基于"血水同治"理论探讨早期糖尿病视网膜病变的治疗OA

The early symptoms of diabetic retinopathy(DR)are insidious,making it easy to miss the opportunity for intervention,and modern medical treatment methods are relatively limited.The Traditional Chinese Medicine(TCM)theory of"treating blood and water simultaneously"holds that blood and water have the same origin physiologically and interact pathologically.The eyes rely on the joint nourishment of blood and water;Stagnation of blood and retention of water lead to intermingling of phlegm and blood stasis,blocking the eye collaterals,and causing fundus lesions such as hemorrhage and exudation in early DR.Based on this theory,combined with the association between retina and liver,spleen,kidney and the metabolism of blood and water,this article proposes that the core pathogenesis of early DR is the dysfunction of liver,spleen and kidney,the intermingling of phlegm-fluid retention and blood stasis,and the coexistence of blood and water disorders.Accordingly,the treatment principle of combining promoting blood circulation and inducing diuresis is established,and treatment is carried out separately according to the focus of fundus lesions:For those mainly with hemorrhage,the treatment is mainly promoting blood circulation and auxiliary inducing diuresis,such as modified Xuefu Zhuyu Decoction;For those mainly with exudation,the treatment is mainly inducing diuresis and auxiliary promoting blood circulation,such as modified Wuling Powder;For those with both hemorrhage and exudation,promoting blood circulation and inducing diuresis are carried out simultaneously,and medicines such as Polyporus umbellatus,Poria cocos,Alisma orientale,Salvia miltiorrhiza,Leonurus japonicus,Pollen typhae can be selected.Theoretical analysis and preliminary clinical practice suggest that this treatment method can effectively improve visual acuity and fundus lesions,providing a new idea for the prevention and treatment of early DR.