络病理论指导糖尿病性视网膜病变理论探析
Theoretical Exploration of Diabetic Retinopathy Guided by Luobing Theory
常丽萍 1马静 2马坤 2贾振华 3魏聪4
作者信息
- 1. 络病理论创新转化全国重点实验室,石家庄 050035
- 2. 河北以岭医药研究院,国家中医药管理局重点研究室(心脑血管络病),石家庄 050035
- 3. 河北以岭医院,石家庄 050091
- 4. 络病理论创新转化全国重点实验室,石家庄 050035;河北以岭医药研究院,国家中医药管理局重点研究室(心脑血管络病),石家庄 050035
- 折叠
摘要
糖尿病性视网膜病变(DR)作为糖尿病最常见和严重的微血管并发症之一,严重威胁着人类健康,其属中医学"消渴目病"范围,历代医家临证经验虽丰富,然而多为零散记载且未开展系统研究.DR病程较长、反复发作、迁延难愈,属"久病入络"范畴.系统构建中医络病理论指导该病防治具有重要临床价值,该文基于脉络末端之孙络与微血管、微循环密切相关性,提出"孙络-微血管"概念,指出DR属"孙络-微血管"病变范畴,呈现孙络瘀阻、绌急、滋生、出血等4类微观病理特征.总结出"气阴两虚"是该病基本病机,"血瘀络阻"是重要病机和关键因素,从而确立"化瘀通络、益气养阴、止血明目"治法,制订通络明目胶囊组方.全方紧紧围绕目络瘀阻、滋生、绌急、出血等病理改变,标本兼顾,共奏散瘀与止血之效,从而达到益气养阴以补其本、化瘀通络以对其要、止血明目以应其变的目的.基础研究表明,通络明目胶囊具有保护视网膜微血管及视网膜细胞综合效应特点,新药Ⅲ期临床试验证实其临床疗效作用确切,且安全性良好,为提高该病临床疗效提供了新的药物选择,也进一步佐证了络病理论在防治DR等临床重大疾病方面的科学价值.
Abstract
Diabetic retinopathy(DR),as one of the most common and serious microvascular complications of diabetes mellitus,seriously threatens human health,and belongs to"Xiaoke eye diseases"in traditional Chinese medicine(TCM),which has been richly experienced by medical practitioners through the ages,but is mostly recorded in a piecemeal manner and has not been systematically researched.This disease is featured by long course and repeated attack,and is refractory,which belongs to the research category of"persistent illness entering collaterals".Systematic establishment of TCM collateral disease theory for guiding prevention and treatment of DR has important clinical value.On the basis of close correlation between tertiary collaterals at the terminal of collaterals and capillaries and microcirculation,the concept of"tertiary collaterals-microvascular"is proposed.It is pointed out that DR falls within the scope of"tertiary collaterals-microvascular"diseases,and presents four types of micro-pathological characteristics,including stasis,insufficiency,growth and bleeding of tertiary collaterals.It is concluded that"deficiency of both Qi and Yin"is the basic pathogenesis of DR,and"blood stasis and collateral obstruction"is the important pathogenesis and key factor.Thus,the treatment method of"dispersing blood stasis,dredging collateral,tonifying Qi and Yin,stopping hemorrhage and improving eyesight"is determined,and the formula of Tongluo Mingmu capsules is developed.The article tightly focuses on the pathological changes such as stasis,growth,insufficiency and bleeding of collaterals,addresses both symptoms and root causes,and plays a synergistic role of both dispersing stasis and stopping bleeding.In this way,it can realize the purpose of tonifying Qi and Yin to replenish the essence,dispersing stasis and dredging collaterals to meet the requirement,as well as stopping hemorrhage and improving eyesight to deal with changes.Fundamental researches demonstrate that Tongluo Mingmu capsules has synergy effects of protecting both retinal capillaries and retinal cells.Phase-Ⅲ clinical trial of new drug has proven definite clinical efficacy and good safety,which provides a new drug choice for enhancing clinical effect of DR,and further supports the scientific value of Luobing theory in preventing and treating DR and other clinically significant diseases.
关键词
糖尿病/糖尿病性视网膜病变/络病理论/脉络学说/孙络-微血管/通络明目胶囊Key words
diabetes mellitus/diabetic retinopathy/Luobing theory/venation theory/tertiary collaterals-microvascular/Tongluo Mingmu capsules引用本文复制引用
出版年
2025
国家科技期刊平台
NSTL
维普
万方数据