〔摘要〕 黄元御，清代著名医家，其代表性著作《四圣心源》的主要学术理论可概括为“土枢四象、一气周流”，强调中气之升降浮沉是维持五脏六腑生理功能的基础，以脾土之气为轴，心、肺、肝、肾为轮，轴运轮转，推动心、肺、肝、肾四象互生互化互制，生生不息。基于“土枢四象、一气周流”理论结合秦裕辉教授临床实践探析年龄相关性黄斑变性，将其病因病机概括为“脾土衰败、湿浊困脾;肝木不足、癸水亏虚;木气郁滞、脾土壅塞”，依“运轴行轮、运轮复轴、轴轮并运”之法，行“健土祛湿以复中焦，滋补乙木、润养癸水，疏达乙木、健运己土”之法，为年龄相关性黄斑变性的辨证论治扩展思路。

    〔关键词〕 年龄相关性黄斑变性;视瞻昏渺;土枢四象、一气周流;黄元御

    〔中图分类号〕R276.7" " " " "〔文献标志码〕A" " " " " 〔文章编号〕doi：10.3969/j.issn.1674-070X.2024.08.028

    Professor QIN Yuhui's experience in treating age-related macular degeneration based on the theory of \"earth as the pivot of the four organs， unified qi in circular flow\"

    DENG Jie1，2， QIN Yuhui1，2*

    1. The First Clinical School of Chinese Medicine， Hunan University of Chinese Medicine， Changsha， Hunan 410007， China;

    2. Graduate School， Hunan University of Chinese Medicine， Changsha， Hunan 410208， China

    〔Abstract〕 HUANG Yuanyu， a renowned physician of the Qing Dynasty， is best known for his seminal work Si Sheng Xin Yuan (Four Sages' Study). The main academic theory applied in this book can be summarized as \"earth as the pivot of the four organs ......