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Common Oral Drugs in Ophthalmology

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Updated: Wednesday, Sep 02,2009, 12:13:38 PM
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Drugs for Removing Wind

The common wind-removing drugs in ophthalmology are of two kinds, diaphoretics pungent in flavour and cool in property and diaphoretics pungent in flavour and warm in property.

Drugs for removing wind have the effect to dispel  Pathogenic wind from the body surface to relieve swelling, stop pain and itching, arrest tears and remove nebula, so they are widely used in ophthalmology, especially in the treatment of external oculopathy at the beginning stage.



 Diaphoretics Pungent in Flavour and Warm in Property

Drugs of this kind are chiefly indicated for ophthalmopathy due to pathogenic wind-cold and the common drugs used in clinic are Jingjie (Herba Schizonepetae ), Qianghuo (Rhizoma seu Radix Notopterygii ) , Fangfeng (Radix Ledebouriae), Gaoben ( Rhizoma et Radix Ligustici), Xixin ( Herba Asari ), and Baizhi ( Radix Angelicae Dahuricae). These drugs have the effect of dispersing pathogenic wind-cold to subdue swelling, stop pain and itching and remove nebula. The drugs Jingjie, Qianghuo and Fangfeng can be very effective in dispersing wind to stop pain and itching and removing nebula and are often used compatibly to treat ophthalmalgia, headache, un-
bearable itching of eye and conjunctivitis caused by exopathic wind-cold; Qianghuo has a better effect in treating ophthalmagia due to pathogenic wind-dampness; Gaoben, the action of which is to disperse pathogenic wind and cold and can reach the vertex, is often used together with other wind-eliminating drugs to treat the cases due to exopathic wind and cold with pain in the vertex; Xixin, with a very strong effect of stopping pain, is often used to treat ophthalmopathy due to pathogenic wind-cold with severe ophthalmolgia and headache but its application should not last long; Baizhi, pertaining to yangming meridian, can relieve pain and lacrimation and is usually used to treat the cases due to exopathic wind and cold with headache and
massive tears.

Diaphoretics Pungent in Flavour and Cool in Property

Drugs of this kind are chiefly indicated for ophthalmopathy due to pathogenic wind-heat and the common drugs used in clinic are Sangye (Folium Mori), Juhua ( Flos Chrysanthemi ) , Bohe ( Herba Menthae ) , Gegen (Radix Puerariae ) , Chantui ( Periostracum Cicadae), Chaihu (Radix Bupleuri ), Manjingzi ( Fructus Viticis )and so on. All these drugs can expell pathogenic wind-heat to stop itching and pain and remove swelling and redness. Sangye and Juhua have the effect to remove pathogenic wind-heat and liver heat to improve the vision. They are often compatibly used to treat ocular diseases caused by pathogenic wind-heat of liver meridian; Bohe is a common drug to treat oculopathy due to pathogenic wind and heat, and Gegen which acts on the yangming meridian to remove wind and heat in the meridian is often used to treat oculopathy with pain in the forehead; Chantui can remove pathogenic wind-heat to relieve nebula and arrest itching, so it is often used to treat corneal nebula, blepharitis marginalis and other obvious itching symptoms of eye; Chaihu has the effect of reducing fever, soothing the depressed liver and invigorating the spleen yang, so when compatibly used with other different drugs, it is often applied to treat corneal nebula due to pathogenic wind-heat or liver heat, ptosis of upper eyelid due to deficiency of the middle energizer, or various internal and external oculopathy due to stagnancy of liver qi.

Heat-clearing Drugs

Heat-clearing drugs which are cold or cool in property have the effect to relieve swelling and pain by removing redness and detoxicating and are chiefly used to treat various ophthalmopathy of heat types caused by noxious heat and Pathogenic fire which invade the eye. The common drugs for heat-removing are classified as heat-clearing and detoxicating drugs, heat-clearing and fire-purging drugs, viscera-purging and heat-clearing drugs, heat-clearing and vision-improving drugs and heat-clearing and blood-cooling drugs.

