糖尿病视网膜病变虚-瘀-痰病机演变及防治思路

糖尿病视网膜病变是糖尿病常见并发症之一,致盲率高,严重影响患者生活质量。随着病程进展,患者眼底病变由轻度非增殖性病变到中度非增殖性病变再到重度非增殖性病变,最后到增殖性病变,其中医病机也相应存在着虚-瘀-痰的演变过程。本病病变以脾、肾、肝为主,其中脾虚为本病发病之本,脾虚日久及肾,导致脾肾两虚,肝肾同源,肾虚致肝阴肝血不足,目失所养,导致视物模糊等一系列症状。致病因素以瘀血、痰浊为主,脏气虚推动无力则血瘀,血瘀气滞,气滞水停日久化为痰浊,后期则痰瘀互结。本病防治根据其不同发展阶段分别以补虚、化瘀、消痰为治则,辨证用药,临床效果良好,可以明显改善患者眼部症状以及全身症状。

Pathogenesis Progression,Prevention and Treatment Ideas of Deficiency,Blood Stasis and Phlegm in Diabetic Retinopathy

Diabetic retinopathy is a common complication of diabetes and it can cause blindness and seriously affecting the life quality. The disease can be divided into mild,moderate to severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. There is pathogenesis progression of deficiency,blood stasis and phlegm. Pathological changes of the disease lie in the spleen,kidney and liver,among which the spleen is the root of the disease. Spleen Qi deficiency leads to kidney Qi deficiency,the liver and the kidney share the same origin causing liver Yin and blood deficiency,failure to nourish eyes leading to symptoms such as blurred vision. Pathogenic factors mainly include phlegm and blood stasis. Zang Qi deficiency failing to propel resulting in blood stasis,Qi stagnation and water accumulation transforming into phlegm. Prevention and treatment principles of the disease are tonifying deficiency,resolving blood stasis and phlegm according to different stages and syndrome differentiation with good effects and can improve the ocular and systemic symptoms of patients.