CAJ | 학술논문

庄曾渊研究员根据老年性黄斑变性发生、发展的病理过程及证候演变规律，基于病证结合的原则，提出从精气血津液辨证分期论治老年性黄斑变性的辨证论治体系。其认为：精气亏损证，多见于老年性黄斑变性早期，治以补肾填精，方以五子衍宗丸合四物汤或杞菊地黄丸；气液失调证，治以舒畅三焦、行气利水散滞，方以小柴胡汤合当归芍药散加减；络伤血溢证，治以凉血止血、益气利湿，方以生蒲黄汤加减；痰瘀互结证，多见于湿性晚期老年性黄斑变性，治以活血化瘀、软坚散结，方以化坚二陈汤合升降散加减。对临诊时出现过渡类型或证候重叠现象，应始终以中医辨证论治为依据。
장증연연구원근거노년성황반변성발생、발전적병리과정급증후연변규률，기우병증결합적원칙，제출종정기혈진액변증분기론치노년성황반변성적변증론치체계。기인위：정기우손증，다견우노년성황반변성조기，치이보신전정，방이오자연종환합사물탕혹기국지황환；기액실조증，치이서창삼초、행기이수산체，방이소시호탕합당귀작약산가감；락상혈일증，치이량혈지혈、익기리습，방이생포황탕가감；담어호결증，다견우습성만기노년성황반변성，치이활혈화어、연견산결，방이화견이진탕합승강산가감。대림진시출현과도류형혹증후중첩현상，응시종이중의변증론치위의거。
In line with the occurrence,pathological development and evolvement rule of symptoms of senile macular degeneration,and based on the integration of disease and symptoms,Prof. Zhuang Zengyuan proposed the stage differentiation and treatment system of senile macular degeneration with essence,qi,blood and body fluid theory. Prof. Zhuang viewed:essence and qi deficiency is commonly seen in the early stage of senile macular degeneration,it should be treated by tonifying Kidney and filling up essence with wuzi yanzong wan plus si wu tang or qiju dihuang wan;qi and fluid maladjustment should be treated by promoting the circu-lation of three Jiao,benefiting qi circulation and water metabolism and dispersing stagnation with modified xi-ao chaihu tong plus danggui shaoyao san;blood disorder due to collateral injury should be treated by cooling blood,stopping bleeding,benefiting qi and removing dampness with modified shengpuhuang tang;interaction of phlegm and stasis is commonly seen in the late stage of senile macular degeneration of damp nature,should be treated by activating blood circulation,resolving stasis and softening masses,with modified huajian erchen tang plus sheng jiang san. For the transitional syndrome or syndrome overlapping during treatment,the treat-ment should be always based on the syndrome differentiation of TCM.