Heat-clearing and Fire-purging Drugs

Drugs of this kind are mainly indicated for ophthalmopathy due to excessive pathogenic heat. The common drugs used in clinic include Longdancao (Radix Gentianae), Huanglian (Rhizoma Coptidis), Huangqin (Radix Scutellariae ), Huangbai ( Cortex Phellodendri ),Shanzhizi ( Radix Dittospori ), Shigao ( Gypsum Fibrosum ), Zhimu ( Rhizoma Anemarrhenae ), Sangbaipi ( Cortex Mori), Danzhuye ( Herba Lophatheri) and so on. Among them, Longdancao, which can remove excessive pathogenic heat of the liver and spleen, is often used to treat corneal disorders due to fire hyperactivity of the liver; Huanglian purges heart fire and irritability and is
used to treat blepharitis angularis or canthal redness; Huangqin and Sangbaipi can purge lung fire and are used to treat hyperemia of bulbar conjunctiva; Huangbai purges kidney fire, disperses deficient fire and controls ministerial fire, and it is often used compatibly with Zhimu to treat ophthalmopathy caused by yin deficiency and fire hyperactivity, and togethor with Huanglian and Huangqin to treat ophthalmopathy due to pathogenic damp-heat; Shanzhizi can purge the fire of sanjiao (triple energizer) and is applicable to all types of ophthalmopathy due to excessive
heat when combined with other heat-clearing drugs; Shigao and Zhimu purge stomach fire and are used to treat palpebral edema and hypopyon; Danzhuye can remove heart fire and induce diuresis and is used to treat pterygiurn and canthal redness.

Viscera-Purging and Heat-clearing Drugs

Drugs of this kind is chiefly indicated for redness, swelling and pain of eye and tears with mucopurulent secretion due to sthenia of yangming fu-organ and internal heat affection of the eye. The common drugs are Dahuang (Radix et Rhizoma Rhei ) and Mangxiao (Natrii Sulphas) and so on.

Heat-clearing and Detoxicating Drugs

Drugs of this kind are chiefly indicated for ophthalmopathy of the excessive heat type due to all sorts of pathogenic noxious heat. The common drugs used in clinic are Jinyinhua ( Flos Lonicerae ), Lianqiao ( Fructus Forsythiae ) , Daqingye ( Folium Isatidis ) , Banlangen (Radix Isaticlis), Zihuadiding (Herba Violae ), Pugongying
(Herba Taraxaci) and so on.

Heat-clearing and Blood-cooling Drugs

Drugs of this kind are mainly indicated for ophthalmopathy caused by heat invasion of blood, especially for bleeding due to blood heat and sudden diminution of vision.The common drugs used clinically are Shengdihuang (Radix Rehmanniae ) , Mudanpi ( Cortex Moutan Radicis ) ,Xuanshen ( Radix Scrophulariae ), Chishaoyao ( Radix Paeoniae Rubra ), Zicao ( Radix Arnebiae seu Lithospermi) and so on. The drugs Mudanpi and Chishaoyao
can remove heat by cooling blood and activate blood circulation to relieve blood stasis; Shengdihuang and Xuanshen remove heat by cooling blood and nourish yin to promote body-fluid production; Zicao is better for heat-clearing and blood-cooling.

Tonic Drugs

Since most ophthalmopathy cases of asthenia types are usually caused by deficiency of qi and blood or of the liver and kidney, the common ophthalmic tonic drugs are clinically classified as qi and blood tonics, and liver and kidney tonics.

Heat-clearing and Vision-improving Drugs

The common drugs of this kind are Xiakucao (Spica Prunellae ) , Juemingzi ( Semen Cassiae ), Qingxiangzi ( Semen Celosiae ), Mimenghua ( Flos Buddlejae ), Muzeicao (Herba Equiseti Hiemalis) and so on. Xiakucao reduces stagnant fire from the liver and gallbladder, applicable to the treatment of ocular redness, swelling and pain due to hyperactivity of liver-fire. Combined with Xiangfu, it can treat pain of the eye due to liver stagnation. Qingxiangzi and Juemingzi clear the liver and improve eyesight. Mimenghua expels wind-heat, nourishes the liver and moistens dryness. They can be used to treat eye disorders of both deficiency and excess syndromes, especially the disorder caused by heat resulting from deftciency of the liver and kidney. Muzeicao disperses windheat, removes cataract and improves eyesight.

