1.湖南中医药大学,湖南省长沙市岳麓区学士路300号,410208
2.湖南中医药大学第一附属医院
3.长沙市中医防治眼底病和视功能保护技术创新中心
292698530@qq.com
收稿:2025-11-17,
修回:2026-06-06,
录用:2026-04-29,
网络首发:2026-07-15,
纸质出版:2026-07-17
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李晴,邓颖,肖莉等.视网膜色素变性的中西医认识[J].中医杂志,2026,67(14):1567-1573.
LI Qing,DENG Ying,XIAO Li,et al.Current Understanding of Retinitis Pigmentosa in Traditional Chinese and Western Medicine[J].Journal of Traditional Chinese Medicine,2026,67(14):1567-1573.
李晴,邓颖,肖莉等.视网膜色素变性的中西医认识[J].中医杂志,2026,67(14):1567-1573. DOI: 10.13288/j.11-2166/r.2026.14.017.
LI Qing,DENG Ying,XIAO Li,et al.Current Understanding of Retinitis Pigmentosa in Traditional Chinese and Western Medicine[J].Journal of Traditional Chinese Medicine,2026,67(14):1567-1573. DOI: 10.13288/j.11-2166/r.2026.14.017.
从现代医学认识、中医病因病机及辨治思路两个方面对视网膜色素变性(RP)的相关研究进行总结。现代医学对RP的认识已由早期侧重致病基因突变的单点解释,逐步发展为对遗传异常、感光细胞损伤、视网膜色素上皮功能失代偿、氧化应激、炎症反应、微环境失衡及循环障碍等多因素连续参与的综合理解。中医学则认为RP病位在目、病本在脏腑,主要与先天不足、肝肾亏虚、脾失健运及脉络瘀阻有关,核心病机可概括为“虚中夹瘀”,强调整体失衡、病程演变及辨证调治。讨论了两种医学体系在疾病演变认识上的差异与互补,认为RP更适宜被理解为一种长期进展、阶段演变、持续失代偿的复杂性疾病。现代医学有助于揭示其分子机制及靶向干预基础,中医学则有助于从整体状态、病程分层和长期调治角度把握其演变规律。
This paper has summarized current studies on retinitis pigmentosa (RP) from two perspectives, which were disease mechanism insights from western medicine, and etiology, pathogenesis and therapeutic principles in traditional Chinese medicine (TCM). From the perspective of western medicine, the understanding of RP has evolved from an early single-factor explanation focusing on pathogenic gene mutations to a more comprehensive, multifactorial model involving genetic abnormalities, photoreceptor cell degeneration, retinal pigment epithelium dysfunction, oxidative stress, inflammatory responses, microenvironmental imbalance, and vascular insufficiency. In TCM, RP is considered to be a disorder manifested in the eyes but rooted in dysfunction of the
zang
-
fu
(脏腑) organs. Its pathogenesis is primarily associated with congenital insufficiency, liver-kidney depletion, impaired spleen function of transportation and transformation, and stasis obstructing the meridians. The core pathological mechanism can be summarized as "deficiency complicated by stasis", emphasizing holistic imbalance, dynamic dis
ease progression, and syndrome differentiation and treatment. The differences and complementarities between the two medical systems in understanding disease progression are further discussed. RP is proposed to be more appropriately regarded as a complex disease characterized by long-term progression, stage-dependent evolution, and persistent decompensation. Western medicine contributes to elucidating the molecular mechanisms underlying RP and provides the foundation for targeted therapeutic interventions, whereas TCM offers a holistic perspective for understanding disease evolution through the assessment of overall functional status, disease-stage stratification, and long-term syndrome-based regulation.
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