针刺上睛明、球后、阳白、窍明结合汤剂辨证论治脑梗死后同向偏盲2例

Acupuncture at Shang Jingming, Qiu Hou, Yangbai, and Qiaoming Combined with Decoction Based on Syndrome Differentiation in the Treatment of Homonymous Hemianopia after Cerebral Infarction: A Report of 2 Cases

摘要: 枕叶梗死是同向偏盲的最常见病因，2023~2024年，黑龙江中医药大学附属第一医院眼科收治2例脑梗死后偏盲患者。2例患者均在脑梗死后出现同向偏盲伴视力下降，于外院接受脑梗死对症治疗1个月以上，视功能及视觉质量未见明显改善，于我院就诊均诊断为脑梗死后同向偏盲、视神经萎缩，予针刺及汤剂口服辨证论治后视野及视力得到改善。本文通过对2例患者的诊治过程进行总结，浅析脑梗死后同向偏盲的发病机制及中医辨证论治经验。

Abstract: Occipital lobe infarction is the most common cause of homonymous hemianopia. From 2023 to 2024, 2 patients with hemianopia after cerebral infarction were admitted to the Department of Ophthalmology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine. Both patients suffered from homonymous hemianopia with decreased vision after cerebral infarction. They received symptomatic treatment for cerebral infarction in other hospitals for more than one month, and their visual function and visual quality did not improve significantly. They were diagnosed with homonymous hemianopia and optic atrophy after cerebral infarction in our hospital. After dialectical treatment with acupuncture and decoction, their visual field and vision were improved. This paper summarizes the diagnosis and treatment process of 2 patients, and analyzes the pathogenesis of homonymous hemianopia after cerebral infarction and the experience of TCM syndrome differentiation and treatment.