| Professor Zhongzhi LI was born in a well-known family of traditional Chinese medicine. He has devoted himself to Chinese medicine more than 50 years, gathered rich experience of treating ophthalmology disease, especiallyocular fundus disease. Thanks to hard study of traditional medicine, intensive reading of TCM masterpiece, learning from many famous TCM masters, which involved internal medicine, gynecology, pediatrics, ophthalmology, Doctor LI developed his unique treating theory by absorbing the essence and became a well-known TCM oculist in nationwide. It is not limited to just one type, however in a combination with whole and local syndromedifferentiation as well as the unity of syndrome and disease differentiation. During his treatment of eye diseases, he thinks that the eye is upper orifice which needs the nourishment of Qi, blood, Yin-fluid and True-blood while damaged easily by the Shenguang. Thus the weakness of Yin is common reason, and nourishing the Yin blood is the main treatment. Eye is the orifice for the liver outside the body, and the blood storing in liver is True-blood. Thecatharsis of liver Qi plays a very important role in development of Shenguang. So another treatment is soothing and calm the liver during treating the eye diseases. The occurrence and development of the diseases revolve many organs and multi-implents, however the Heart Yang is very important. Doctor Li thinks highly of the preventive treatment of diseases, combination of the nourishing of life and treating disease, having few desires and nurturing the Soul and body. The occurrence of many stubborn ocular fundus disease relates to the endless thought and desire. He loves Confucianism and considers the thought of mean in his prescription. Comparing with the distant vision, he pays more attention on the near vision especial during the treatment ofamblyopia. He promotes that recovery of the near vision plays an important role of recovery of themacula lutea function, and the production of the eyeshade should be black outside and red inside which is single frequency. With a long time treatment and training of Threading a needle precisely is more useful than stringing beads.Western medicine examinations like FFA, OCT, ERG, etc are also be taken seriously during his treatment.In the second part, it summarize the knowledge and treatment of Chinese and Western Medicine currently. The opinion of Chinese Medicine of this disease is weakness of liver, spleen and kidney while combination of phlegm and blood stasis. So the treatment is to supply the liver, spleen and kidney while dissipating phlegm and removing blood stasis, instead of focusing on the function of heart which is the unique opinion of tutor's. He also reviews the new knowledge of this disease simply, which includes many researches,such as drugs and operations,but those treatment effects are not so satisfactory and expensive, even with side effects. Thus the alternative choice is Chinese medicine with its' effeteness, cheap and non-toxic advantages. Although Chinese medicine couldn't cure this disease, it can delay the development of the disease. The clinical research of this disease become more and more objective by the development of the using of OCT.In Doctor Li's opinion, the etiology and pathogenesis of AMD based on the weakness of spleen and kidney, stress on the asthenia of essence and blood, phlegm-turbid and blood stasis existcontinually, those promote and develop the course of disease. The main courses of dry age-related macular degeneration are the infirmities of old age, the asthenia of kidney, the weakness of spleen and devitalization of heart yang. As for the neovascular age-related macular degeneration, it mainly caused by the weakness of liver,spleen,kidney, Camp blood stagnation, Endogenous blood,water-fire imbalance,the depressed heat of heart, less blood and fluid of vessels, blood stasis caused by deficiency, loss of healthy transportation, turbid water and phlegm. Meanwhile, he thinks the cause of AMD is related many organs not only single one. Not only the liver, spleen and kidney are related to the disease,but also the heart.Being a vital viscus like a king of the body,the heart controls mental activities which conducts the Shenguang. The heart stores fire, while the old people lack of heart-yang which can warm and shining the body, or they lack of heart-yin which can lead blood heat. The heart dominates blood circulation and vessels that nourish the eye and develop the Shenguang. Those theories are different from the traditional theory that AMD is only realted to liver, spleen and kidney. Summing up the experience of Doc Li, the treatment of dry AMD is to strengthen spleen, supply kidney, smooth liver, warm heart-yang and reduce phlegm, while treating the neovascular AMD is to nourish essence and blood, Clear Ying heat and cool blood, resolve depression,and reduce phlegm and blood stasis. In the clinical research, we studied and summed up Doctor Li's experience of knowing and treating AMD for three years. The curative effect is evaluated by the vision, RNL, CBRC and TCM syndrome. Results:1.30 cases(35 eyes) in treatment group,7 eyes were cured,13 eyes had effect and 15 eyes with no effect, the total effectiverate was 57.14%.30 cases(30 eyes) in control group,3 eyes were cured, lOeyes had effect and 17 eyes with no effect, the total effectiverate was 51.43%, There was significant difference between two gtoup(P< 0.05).2. The treatment group and the control group were treated with the changes of visual acuity before and after treatment,the curative effect ofthe treatment group was better than the control group (P<0.05) 3. There was significant difference of RNL?CBRC thickness changes in treat group before and after treatment (P< 0.05),while with no difference of RNL thickness in control group (P> 0.05), with significant difference of CBRC thickness (P< 0.05), the CRBC thickness of treatment group is better than control group with significant difference.4. There was significant difference between before and after treatment of the symptom of eyes in both two groups (P< 0.05),and the treat group is better than control group.Through the above research, Doctor Li's experience of treating AMD are to nourish yin and focus on the heart function. First, the pathology and etiology of AMD is based on the weakness of spleen and kidney, keynote is insufficiency of essence and blood, key points are depressed heat of blood and devitalization of heart yang, the Heart-fire is important in the cause of disease and also the phlegm and blood stasis are symptoms. Second, yin frequently in deficiency and Multiple organs treating is common used in the treatment, while focus on regulating the function of heart. Third, to prescript guided by this treating theory can improve the patients'vision, prolong the development of disease,enhance the quality of life, is safe and effective. |
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