Oi and Blood Tonics

Qi Tonics

Drugs of this kind are applicable to sleepy eyelids and chronic nebula. The common drugs used in clinic are Huangqi (Radix Astragali seu Hedysari), Baizhu (Rhizoma Atractylodis Macrocephalae ), Dangshen ( Radix Codonopsis Pilosulae ), Shanyao (Rhizoma Dioscoreae ) and so on.

Blood Tonics

Drugs of this kind are applicable to dry sensation of eye, dizziness and night blindness due to deficiency of blood. The common drugs used in clinic are Shudihuang (Radix Rehmanniae Praeparata ), Baishaoyao ( Radix Paeoniae Atba ) , Danggui ( Radix Angelicae Sinensis ), Heshouwu ( Radix Potygoni Multiflri ),  Sangshenzi (Fructus Mori ), Ejiao (Colla Corii Asini ) , Guiyuanrou (Arillus Longan) and so on.

Liver and Kidney Tonics

Drugs of this kind are applicable to internal and external oculopathy due to asthenia of the liver and kidney. The common drugs used in clinic are Gouqizi (Fructus Lycii) , Nuzhenzi ( Fructus Ligustri Lucidi) , Tusizi ( Semen Cuscutae), Chushizi ( Frucuts Broussonetiae), Duzhong ( Cortex Eucommiae ), Hanliancao ( Herba Ecliplae), Fupenzi (Fructus Rubi), Shudihuang ( Radix Rehmanniae Praeparata) and so on. Among them, Gouqizi, which nourishes the liver and kidney and replenisixes vital essence to improve eyesight, is widely used to treat internal and external oculopathy caused by deficiency of the liver and kidney; Nfizhenzi, nourishing liver and kidney yin, is good at treating internal heat due to yin asthenia and is often used compatibly with Hanliancao to treat ocular bleeding at the early stage because of their joint action of cooling blood and stopping bleeding; Tusizi tonifies the liver and kidney to improve the vision; Chushizi reinforces liver and kidney to improve eyesight; Fupenzi tonifies the liver and kidney to reinforce vital essence to improve the vision; Duzhong, which nourishes the liver and kidney to strengthen bones and muscles, is widely used in a compatible way to treat internal oculopathy caused by asthenia of the liver and kidney with lassitude in loins and legs or listlessness and weakness; Shudihuang has a stronge action of nourishing yin and is often used to treat internal ocular diseases due to yin deficiency but should cautiously be applied to the cases with asthenia of the spleen and stomach, for it is moist and greasy in nature.

Drugs for Eliminating Dampness

Ophthalmopathy caused by pathogenic dampness is quite common in clinic. Drugs for eliminating dampness can astringe pathogenic dampness to treat ulcer, swelling
and nebula and are widely used in ophthalmic treatment.However, they must be cautiously applied to the cases due to deficiency of yin and blood or consumption of body fluids. The common drugs of this group include two kinds: aromatic drugs for resolving dampness and drugs for inducing diuresis and excreting dampness.


