摘要
Abstract
Diabetic macular edema(DME)is a common and serious complication of diabetic retinopathy.The damage of blood-retinal barrier caused by retinal microvascular injury in patients leads to the accumulation of extracellular fluid in the macular area,retinal thickening or hard exudation deposition.As the most sensitive part of vision,macular area will have a serious impact on vision once edema occurs,and multiple recurrences may cause structural damage to the macular area.DME is a common cause of vision loss and even blindness in diabetic patients,and its treatment has always attracted much attention.The disease has the characteristics of easy recurrence and long course,and the cost of Western medicine treatment is expensive with poor control rate.In view of this situation,TCM classical theory and clinical practice can be used to explore the diagnosis and treatment of DME.The theory of"body fluid participates in blood generation by the transfusion of meridians"comes from ZHANG Ji's Shanghan Lun(《伤寒论》),and explains the process of water and body fluid entering the meridians to generate blood.Water and body fluid will form pathological products such as phlegm and blood stasis on condition that they can not enter the meridians to generate blood smoothly.These pathological products remain in the macular area and hinder the normal operation of blood,resulting in the mutual accumulation of water and blood stasis,and thus causing edema.Based on this theory and in combination with the etiology and pathogenesis of diabetes,Professor XIA Qingyan believes that the diagnosis and treatment of DME should start from diabetes,that the role of spleen and stomach,kidney,and Yingwei(营卫)during the process of"water entering the meridians"should be emphasized,and that DME should be understood from the aspects of blood stasis and water.The treatment follows the principles of invigorating spleen and replenishing Qi(气),promoting blood circulation to remove blood stasis,and warming Yang(阳)and tonifying kidney.The method of activating blood and promoting diuresis has achieved good clinical effects in the treatment of DME,which provides a reference for the diagnosis and treatment of diabetic macular edema in TCM.关键词
糖尿病/糖尿病性黄斑水肿/活血利水法/水入于经/血水Key words
Diabetes mellitus/Diabetic macular edema/Activating blood and promoting diuresis method/Water enters meridians/Bloody water分类
医药卫生
