目的:探讨视网膜水肿与中医辨证的相关性。方法:经荧光素血管造影和光学相干断层成像检查确诊眼底有视网膜水肿的患者207例,进行问卷调查,记录患者全身症状、舌脉和眼底水肿情况。根据患者的症状群进行中医症状、病位、证候排序分析,虚实证分析。结果:眼底有水肿的患者除了视物模糊外的中医症状出现的频率超过20%的症状依次是:神疲乏力、失眠、健忘、大便稀溏、头晕。眼底水肿患者中辨证证型为脾气虚者为106例(51.2%);肾阴虚79例(38.2%);心血虚62例(30.0%);肾阳虚35例(16.9%);血瘀证6例(2.9%);湿热内蕴12例(5.8%);无证可辨者20例(9.7%)。对患者进行虚实辨证,其中虚/虚实夹杂证175例,实证12例,有20例全身无证可辩,虚/虚实夹杂证占84.5%,实证占5.8%。结论:根据有视网膜水肿的患者的临床表现及症状分型,其辨证具有一定的规律性,即中医证候特点为脾气虚居多,其次是肾阴虚,再次是心血虚。眼底视网膜水肿与内科水肿的外观表现相似,但证型分布有不同,亦可见于血虚、阴虚证中。眼底新生血管从局部辨证来讲是瘀血,属于有形之"实",但其本在于气虚、血虚和阴虚,属本虚标实或虚实夹杂。眼底视网膜水肿从局部辨证来讲是水湿,属于有形之"实",但其本在于气虚、血虚和阴虚,属本虚标实或虚实夹杂。

·AIM:To explore the relation between retinal edema and Syndrome differentiation of TCM.·METHODS:Patients suffering CSC,CEC,MDM,AMD,RVO and DR had been chosen as study subjects.All cases were found retinal edema by FFA and OCT examination.Differentiate and sort general symptoms,zangfu location,pattern,the relation between retinal edema and Syndrome differentiation of TCM on the basis of complaint,tongue and pulse interpretation from patients.·RESULTS:Among 207 patients with retinal edema symptoms with frequency of occurrence above 20% were hypodynamia,anypnia,morbid forgetfulness,dizziness and loose stool.In the cases with found retinal edema pattern constituent:106 cases(51.2%)belong to spleen-QI deficiency;79 cases(38.2%)kidney-YIN deficiency;62 cases(30.0%)heart-blood deficiency;35 cases(16.9%)kidney-YANG deficiency;6 cases(2.9%)stagnation of Blood;12 cases(5.8%)Damp Heat and 20 cases(9.7%)no pattern.Deficiency was shown in 175 among 207 patients with retinal edema.·CONCLUSION:According to clinical manifestation and symptom,differentiation of neovascular had some regularity:spleen-QI deficiency pattern is the most,the second is kidney-YIN deficiency,the third is heart-blood deficiency.There were resemblance of appearance between internal medicine and retinal edema but pattern of syndrome had evident difference.Blood and YIN deficiency can result in retinal edema.Accoding to regional signs retinal edema shows the appearance of excess syndrome but its origin was deficiency of QI,Blood and YIN.By essence it was deficiency syndrome transforming into excess or simultaneous deficiency and excess.·

R276.7

中国2004年江苏省中医药管理局青年课题资助项目~~