1.湖南中医药大学第一附属医院,湖南省长沙市雨花区韶山中路95号,410000
2.湖南中医药大学
3.湖南省中医药防治眼耳鼻咽喉疾病与视功能保护工程技术研究中心
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收稿:2024-07-30,
修回:2024-10-17,
纸质出版:2024-12-02
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吕怡,钟缘,彭俊等.彭清华基于“辛以润之”治疗干眼经验[J].中医杂志,2024,65(23):2399-2403.
LYU Yi,ZHONG Yuan,PENG Jun.Professor PENG Qinghua's Experience in Treating Dry Eyes based on "Moistening with Acrid Medicinals" Theory[J].Journal of Traditional Chinese Medicine,2024,65(23):2399-2403.
吕怡,钟缘,彭俊等.彭清华基于“辛以润之”治疗干眼经验[J].中医杂志,2024,65(23):2399-2403. DOI: 10.13288/j.11-2166/r.2024.23.003.
LYU Yi,ZHONG Yuan,PENG Jun.Professor PENG Qinghua's Experience in Treating Dry Eyes based on "Moistening with Acrid Medicinals" Theory[J].Journal of Traditional Chinese Medicine,2024,65(23):2399-2403. DOI: 10.13288/j.11-2166/r.2024.23.003.
总结彭清华教授基于“辛以润之”治疗干眼的经验。认为导致干眼“阴液亏虚”现象的根本原因为阳气不足,虚寒内生,阴液凝滞;阳气闭阻于内,阴液不行;阴枯液耗,虚阳上越。临证以“辛以润之”为根本治法,阳虚津凝者,以辛温之品温阳散寒,运行津液,使阴凝得化,常用药物有附子、干姜、细辛等;其中脾阳不足常用附子理中丸加减,肺阳不足常用小青龙汤加减,肾阳不足常用金匮肾气丸加减。阳郁津停者,以辛开之品透阳解郁,通滞行津,使阳气舒展,阴液流通,常用药物有麻黄、桂枝、柴胡等;其中阳郁肌表常用麻桂类方加减,阳郁于内常用四逆散加减。阴亏津竭者,在西洋参、南沙参、北沙参、玉竹等养阴生津药物或增液汤的基础上配合辛润之法,使阴阳互化而不燥,常用药物有人参、黄芪、肉苁蓉、肉桂等。
This article summarized Professor PENG Qinghua's experience in treatment of dry eyes with principles of "moistening with acrid medicinals". It is believed that the root cause of dry eyes with "
yin
fluids deficiency" phenomenon is that
yang qi
deficiency, deficient cold generating, and
yin
fluids stagnation;
yang qi
blocking inside,
yin
fluids fail to move;
yin
exhaustion and fluid consumption, deficient
yang
rising. In clinic, "moistening with acrid medicinals" could be the basic therapeutic methods. For patients with
yang
-deficiency and fluids-stagnation syndrome, acrid and warm medicinals could be used for warming
yang
and dispersing
cold, moving fluids, and transforming
yin
stagnation, commonly choosing Fuizi (
Aconiti Lateralis Radix Praeparata
), Ganjiang (
Zingiber officinale Rosc
), Xixin (
Asari Radix et Rhizoma
) and so on. If there is spleen
yang
deficiency, modified
Fuzi Lizhong Pill
(附子理中丸) could be used, if lung
yang
deficiency, modified
Xiaoqinglong Decoction
(小青龙汤) could be used, and if kidney
yang
deficiency, modified
Jinkui Shenqi Pill
(金匮肾气丸) could be used. For patients with
yang
-stagnation and fluids-retention syndrome, acrid and warm and opening medicinals could be used for expelling
yang
and resolving constraint, unblocking stagnation and moving fluids, to spread
yang qi
and free
yin
fluids, commonly choosing Mahuang (
Ephedra sinica Stapf
), Guizhi (
Ramulus Cinnamomi
), Chaihu (
Bupleuri Radix
) and so on. If there is
yang
stagnation in exterior parts, modified
Mahuang Guizhi
-
Like Formulas
(麻桂类方) were commonly used, and for
yang
stagnation inside the body, modified
Sini Powder
(四逆散) were commonly used. For patients with
yin
-deficiency and fluids-exhaustion syndrome, on the basis of tonifying
yin
and generating fluids medicinals like Xiyangshen (
Panax quinquefolius L.
), Nanshashen (
Adenophorae Radix
), Beishashen (
Glehniae Radix
), Yuzhu (
Polygonati Odorati Rhizoma
) or
Zengye Decoction
(增液汤), combined with the method of moistening with acrid medicinals, so
yin
and
yang
transforming with each other without dryness, and the common medicinals include Renshen (
Ginseng Radix et Rhizoma
), Huangqi (
Astragali Radix
), Roucongrong (
Cistanches Herba
), Rougui (
Cinnamomi Cortex
) and so on.
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