基于"阳常有余,阴常不足"从肾论治湿性年龄相关性黄斑变性OA

Wet age-related macular degeneration(wAMD)is a progressive eye disease primarily caused by aging that leads to gradual vision loss.Factors such as smoking,environment and genetics may also influence its onset and progression.The structure and function of the eye develop earlier than those of other organs,forming a basis for its susceptibility to pre-mature aging.From the perspective of traditional Chinese medicine,the kidney is the foundation of the body,governing the processes of birth,growth,maturation,aging and death;therefore,aging begins with the kidney.The pathogenesis of wAMD in traditional Chinese medicine is complex.The macula belongs to the water orbiculus governed by the kidney,and its occur-rence and development are closely related to the kidney,often presenting with the manifestation of"Yang being often in ex-cess,while Yin being often deficient".Based on this theory,this article explores the etiology of wAMD from the perspective of the kidney,proposing that kidney deficiency runs through the entire course of wAMD—its early,middle and late stages—and tends to affect the liver and spleen.The overall progression follows a dynamic pattern:in the early stage(neovasculariza-tion stage),kidney deficiency with fire hyperactivity leads to incipient visual impairment;in the middle stage(active neo-vascularization stage),liver-kidney Yin deficiency causes weakening of normal ophthalmic function;in the late stage(inac-tive neovascularization stage),spleen-kidney deficiency results in blurred vision.In clinical practice,treatment should focus on the kidney,supplemented by addressing the liver and spleen based on etiology,with syndrome differentiation and staging.In the early stage,the approach should be to tonify the kidney,protect the eye,nourish Yin and reduce fire,emphasizing pre-vention before disease onset.In the middle stage,the focus should be on supplementing liver and kidney,nourishing Yin and resolving stasis,emphasizing preventing progression after disease onset.In the late stage,the strategy should be to tonify the kidney,strengthen the spleen,resolve phlegm and dispel dampness,emphasizing preventing recurrence once the condition stabilizes.These approaches aim to restore normal ophthalmic function and sharp vision,playing a significant role in improv-ing central vision,enhancing patients'quality of life and alleviating pathological manifestations in the retinal macula,thereby offering new methods and insights for the clinical application of traditional Chinese medicine in the prevention and treatment of wAMD.