宋焰 李翔 聂辅娇 符超君 秦裕辉

    〔摘要〕 秦裕辉教授系湖南省名中医、眼科专家，从医37年，具有丰富的临床经验。上睑下垂有先天与后天之分：先天多因禀赋不足，脾肾阳虚，睑肌发育不全而致升举乏力;后天多由脾胃气虚，升阳无力或气血亏虚，风邪客睑所致。秦教授认为胞睑在五轮学说中为肉轮，在脏属脾，脾与胃相表里，故本病多从脾胃论治，同时要将患者眼的局部症状与全身症状及体质特征结合起来辨析病因病机，从整体出发，分清扶正与祛邪的轻重缓急。处方用药上以牵正散、人参败毒散、补阳还五汤经典方剂为基础，以补气、祛痰、通络为主，调整患者气血阴阳，使其气血充足，脉络通畅，胞睑得精气充养则能开合自如。秦教授在临床上治疗上睑下垂用药经典，直中病机，疗效显著，记录其医案三则，以飨后学。

    〔关键词〕 上睑下垂;牵正散;人参败毒散;补阳还五汤;医案;秦裕辉

    〔中图分类号〕R276.7 ? ? ? 〔文献标志码〕B ? ? ? ?〔文章编号〕doi：10.3969/j.issn.1674-070X.2022.01.019

    〔Abstract〕 Professor Qin Yuhui is a famous doctor of traditional Chinese medicine in Hunan Province， as well as an ophthalmological expert. He has been practicing medicine for 37 years and has extensive clinical experience. Ptosis can be divided into congenital and acquired. Congenital is often due to insufficient endowment， Yang deficiency of the spleen and kidney， and hypoplasia of the eyelid muscles， which lead to lack of lift. The acquired disease is mostly caused by spleen and stomach Qi deficiency， weakness of rising Yang or deficiency of Qi and blood， and wind evil staying on the eyelids. Professor Qin believes that the eyelid is the flesh wheel in the five-wheel theory. It belongs to the spleen ......