目的 对比治疗3种致盲性眼病糖尿病视网膜病变（diabetic retinopathy，DR）、青光眼、年龄相关性黄斑变性（age-related macular degeneration，AMD）中药的特点和用药规律异同。方法 检索中国知网、万方、维普、中国生物医学文献数据库和古今医案云平台2000年1月—2023年10月的相关文献和医案，对治疗3种致盲性眼病的中药进行用药频次、性味归经、功效分类、关联规则、核心处方等数据挖掘分析。结果 DR、青光眼、AMD 3种疾病使用频数排名前3位的中药分别为黄芪、丹参、生地黄，当归、茯苓、柴胡，枸杞子、茯苓、当归。关联规则展示了治疗三者置信度最高的中药组合分别为黄芪→葛根-生地黄、当归→白芍-茯苓、枸杞子→菟丝子-当归。3种眼病的核心证候以虚为主，总体呈虚实夹杂。其中，DR以气阴两虚证为多，最主要的证候用药为丹参-牡丹皮-当归-茯苓-枸杞子-黄芪-山药-生地黄；青光眼以肝郁气滞证为多，最主要的证候用药为川芎-茯苓-黄芪-泽泻；AMD以脾虚证为多，最主要的证候用药为车前子-黄芪。DR是以山茱萸-牡丹皮-葛根-泽泻-麦冬-山药-当归构成的六味地黄丸为基础进行加减，体现养气阴、健脾肾、清湿热、祛瘀血的治法；青光眼是以川芎-茯苓-生地黄-泽泻-枸杞子-红花-黄芪-柴胡-当归-菊花-葛根构成的加减六味地黄汤为基础进行加减，体现行气机、利水湿、补肝肾、清肝热的治法；AMD是以菟丝子-茯苓-熟地黄-枸杞子-当归-三七-黄芪构成的保元八珍汤为基础进行加减，体现补肝肾、健脾肾、行气血、益正气的标本同治的治法。结论 对比了治疗3种致盲性眼病DR、青光眼、AMD中药的特点，得出关键方剂并揭示其用药规律异同，从而为相关临床的复方开发利用提供有力依据。

Objective This study aims to compare the characteristics and principles of traditional Chinese medicine (TCM) used in the treatment of three types of blinding eye diseases, including diabetic retinopathy (DR), glaucoma, and age-related macular degeneration (AMD). Methods Relevant literature and medical cases from January 2000 to October 2023 were retrieved from databases, including CNKI, Wanfang database, VIP database, China Biology Medicine Disc, Ancient and Modern Medical Cases Cloud Platform. Data mining analysis was conducted on medication frequency, meridian tropism, efficacy classification, association rules, and core prescriptions. Results The top three commonly used TCMs in treatment of DR were Huangqi (Astragali Radix), Danshen (Salviae Miltiorrhizae Radix et Rhizoma) and raw Dihuang (Rehmanniae Radix). The top three frequently used TCMs in the treatment of AMD were Danggui (Angelicae Sinensis Radix), Fuling (Poria) and Chaihu (Bupleuri Radix). The top three frequently used TCMs in treatment of glaucoma were Gouqizi (Lycii Fructus), Poria and Angelicae Sinensis Radix, respectively. According to association rules analysis, the combinations of TCM with the highest confidence level in treatment of these diseases were Astragali Radix→Gegen (Puerariae Lobatae Radix)-Rehmanniae Radix for DR therapy; Angelicae Sinensis Radix→Baishao (Paeoniae Radix Alba)-Poria for glaucoma therapy; Lycii Fructus→Tusizi (Cuscutae Semen)-Angelicae Sinensis Radix for AMD therapy. The core syndromes of the three eye diseases are mainly deficiency, with a mixture of excess. Among them, DR is characterized by qi-yin deficiency, and the main syndrome drugs were Salviae Miltiorrhizae Radix et Rhizoma-Mudanpi (Moutan Cortex)-Angelicae Sinensis Radix-Poria-Lycii Fructus-Astragali Radix-Shanyao (Dioscoreae Rhizoma)-Rehmanniae Radix. Glaucoma is characterized by liver depression and qi stagnation, and the main drugs were Chuanxiong (Chuanxiong Rhizoma)-Poria-Astragali Radix-Zexie (Alismatis Rhizoma). AMD is characterized by spleen deficiency, and the main drugs were Cheqianzi (Plantaginis Semen)-Astragali Radix. The TCM prescriptions for DR were based on the Liuwei Dihuang Pills composed of Shanzhuyu (Corni Fructus)-Moutan Cortex-Puerariae Lobatae Radix-Alismatis Rhizoma-Ophiopogonis Radix-Dioscoreae Rhizoma-Angelicae Sinensis Radix, which embodies the treatment policy of nourishing qi-yin, strengthening spleen and kidney, clearing damping heat, removing extravasated blood. The TCM prescriptions for glaucoma were based on the modified Liuwei Dihuang Decoction composed of Chuanxiong Rhizoma-Poria-Rehmanniae Radix- Alismatis Rhizoma-Lycii Fructus-Carthami Flos-Astragali Radix-Bupleuri Radix-Angelicae Sinensis Radix-Carthami Flos-Puerariae Lobatae Radix, which embodies the treatment policy of promoting qicirculation, promoting diuresis and dampness, tonifying liver and kidney, clearing liver heat. The TCM prescriptions for AMD are based on the Baoyuan Bazhen Decoction composed of Cuscutae Semen-Poria-Shudihuang (Rehmanniae Radix Praeparata)-Lycii Fructus-Angelicae Sinensis Radix-Notoginseng Radix et Rhizoma-Astragali Radix, which embodies the treatment policy of nourishing the liver and kidney, strengthening the spleen and kidneys, promoting qi and blood circulation, and tonifying the vital energy to treat both cause and symptoms.Conclusions The current study compared the characteristics of TCM used in the treatment of DR, glaucoma, and AMD, thus identifying key prescriptions and elucidating their medication principles, offering valuable insights for the development and utilization of related clinical compounds.

R283.21

国家自然科学基金面上项目（82074499）;广州地区中西医协同临床重大创新技术建设项目（2023年度联合建设项目序号5）