视网膜静脉阻塞（RVO）中医分期分型规律研究

【作者】 马素红；

【导师】 郑燕林；

【作者基本信息】 成都中医药大学 ， 中医眼科学， 2006， 硕士

【摘要】 目的：以研究视网膜静脉阻塞(retinal vein occlusion，RVO)为代表，通过分析视网膜静脉阻塞的基本特征，研究不同病程时期和不同中医证型的中西医证候特点及相关检查结果的分布情况，预期得出一套眼底血证的中医分期分型标准，以便推广应用。 方法：采用病例回顾方法，将近十二年来于我校附属医院眼科确诊入选的RVO病例按照近期提出的眼底血证分期理论(分为出血期、瘀血期、死血期及干血期)分别纳入各期。再通过填写CRF表，收集患者眼部情况、自觉症状(分主要症状和次要症状)、舌象、脉象等内容。然后严格按照中医辨证原则进行辨证分型，所得数据经过统计分析，以明确所收集的RVO病例总体上以何种证型为主，四期中每一期又以哪一型或哪几型为主。 此外，通过研究，预期能够明确视网膜静脉阻塞的中医分期分型与患者一般情况、既往病史、用药及手术史、眼科专科检查结果、相关实验室检查、FFA等项目(具体内容见附表)之间有无联系，有什么样的联系。以便总结各主要中医证型的特征性、规律性所在，并从现代医学角度使RVO的中医分期分型标准化。 结果： 1．RVO的发病有一定的流行病学特征； 2．RVO各期各主要中医症候发生率有明显差异； 3．RVO各期中医证型分类有一定规律性； 4．RVO总体上及各期各主要并发证的发生均有不同的变化特点； 5．RVO五种主要中医证型间各实验室检查项目积分均数比较结果有统计学意义； 6．RVO五种主要中医证型之间视网膜硬性渗出范围及NP范围比较结果均有统计学意义； 结论： 1．RVO中医证型总体上以肝肾阴亏型为主； 2．四期中，出血期以气滞血瘀型为主，其次为阴虚火旺型和肝肾更多还原

【Abstract】 Objective: to observe the symptoms and characteristics of retinal vein occlusion (RVO) in different stage , so that we can get some regularities about bleeding eye diseases .according to these regularities a sort of standard will be find . this standard is expected to be useful when we decide the stage and TCM pattern of retinal vein occlusion .Methods: reviewing 190 cases of RVO in past ten years , recording their symptoms, results of examination, FFA and so on. according to the latest opinion brought forward recently ,we devide the patients into four different stages, viz. bleeding stage, gore stage, dead blood stage and dry blood stage, at the same time, all cases will be bring into corresponding TCM patterns .finally, analysising all data by statistics . Results: in each stage, TCM patterns are notably different. and they change following specifical rule. the evolvement of syndromes has their certain characteritic. five basic TCM patterns of RVO have some different correlation with laboratory examinations, retinal effusion and non-perfusion.Conclusion: on the whole, Yin-Deficiency of Liver and Kidney is the most familiar pattern, in earlier stage , Qi stagnation and Blood stasis is the main pattern. the next is Intense Fire due to Yin-Deficiency. in second stage, Qi stagnation and Blood stasis is still the main TCM pattern. in last two stages, Phlegm accumulates with stagnant Blood and Yin-Deficiency of Liver and Kidney is their basic TCM pattern respectively. average area of retinal effusion of Phlegm accumulates with stagnant Bloodln is the bigest, while, Yin-Deficiency of Liver and Kidney is the smallist. among the two TCM patterns , Intense Fire due to Yin-Deficiency and stagnation of Dampness-Heat , the happening rates of non-perfusion is specially high.更多还原