Drugs for Inducing Diuresis and Excreting Dampness

Drugs of this kind are used for the treatment of ocular troubles resulting from the upward attack of dampness or pathogenic damp-heat. The common drugs used in clinic include Fuling ( Poria ), Zhuling ( Polyporus ), Zexie ( Rhizoma A1ismatis ), Cheqianzi ( Semen Plantaginis), Yiyiren (Semen Coicis), Huashi (Talcum), Chixiaodou ( Semen Phaseoli ), Mutong ( Caulis Aristolochiae Manshuriensis) and so on. Among the drugs, Fuling and Yiyiren excrete dampness and induce diuresis by invigorating spleen and are used to treat ophthalmopathy caused by excessive dampness due to spleen asthenia; Zhuling, with the stronger effect of inducing diuresis and excreting dampness, can treat ocular edema, especially severe retinal edema when compatibly used with Fuling; Zexie, besides its effect of inducing diuresis and excreting dampness, can purge the pathogenic damp-heat of kidney and bladder and is compatibly used with Cheqianzi and Zhuling to treat ophthalmopathy due to damp retention or pathogenic damp-heat; Cheqianzi, which also has the effect of removing liver heat to improve eyesight, is compatibly used with other liver-heat-removing drugs to treat ocular redness, swelling and nebula due to hepatical heat; Huashi, which induces diuresis, excretes dampness and removes pathogenic heat and summer-heat, is used to treat ocular diseases due to pathogenic damp-heat; Chixiaodou, inducing diuresis to remove swelling and detoxicaring to evacuate pus, can not only treat retinal edema but also cure ocular ulcer and furuncle when it is compatibly used with other heat-clearing and detoxicating drugs; Mutong can remove heat and induce diuresis and is good at removing the pathogenic heat of heart and small intestine, so it is compatibly used with Zhuye, Huanglian and Shengdihuang to treat ophthalmopathy due to dampness and heat manifesting canthal redness, aphthous stomatitis, yellowish urine and a reddish tip of the tongue.

Aromatic Drugs for Resolving Dampness

Drugs of this kind are applicable to ophthalmopathy caused by internal retention of pathogenic dampness. The common drugs used in clinic are Huoxiang (Herba
Agastachis ) , Peilan ( Herba Eupatorii ) , Cangzhu ( Rhizoma Atractylodis ), Shicb_angpu (Rhizoma Acori Craminei), Baidoukou ( Semen Amomi Rotundus ) , Sharen (Fructus Amomi) and so on. The drugs Huoxiang and Peilan, which can relieve dampness by diaphoretic and regulate the middle energizer to resolve turbidity, are often used together to treat internal and external oculopathy caused by exopathic dampness or damp obstruction of spleen and stomach; Cangzhu astringes dampness by invigorating spleen and is used to treat palpebral ulcer, nebula and retinal edema, and it can treat nyctalopia due to liver asthenia when decocted with pig liver; Shichangpu which is aromatic can remove dampness and improve vision by resuscitation; Baidoukou and Sharen have the effect of regulating qi, drying dampness and warming the middle energizer and are often used to treat ocular disorders due to damp retention in the spleen and stomach.

Blood-regulating Drugs

Drugs of this kind are used for the treatment of ophthalmopathy caused by suffusion, blood stasis, blood heat and blood asthenia. For suffusion cases, the treatment should be to arrest bleeding, for blood stasis to activate blood circulation, for blood heat to cool blood, and for blood asthenia to tonify blood. As blood-cooling drugs and blood tonics are mentioned in the heat-clearing and tonic
drugs above, hemostatic drugs and drugs for promoting blood circulation and removing blood stasis are to be discussed here.
  

Hemostatic Drugs

These drugs are applicable to hemorrhagic ophthalmopathy. Since their hemostatic effects are different by cooling, by astringing and by removing stasis, the common hemostatics in ophthalmology should be carefully chosen in clinic according to the hemorrhagic causes.

Cooling Hemostatics: They are used to treat hemorrhagic syndromes of bleeding due to blood heat, and the common drugs are Daji (Herba seu Radix Cirssi Japonici), Xiaoji (Herba Cephalanoploris ), Cebaiye ( Cacumen Biotae), Baimaogen ( Rhizoma Imperatae ), Iiyu ( Radix Sanguisorbae), Huaihua (Flos Sophorae) and so on.

Astringing Hemostatics: They are used to treat ophthalmopathy with new hemorrhagia and traumatic bleeding, and the common drugs are Baiji (Rhizoma bletellae ),  Xueyutan ( Crinis Carbonisatus ),  Xianhecao ( Herba Agrimoniae ) , Oujie ( Nodus Netamoinis Rhizomatis) and so on.

Stasis-removing Hemostatics: They are used to treat the cases of bleeding due to blood-stasis and the common drugs are Sanqi (Radix Not(Ginseng), Puhuang (Pollen
Typhae ), Qiancao (Radix Rubiae ), Huaruishi ( Ophicalcitum) and so on.

