从"营衰卫伐"论治老年性干眼OA

Dry eye is a chronic disorder of the ocular surface,attributable to a multitude of factors,which exhibits a high prevalence among the elderly population and significantly impairs patients'quality of life.The phrase"exhaustion of nutritive level and hyperactivity of defensive level"serves as a broad generalization of the imbalance between the camp and the guard of the elderly,as discussed in Ling Shu·Ying Wei Sheng Hui.Drawing upon the theoretical framework of nutritive and defensive levels in TCM,this article posited that"exhaustion of nutritive level and hyperactivity of defensive level"constitutes the pathogenic foundation of senile dry eye.The exhaustion of yin in nutritive level is identified as the root cause of the condition,while the internal manifestation of defensive qi represents the disease's progressive development.The culmination of the disease is characterized by the presence of phlegm and blood stasis.The article delineated three progressive pathological stages:the gradual exhaustion of yin in nutritive level to fluid and blood deficiency and subsequent malnourishment of the eyes;the weakening of defensive level,resulting in the inability to control external pathogens and ineffective treatment;and the association of exhaustion of nutritive level and hyperactivity of defensive level with turbidity,which consequently gives rise to phlegm and blood stasis.The therapeutic approach should adhere to the principles of replenishing blood and essence to enhance nutritive level,promoting qi circulation and facilitating the opening of the orifices to clear the eyes,and removing phlegm and resolving blood stasis to improve ocular clarity,with the objective of nourishing yin in nutritive level,harmonizing qi of defensive level,supporting healthy qi,and dispelling pathogenic factors,to alleviate ocular astringency,thereby offering ideas for clinical diagnosis and treatment.