论著·社区中医药
CHINESE COMMUNITY DOCTORS 季节过敏性结膜炎是一种与自身免疫系统相关的变态反应性结膜炎[1]，发病具有季节性、反复性[2]。主要表现为眼痒、畏光、流泪、眼部异物感、烧灼感等症状，在中医文献中记载的痒若虫行症、时复症、眼内风痒症与季节过敏性结膜炎相近。《证治准绳·七窍门》中描述本病发病“如花如潮，至期而发，至期而愈”。各医家很早就认识到过敏性结膜炎与季节的相关性[3]。理论渊源：《审视瑶函》[4]首次记载了因时辨证理论：时复证，岁岁至期来，过期而又愈，久而不治，遂
成其害。此证谓目病不治，捱挨忍待自愈。书中提出了依据四时季节不同辨证论治理论。燕京韦氏眼科在《审视瑶函》因时辨证理论的基础上提出：依据春夏秋冬四时气候、病气及五轮病位不同，这是发病的外因，结合正气不足之内因，中药辨证施治、同时应用加味桑明液熏眼，内外治并用来治疗季节过敏性结膜炎。韦文轩老先生在内外治结合治疗外障眼病方面尤其擅长，其是韦氏眼科第二代传人。在《韦文轩眼科方诀与经验》中记载[5]：时复目痒症，病发于春季者，洗肝汤加减；病发于夏季者，导赤洗心汤加减；病发于秋季者，暴赤泻肺汤加减；病发于冬季者，六味地黄汤加减。同时外用加味桑明液洗剂熏眼。加味桑明液洗剂是在韦文贵经验方桑明液即桑叶、元明粉两味药物基础上加入浮萍及秦皮，一是为止痒退赤，二是为加强药效，减轻不良反应。笔者在跟随韦氏眼科第四代传人韦启平教授师承学习期间，对季节过敏性结膜炎采用因时辨证内外治并用治疗颇有心得。资料与方法2019年1-12月收治季节过敏性结膜炎患者40例，随机分为两组，各20例。试验组男11例，女9例；年龄9～50岁，平均29.76岁。对照组男10例，女10例；年龄9～50岁，平均28.94岁。两组患者病程3d～3年。两组患者一般资料比较，差异无统计学意义(P ＞0.05)，具有可比性。
诊断标准：⑴中医诊断标准：参照中华人民共和国中医药行业标准-中医病症诊断疗效标准.ZY/T001.1-94，74。眼
部奇痒难忍，碜涩不适；甚则畏光、流泪。②呈周期性反复发作。③眼部检查见白睛红赤肿胀，睑内扁平颗粒丛生，状如铺路卵石样；或可见黑睛边缘出现黄灰色或黯红色胶样隆起结节，白睛呈污红或
黄浊色；或以上两种并见。⑵西医诊断标准：参照葛坚《眼科学》。①症状不典型时加查：结膜分泌物或结膜刮片查嗜酸粒细胞阳性等实验室检查。②
doi:10.3969/j.issn.1007-614x.2020.35.040
摘要目的：研究因时辨证内外治并用治疗季节过敏性结膜炎的临床疗效。方法：2019年1-12月收治季节过敏性
结膜炎患者40例，随机分为两组，各20例。试验组根据春夏秋冬四季不同变化辨证口服中药及加味桑明液外用熏眼
治疗；对照组采用生理盐水熏眼及埃美丁滴眼液治疗。比较两组治疗效果。结果：试验组治疗总有效率高于对照组，
且复发率低于对照组，差异均有统计学意义(P ＜0.05)。结论：因时辨证内外治并用治疗季节过敏性结膜炎的疗效确
切，可有效降低复发率，值得广泛推广应用。
关键词因时辨证；内外治并用；季节过敏性结膜炎
陈怡璇
Clinical obrvation of asonal allergic conjunctivitis treated by dialectical internal and external therapy according to
time
全等变换Chen Yan
Affiliated Hospital of Changchun University of Traditional Chine Medicine,Jilin Changchun 130021
猫头鹰的故事Abstract Objective:To study the clinical efficacy of dialectical internal and external treatment according to time in the
treatment of asonal allergic conjunctivitis.Methods:From January to December 2019,40patients with asonal allergic
conjunctivitis were lected,they were randomly divided into the two groups with 20cas in each group.According to the different
changes of spring,summer,autumn and winter,the experimental group was treated with traditional Chine medicine and Jiawei
霜降养生
Sangming liquid for external u.The control group was treated with saline fumigation and emedastine difumarate eye drops eye
drops.The therapeutic effects of the two groups were compared.Results:The total effective rate of the experimental group was
可口可乐咖啡
higher than the control group,and the recurrence rate was lower than that of the control group,the difference was statistically
significant(P ＜0.05).Conclusion:The combination of dialectical internal and external treatment according to time is effective in the
treatment of asonal allergic conjunctivitis,which can effectively reduce the recurrence rate and is worth popularizing.
Key words Dialectical due to time;Combination of internal and external treatment;Seasonal allergic conjunctivitis
因时辨证内外治并用治疗季节过敏性结膜炎的临床观察
陈艳
130021长春中医药大学附属医院，吉林长春大个子老鼠和小个子猫的故事
凉台沟
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槲寄生下
