[关键词]
[摘要]
总结关国华教授辨治岭南地区中心性浆液性脉络膜视网膜病变(CSC)的临证思路。关国华教授根据“黄斑属脾”理 论,同时结合岭南地区的地域、气候和人群体质特征,提出脾虚湿困是岭南地区CSC发病的根本病机,CSC中后期则逐渐累 及肝肾,可致血瘀水停。治疗CSC发病之初,重在治脾,方药采用二陈汤为基础方加减以健脾利湿;中后期则强调肝脾肾 同治,水血同治,方药以驻景丸合五苓散为基础方,补益肝肾,健脾活血利水。倡导治脾贯穿治疗全程,同时随证化裁、 用药通权达变,以收显效。
[Key word]
[Abstract]
This article summarized Professor GUAN Guo-Hua’s clinical experience in treating central serous chorioretinopathy(CSC)in Lingnan area. Based on the theory of“macula due to the spleen dysfunction”,and by taking the geographical and climatic characteristics of Lingnan area as well as the body constitutional features of Lingnan residents into account, Professor GUAN Guo- Hua proposed that spleen deficiency leading to damp encumbrance was the fundamental pathogenesis of CSC in Lingnan area, and liver and kidney were gradually affected in the middle and late stages of CSC,which finally resulted into blood stasis and water retention. For the treatment of initial attack of CSC,the focus was on treating the spleen,and Erchen Decoction was adopted as the basic prescription for modified application to strengthen the spleen and drain dampness;for the treatment of CSC in the middle and late stages,the emphasis was on simultaneous treatment of the liver,spleen and kidney as well as blood and water,and Zhujing Pills and Wuling Powder were adopted as the basic prescriptions for nourishing the liver and kidney and for strengthening the spleen,activating blood and promoting urination. The treatment of the spleen is advocated throughout the whole treatment process,and the medication of drugs should be modified based on syndrome differentiation and according to the specific conditions,thus to achieve significant results.
[中图分类号]
R276.774
[基金项目]
国家中医药管理局专病专科循证能力提升项目(编号:2019XZZX-YK003)