Drugs for Promoting Blood Circulation and Removing Blood Stasis

Drugs of this kind are used to treat ophthalmopathy caused by stagnancy of qi and blood and are often applied together with drugs to promote qi circulation. The common drugs are Taoren (Semen Persicae ), Honghua ( Flos Carthami) , Danshen (Radix Salviae Miltiorrhizae), Chuanxiong ( Rhizoma Ligustici Chuangxiong ), Liujilu ( Herba Artemisiae Anomalae ), Zelan ( Herba Alismatis), Wangbuliuxing (Semen Vaccariae ), Ruxiang (Resina Olibani), Moyao (Myrrha), Chishaoyao (Radix Paeoniae Rubra ), Mudanpi (Cortex Moutan Radicis), Sumu (Lignum Sappan), Jixueteng ( Caulis Spatholobi) and so on.

Drugs for Regulating Qi

Drugs of this kind are used to treat ophthalmopathy caused by disorder of qi, most of which are pungent in flayour and warm in property, can easily consume qi and yin and should be cautiously used in the case of yin asthenia syndromes. The common drugs for regulating qi are clas sifted into two groups: the drugs for relieving liver and regulating qi and the drugs for promoting qi circulation to remove stagnancy.
 

Drugs for Relieving Liver and Regulating Qi

Drugs of this kind are used to treat ophthalmopathy due to stagnancy of liver qi. The common drugs used in clinic are Chaihu (Radix Bupleuri), Xiangfu (Rhizoma
Cyperi),  Qingpi  (Pericarpium  Cirri  Reticulatae Viride ), Chuanlianzi (Fructus Meliae Toosendan ), Yujin (Radix Curcumae), Foshou (Fructus Citri Sarcodactylis )  and so on.

Drugs for Promoting Qi Circulation to Remove Stagnancy

Drugs of this kind are used to treat ophthalmopathy caused by qi stagnancy of spleen and stomach.  The common drugs used in clinic are Chenpi (Pericarpium Citri Reticulatae ) , Muxiang (Radix Auklandiae ) , Zhishi ( Fructus Aurantii Immaturus ), Houpo ( Cortex Magnoliae Officinalis ), Wuyao ( Radix Linderae ), Binglang ( Semen Arecae ), Chenxiang ( Lignum Aquilariae Resinatum) and so on.

Drugs for Dissipating Mass

Drugs of this kind have the effect of removing blood stasis and mass or removing stagnant food to improve appetite. In the course of ocular disorders, they can compatibly used to treat lumps, nodules and scars caused by stagnancy of qi and blood and by accumulated phlegm. The common drugsin clinic are Kunbu ( Thallus Laminariae), Haizao ( Sargassum ), Walengzi ( Concha Arcae ),Xiakucao ( Spica PruneUae ) , Beimu ( Bulbus Fritillariae ) , Muli ( Concha Ostreae ) , Sanleng (Rhizome Sparganii), Ezhu ( Rhizoma Zedoariae ), Haigeke ( Concha Meretricis seu Cyclinae), Haifushi (Pumex) and so on.

Drugs of Removing Nebula to Improving Vision

Drugs of this kind can dispel wind and heat, remove hepatical heat, calm liver and relieve nebula to improve the vision. The common drugs used in clinic are Chantui ( Periostrazum Cicadae), Qinpi ( Cortex Fraxini ) , Gujingcao ( Flos Eriocauli ), Muzeicao (Herba Equiseti Hiemalis ), Mimenghua ( Flos Buddlejae ),  Shijueming
( Concha Haliotidis ), Baijili ( Fructus Tributi ), Qingxiangzi ( Semen Celosiae ) , Zhenzhumu ( Concha Margaritifera Usta ) , Shetui (Periostracum Serpentis ) , Haipiaoxiao (Os Sepiella seu Sepiae) and so on.

Chantui, Qinpi, Gujingcao and Mimenghua are applicable to nebula due to pathogenic wind and heat, and Shijueming, Baijili, Zhenzhumu and Qingxiangzi are applicable to nebula due to hepatical heat. When compatibly used, they are all used widely in clinic to treat various new and old nebulas.


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