANG Zhongyong
出处 《中医临床研究》 2022年第36期45-47,共3页 Clinical Journal Of Chinese Medicine
基金 中国民族医药学会科研项目(2020ZY118-580101) 河北省中医药管理局中医药科研计划项目(2020515、2021349) 河北省王元松名中医工作室支持项目。
关键词 糖尿病性视网膜病变 消渴目病 中医药 综述 Diabetic retinopathy Diabetes eye disease Traditional Chinese medicine Review
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