从"亢害承制"理论探讨清肝补肺法治疗前葡萄膜炎OA

Anterior uveitis(AU)is a recurrent ocular inflammatory disease,often associated with systemic autoimmune disorders.From the perspective of Traditional Chinese Medicine(TCM)pathogenesis,one of its common mechanisms is"liver-fire stagnation with heat and lung-Qi deficiency",liver-Yang tends to be hyperactive while lung-Yin tends to be deficient.Hyperactive liver-fire counter-restricts the lung(metal),leading to internal accumulation of damp-heat.The pathological process of AU can be interpreted through the theory of"hyperactivity leading to harm and restraint maintaining balance".This theory elucidates the regulatory mechanisms of internal homeostasis through the generating,restraining,and controlling relationships among the five elements.Based on this theory,this article systematically explores the imbalance and reconstruction of the five-element restraint relationships during the onset of AU.The pathogenesis of AU is closely related to dysfunction of liver and lung.The liver belongs to wood and lung to metal.The restraining relationship of"metal controlling wood"in the five-element theory,along with the connection of their meridians from head to tail,provides a theoretical basis for treating AU from the perspective of liver and lung.Dysregulation of the ascending and descending functions of liver and lung Qi leads to failure of metal-Qi to control wood.Consequently,liver-wood Qi and fire become hyperactive,creating a state of"conflict between metal and wood".Coupled with interwoven pathological factors such as fire-heat and dampness,this results in reversed flow of Qi and blood disturbing the ocular orifices,thereby triggering AU.In treatment,the principle should be based on the method of"clearing liver and tonifying lung".By soothing liver to purge fire and supplementing lung-Qi,the coordinated ascending and descending functions of liver and lung Qi are restored.Simultaneously,the five-element restraining relationship is utilized to suppress hyperactive liver-Yang,supplemented with methods to nourish kidney-water and subdue liver-Yang.This corrects the pathological state of"wood-excess and metal-deficiency",restores the body's"balance of restraint and control",and thus controls the recurrent episodes of AU.