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¡¡¡¡Abstract£º¡¡In this paper, the etiology and pathogenesis of macular edema in Traditional Chinese Medicine, syndrome differentiation and treatment, as well as the characteristics of the use of prescription and drugs were discussed in detail. It was believed that the direct pathogenesis of macular edema was blood stasis and water retention, which was mainly related to dysfunction of spleen in transportation, liver dysfunction, kidney Yang qi dysfunction and qi-yin deficiency. The method of promoting blood circulation and inducing diuresis should be used throughout the treatment of macular edema. At the same time, it should follow the principle that the treatment for water and blood must first treat the qi, and cooperate with the method of strengthening the spleen and replenishing qi, dispersing stagnated liver qi to relieve qi stagnation, warming Yang and benefiting qi, benefiting qi and nourishing yin and regulating qi-flowing to activate stagnancy. Plantain seed having the effect of inducing diuresis and excreting dampness could be reused in the treatment of macular edema. The common dose was 20¡«30 g, and the maximum dose could reach to 60 g, which had unexpected effect on the treatment of macular edema. The article also gave a medical record about macular edema with the TCM treatment.
¡¡¡¡Keyword£º¡¡macular edema; blood stasis and water retention; promoting blood circulation and inducing diuresis; treating the qi; plantain seed;
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¡¡¡¡[1] XU Y,RONG A,XU W,et al. Comparison of 12-month therapeutic effect of conbercept and ranibizumab for diabetic macular edema:a real-life clinical practice study[J].BMC Ophthalmol,2017,17(1):158.
¡¡¡¡[2] ºþ±±ÖÐҽѧԺ.½ðØÑÒªÂÔ½âÒå[M].ÉϺ£:ÉϺ£¿ÆÑ§¼¼Êõ³ö°æÉç,1981:145.
¡¡¡¡[3]ÌÆÈÝ´¨.Ѫ֤ÂÛ[M].¹È½¨¾ü,Уע.±±¾©:ÖйúÒ½Ò©¿Æ¼¼³ö°æÉç,2011:85,117,3.
¡¡¡¡[4]ÅíÇ廪.ÑÛ¿Æ»îѪÀûË®·¨µÄÑо¿[M].±±¾©:ÖйúÖÐÒ½Ò©³ö°æÉç,2018.
¡¡¡¡[5]ÅíÇ廪,Áõºì¾ê,»Æ¶«Ïæ.ˮѪͬÖεÄÀíÂÛÔÚÑÛ¿ÆÓ¦ÓÃ[J].ÁÉÄþÖÐÒ½ÔÓÖ¾,1993,20(2):10-11.
¡¡¡¡[6]ÅíÇ廪.ÑÛ¿ÆË®ÑªÍ¬ÖÎÂÛ[J].½Î÷ÖÐÒ½Ò©,1994,25(S2):9-11.
¡¡¡¡[7]ÐÏÈêö©.»ÆµÛÄÚ¾·ÁéÊàÆª[M].Î人:»ªÖпƼ¼´óѧ³ö°æÉç,2017:356,296.
¡¡¡¡[8] KIM I,MOON SO,KIM SH,et al. Vascular endothelial growth factor expression of intercellular adhesion molecule 1(ICAM-1),vascular cell adhesion molecule 1(VCAM-1),and E-selectin through nuclear factor-kappa B activation in endothelial cells[J].J Biol Chem,2001,276(10):7614-7620.
¡¡¡¡[9] FUNATSU H,NOMA H,MIMURA T,et al. Association of vitreous inflammatory factors with diabetic macular edema[J].Ophthalmology,2009,116(1):73-79.
¡¡¡¡[10] MUTHUSAMY A,LIN CM,SHANMUGAM S,et al. Ischemia-reperfusion injury induces occludin phosphorylation/ubiquitination and retinal vascular permeability in a VEGFR-2-dependent manner[J].J Cereb Blood Flow Metab,2014,34(3):522-531.
¡¡¡¡[11]ÕÅ»Ê,ȫ濾ê,Ñîл³,µÈ.¿µ°ØÎ÷ÆÕÁªºÏ²£Á§ÌåÇиîÊõ¶ÔÌÇÄò²¡ÐԻưßË®Ö×»¼Õß·¿Ë®VEGF¡¢SDF-1µÄÓ°Ïì[J].ÖйúÁÙ´²Ò©ÀíѧÓëÖÎÁÆÑ§,2019,24(2):218-222.
¡¡¡¡[12]ÍõÈô¹â,ÓÈÕÑÁá.ÊÔÎöѪðöÐγɼ°ÏÖ´úÑо¿¶ÔѪðöÈÏʶµÄÉ[J].ÖйúÖÐÒ½Ò©¿Æ¼¼,2001,8(4):272-276.
¡¡¡¡[13]Îâè©.β¡Ìõ±æ[M].ÄϾ©ÖÐÒ½Ò©´óѧβ¡Ñ§½ÌÑÐÊÒ,ÕûÀí.±±¾©:ÈËÃñÎÀÉú³ö°æÉç,2005:176-177.
¡¡¡¡[14]ºÂÃ÷·Ò,·¶Ó±,ÁºÃ¯ÐÂ.³µÇ°×ÓDZÔÚ¹¦Äܵķ¢¾òÓëÀûÓÃ[J].ʱÕä¹úÒ½¹úÒ©,2015,26(10):2479-2481.
¡¡¡¡[15]¹¢·Å,Ëïò¯,ÑîÀò,µÈ.³µÇ°×ÓÓ복ǰ²ÝÀûÄò×÷ÓÃÑо¿[J].ÉϺ£ÖÐÒ½Ò©ÔÓÖ¾,2009,43(8):72-74
¡¡¡¡[16]ÔøÃÎéª,ÀîÃç,Õű´±´,µÈ.ÝãÜÂ×Ó¡¢Þ²ÜÓÈÊ¡¢³µÇ°×ÓµÄÀûË®¹¦Ð§±È½Ï[J].ÖгÉÒ©,2018,40(1):40-46.
¡¡¡¡[17]ÏîÓî,ÁõÏþÇå,Ò¦Õð,µÈ.ÅíÇ廪½ÌÊÚÔËÓûîѪÀûË®·¨ÖÎÁƲ£Á§Ìå»ýѪµÄ¾Ñé[J].ÖйúÖÐÒ½ÑÛ¿ÆÔÓÖ¾,2019,29(3):225-227,232.
¡¡¡¡[18]½¯Åô·É,Åí¿¡,ÅíÇ廪.dzÎö»Æ°ßÊôÆ¢[J].ÖйúÖÐÒ½ÑÛ¿ÆÔÓÖ¾,2020,30(1):42-44,48.