非動脈炎性前部缺血性視神經病變

Non-arteritic Anterior Ischaemic Optic Neuropathy (NAION)

非動脈炎性前部缺血性視神經病變表現為突發性單側視覺喪失,視野缺損及視力下降,但不伴有劇烈疼痛。


此病對應中醫眼科病之〝暴盲〞(定義:平素眼無它病,外觀端好,猝然一眼或雙眼視力急劇下降,甚至失明的內障眼病)。此病如未有適當治療,可發展為中醫眼科病中之〝青盲〞(定義:青盲是指眼外觀端好,而視力漸降至盲無所見的眼病)。


此病需要西醫血液學及頭顱影像等檢查以排除其他疾患方能確診。此病屬中醫眼科瞳神疾患,患眼發病時視力驟降甚至失明,病機多為肝火上攻目系或氣滯血鬱,導致竅道蔽阻而發病。中醫所謂〝目系〞指眼球後方與腦相連繫的組織,為足厥陰肝經所主,與肝、腎關係密切。眼底檢查可見視乳頭水腫、充血、靜脈擴張等;中醫可將這些症狀考慮為〝熱盛血壅,氣血不通〞,或〝陰精虧虛,氣血不暢,壅塞脈道〞等。


中醫治病時必須分清虛實,急性期多見實證,慢性多虛實夾雜。實證以瀉肝疏肝為主;本虛標實則以滋養肝腎、補益氣血為主,佐以活血通絡。 

   

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