CAJ | 학술논문

目的：通过证候调查及专家问卷咨询探讨原发性青光眼抗青光眼术后中医证候特点，以建立青光眼术后证候诊断标准。方法将青光眼术后证候调查结果汇总为调查问卷进行专家咨询，根据回馈建议修正证候分型并通过术后1个月、6个月及1年对比分析总结其证候特点，确定证候诊断。结果（1）根据专家咨询建议将证候类型修正为气郁证、气虚证、气血两虚证、肝肾阴虚证4种，且绝大多数患者可纳入此4种证候分型。（2）原发性青光眼患者在术后1个月气郁证46例，气虚证18例，气血两虚证19例，肝肾阴虚证23例；术后6个月上述4种证型分别为37、15、33、29例；术后1年分别为32、9、36、31例。（3）青光眼患者在术后6个月时证候转化率为28.9%，1年时证候转化率为10.2%。（4）血瘀证兼证在青光眼术后1个月、6个月、1年的比例分别是73.6%、64.1%、75.9%。结论（1）原发性青光眼患者术后均可分为气郁证、气虚证、气血两虚证、肝肾阴虚证4种证型。（2）原发性青光眼患者在术后早期均以气郁证多见；证型稳定后以气郁证、气血两虚证、肝肾阴虚证多见；随着病程延长，存在着证候由气郁证向气血两虚证、肝肾阴虚证转化，即由实转虚的趋势。（3）原发性青光眼在术后6个月以后证型相对稳定，说明术后青光眼具有相同或类似的病例基础。（4）血瘀证是青光眼术后重要的病理特点之一。
목적：통과증후조사급전가문권자순탐토원발성청광안항청광안술후중의증후특점，이건립청광안술후증후진단표준。방법장청광안술후증후조사결과회총위조사문권진행전가자순，근거회궤건의수정증후분형병통과술후1개월、6개월급1년대비분석총결기증후특점，학정증후진단。결과（1）근거전가자순건의장증후류형수정위기욱증、기허증、기혈량허증、간신음허증4충，차절대다수환자가납입차4충증후분형。（2）원발성청광안환자재술후1개월기욱증46례，기허증18례，기혈량허증19례，간신음허증23례；술후6개월상술4충증형분별위37、15、33、29례；술후1년분별위32、9、36、31례。（3）청광안환자재술후6개월시증후전화솔위28.9%，1년시증후전화솔위10.2%。（4）혈어증겸증재청광안술후1개월、6개월、1년적비례분별시73.6%、64.1%、75.9%。결론（1）원발성청광안환자술후균가분위기욱증、기허증、기혈량허증、간신음허증4충증형。（2）원발성청광안환자재술후조기균이기욱증다견；증형은정후이기욱증、기혈량허증、간신음허증다견；수착병정연장，존재착증후유기욱증향기혈량허증、간신음허증전화，즉유실전허적추세。（3）원발성청광안재술후6개월이후증형상대은정，설명술후청광안구유상동혹유사적병례기출。（4）혈어증시청광안술후중요적병리특점지일。
OBJECTIVE To investigate the characteristics of TCM syndromes and evolution in postoperative patients with primary glaucoma through expert consultation and “The TCM Syndromes Questionnaire”. METHODS Revised the syndrome types of postoperative glaucoma based on expert suggestion of “The TCM Syndromes Ques-tionnaire”. And then the distribution and evolution of TCM syndromes were analyzed comparatively in postoperative patients at one month, six month and 1year. RESULTS (1) the TCM syndromes were qi stagnation due to depression of the liver qi deficiency, deficiency of both qi and blood, yin deficiency of liver and kidney; and most of patients could be included among these 4 kinds. (2) The patients of primary glaucoma with qi stagnation syndrome, qi defi-ciency, deficiency of both qi and blood, yin deficiency of liver and kidney were respectively 46, 18, 19 and 23 cases one month of postoperative;37, 15, 33 and 29 cases six months, and 32, 9, 36 and 31 cases one year postoperative. (3) The change of TCM syndrome was 28.9%six month postoperative;but 10.2%1 year postoperative. (4) The rate of blood stasis syndrome in one month, six months and 1 year postoperative was 73.6%, 64.1%and 75.9%. CON-CLUSIONS (1)The syndromes of postoperative glaucoma could be divided into 4 types of qi stagnation due to de-pression of the liver, qi deficiency, deficiency of both qi and blood, yin deficiency of liver and kidney. (2) Four types of glaucoma had the same types of syndrome in the early postoperative they were more common qi stagnation. With the extension of the course, there was the trend of transformation from excess into deficiency syndrome. (3) Af-ter 6 months, the TCM syndrome was relatively more stable. (4) Blood stasis syndrome was an important pathology with postoperative glaucoma.