针灸与中药治疗青光眼之规律探讨

发布时间：2018-05-31 20:19

本文选题：青光眼 + 针灸　；参考：《南京中医药大学》2017年博士论文

【摘要】：研究目的:本文旨在通过收集古籍眼科文献和现代医学期刊记载的有关青光眼(五风内障、绿风内障、青眼盲等)针刺和中药治疗的相关文献和经验,并经系统检索、筛选疏理、总结归纳挖掘历代医家治疗青光眼的针刺选穴和中药证治的方案、规律和经验,为临床提供文献理论的支持并拓展治疗青光眼创新治疗的思路。研究方法:本研究通过查询和检索中国知网、万方数据库等文献库,结合手工和图书馆查询借阅等方式,尽可能收集和筛选符合相关主题和关键词的文献资料,结合上述查询有效文献建立青光眼文献的数据表,并根据评价进行一一录入和分析,统计其证候类型、中药和选穴等出现频次和频率。古代文献来源涉及年代从战国到明清时期的眼病论着,筛选关键词有"五风内障、雷头风、偏头风、乌风、青风、绿风"等,现代文献检索中国知网(CNKI)数据库2000年1月1日至2015年12月31日有关针灸和中药治疗青光眼的相关临床文献研究及经验,检索主题以针灸或中药治疗青光眼为主,关键词:针刺、针灸、中药、中医、青光眼、五风内障等。归纳和整理相关数据,进一步统计、分析古今文献中记载的青光眼的证型分类和归属脏腑以及针刺用穴和中药的规律。研究结果:通过回顾性研究发现符合纳入的文献及论着包括《黄帝内经》、《备急千金药方》、《外台秘要》、《秘传眼科龙木论》、《审视瑶函》、《赤水玄珠》等,综上所述和临床文献研究报道的相关文献共计2606余篇,排除无中医参与治疗以及未明确疗效评价等文章,经检索总共收集47余篇有关针灸和中药治疗该眼病的文献报道,在上述文献检索结果中,通过人工检索,手工筛选符合上述标准的文献共有35篇。经过整理后共收集有关中医治疗青光眼的临床研究文献约35篇,中药临床研究文献17篇,针刺临床研究文献11篇,视神经保护中医治疗文献7篇,"肝郁气滞"证型是文献记载中出现最频繁的证候,也就是最常见的证候,睛明穴是针刺中最常用的穴位,其中奇穴的应用比例也远高于循经取穴,中药茯苓和羚羊角二味在古籍文献中应用最多,茯苓、丹参、决明子三味中药是现代临床治疗该病最常用的中药。研究结论:通过对原发性青光眼的文献整理研究,无论是古代名医还是现代流派都以"肝"为治疗青光眼的主要证治基础,"循肝经"取穴,"循肝经"用药,在青光眼的病程中注重补气、培元固本,是治疗青光眼的针刺、用药大法。针刺在治疗青光眼的原则上应当以"调经行气、活血通络"为主要治疗原则,结合临床各种证候变化,给予循经加减、远近配穴以完善不同辩证施治的方案。结合古籍和现代临床文献资料我们发现本研究中针刺取穴主要以眼部的局部取穴为主穴,结合循经特点,依据证候变化,加以调整,并善用、多用奇穴和特定穴为规律的针刺治疗方法,也是目前临床治疗该眼病最有效的方法之一,这也与我导师在治疗疑难眼病的临床经验及原则颇为一致。
[Abstract]:Objective: the purpose of this study is to collect the relevant literature and experience of acupuncture and Chinese medicine on glaucoma (five cataract, green wind cataract, blind blindness, etc.) recorded in the ancient books of Ophthalmology and modern medical journals, and through systematic retrieval, screening and dredging, summarizing and summarizing the prescription of acupuncture point selection and Chinese medicine treatment in the treatment of glaucoma. Case, law and experience to provide support for clinical literature theory and to expand the thought of treatment of innovative treatment of glaucoma. Research methods: This study collects and screens documents that conforms to related topics and keywords by searching and retrieving the Chinese knowledge network, the Wanfang database and other documents, combining manual and library inquiries. According to the above inquiry effective literature, the data table of glaucoma literature was set up. According to the evaluation, the syndrome types, the frequency and frequency of traditional Chinese medicine and selection of acupoints were recorded and analyzed. The ancient literature sources related to the eye diseases from the Warring States to the Ming and Qing Dynasties, and the key words were "five wind cataract, thunder head wind, partial wind, Wu" Wind, green wind, green wind, and so on, modern literature retrieves the related clinical literature research and experience related to acupuncture and Chinese medicine in the treatment of glaucoma from January 1, 2000 to December 31, 2015 in the CNKI database. The key topics are acupuncture, acupuncture, acupuncture, Chinese medicine, Chinese medicine, glaucoma, five cataract, etc. And collate the relevant data, further statistics, analyze the classification of glaucoma in ancient and modern literature and the law of belonging viscera and acupuncture points and Chinese medicine. A total of more than 2606 articles related to the reports of the literature and the clinical literature were collected in a total of more than 2606 articles, excluding the articles on the treatment of the Chinese medicine and the evaluation of the undefined curative effect. More than 47 articles about the treatment of the ophthalmopathy were collected by the retrieval of acupuncture and Chinese medicine. There are 35 articles in line with the above standards. After collation, there are about 35 clinical literature on the treatment of glaucoma, 17 clinical literature, 11 clinical literature, 7 TCM treatment documents for optic nerve protection, and the most frequent syndromes in the literature are the syndrome of "liver depression and qi stagnation", that is, The most common syndrome, Jingming point is the most commonly used acupuncture point, of which the proportion of the odd points is far higher than the meridian acupoint, the two flavors of tuckahoe and antelope horn are used most in ancient books. Poria cocos, Salvia miltiorrhiza and cassia seed are the most commonly used traditional Chinese medicine in modern clinical treatment of the disease. Both ancient and modern schools take "liver" as the main basis for the treatment of glaucoma, "follow the liver meridian", "follow the liver meridian", "follow the liver meridian", pay attention to supplementing qi in the course of glaucoma. It is the acupuncture for the treatment of glaucoma and the big method of medication. The principle of acupuncture in the treatment of glaucoma should be "regulating menstruation and activating blood and activating blood." Tongluo "for the main principle of treatment, combined with the variety of clinical syndromes, to follow meridians and subtract, far and close matching points to improve the different dialectical treatment. Combined with ancient books and modern clinical literature, we found that the main acupuncture points in this study are mainly ocular points in the eye point, according to the characteristics of the meridians, according to the changes of syndrome, and adjust, and It is also one of the most effective methods to treat the ophthalmopathy, which is also one of the most effective methods to treat the ophthalmopathy. It is also in line with my tutor's clinical experience and principles in the treatment of difficult ophthalmopathy.
【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R246.82

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