陈向东教授运用桂枝茯苓丸加味治疗糖尿病黄斑水肿经验

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〔摘要〕 陈向东教授通过长期临床经验结合微观辨证理论得出，糖尿病黄斑水肿的病机特点为消渴耗气，气虚不运，阳气郁滞，血瘀视衣，病程日久，水湿停聚，痰湿内生，痰瘀互结，发为水肿，故以“通阳解郁，活血利水”为治疗原则，化裁经方桂枝茯苓丸临证加减，为治疗糖尿病黄斑水肿提供新的治疗思路。

〔关键词〕 糖尿病视网膜病变；糖尿病黄斑水肿；微观辨证；痰瘀互结；活血利水法；桂枝茯苓丸

〔中图分类号〕R276         〔文献标志码〕A          〔文章编号〕doi：10.3969/j.issn.1674－070X.２０24.06.017

Professor CHEN Xiangdong's experience in treating diabetic macular edema with modified Guizhi Fuling Pill

GUO Xinyi1， HUANG Longrong1， GUO Yonghong3， CHEN Xiangdong1，2*

1. The First Clinical School of Chinese Medicine， Hunan University of Chinese Medicine， Changsha， Hunan 410007， China;

2. Hunan University of Chinese Medicine， Changsha， Hunan 410208， China; 3. Hengyang Hospital of Chinese Medicine， Hengyang， Hunan 421000， China

〔Ａｂｓｔｒａｃｔ〕 Professor CHEN Xiangdong， based on long-term clinical experience and microscopic pattern differentiation theory， concluded that the pathogenesis of diabetic macular edema （DME） is characterized by qi deficiency， which is due to wasting thirst disorder， failing in transportation， stagnation of yang qi， blood stasis in the retina， retention of water-dampness in a prolonged disease course leading to endogenous phlegm-dampness， and， finally， intertwined phlegm and blood stasis. Therefore， taking "activating yang to relieve stagnation， and circulating blood and draining water retention" as the therapeutic principle， the classic formula Guizhi Fuling Pill is applied and modified according to different clinical conditions. This paper aims to provide a new therapeutic idea for the treatment of DME.

〔Ｋｅｙｗｏｒｄｓ〕 diabetic retinopathy; diabetic macular edema; microscopic pattern differentiation; intertwined phlegm and blood stasis; circulating blood and draining water retention; Guizhi Fuling Pill

糖尿病黄斑水肿（diabetic macular edema， DME）是造成糖尿病视网膜病变患者视力损害的最常见原因之一，75%糖尿病视网膜病变致盲患者合并有DME[1-2]。（剩余8731字）