Naoluotong Effects And Mechanisms Of The Different Course Of Diabetic Retinopathy In Rats

Diabetic retinopathy is the most commonly and severely long-term microvascular complication of diabetes mellitus(DM), One of four reasons leading to blindness at present. Western medical is not still very clear about its pathogenesis, and microcirculation disturbance Chiefly is thought to play an critical role in the occurrence and development of DR without valid prevention and cure measures at the moment. In the past few years, based on the traditional Chinese medicine(TCM) principles of treating "pre-diseases" and "The prolonged illness attacking the collateral branch of large channel", we have reported that significant amelioration can be provided by treatment with drugs of promoting blood circulation and dredging the channels through clinical and experimental studies, which suggested the retention of blood stasis in channels was the main pathological base and invigorate the circulation of blood stasis and dredging the channels was the clinical principles of treating DR. The goal of the present study was to evaluate the protective and therapeutic effects and mechanisms of Luo Tong on streptozotozin-induced diabetic retinopathy after 6 9 12 months and to investigate the nature , the clinical diagnosis and therapeutic principle of Collateral Disease, as well as the compatibility characteristics of drugs for treating collateral disease.The Literature and theory research section preliminarily summarized and discussed the present study on DM and DR with Chinese and western medicine, and pointed out the existing problems of current situation and the methods of further research as follows : On literature , venerate hi story, place emphasis on correction; In theory , Venerate literature , Emphasize innovation ; On clinical , Reference experience , Lay stress on proof ; On scientific research , Venerate scientific knowledge , Follow rules and laws. The etiology, pathogenesis and clinical manifestation of retention of blood stasis in channels in DR, as well as the treatment principles of DR and Collateral Disease, were summarized and generalized from the studies of modern and archaic documentary materials which can reflect the academic viewpoints of different schools of TCM. We also summarized the basic therapeutic principles and methods for treating collateral disease, For instance, stasis resolving should be adopted according to the particular cause and the locality of disease, elimination in combination with reinforcement, And the compatibility c characteristics of drugs for treating collateral disease by an analogy. That is to say, drugs pungent and sweet in flavor with the function of dispersing pathogenicfactors and opening the blockage in collaterals, Insect herbs with the property of running with the function of removing evil Qi and dredging the collaterals, Animal herbs with the same nature of human body with the function of cultivating the essential Qi.The experimental study adopted the retina digest technique, cell death in situ detect, immunohistochemical stain, light microscope and transmission elctron microscope observation and computer Image Analysis , in order to determine the 6 9 12 months' diabetic rat retinal capillary pathological changes and Luo Tong's prevention and cure actions. The results showed the expression level of FN and LN was significantly higher in the model group, and retinal microvessels of 6-month diabetic rats showed TUNEL+ pericyte, which were absent in control rats. Retinal micrographs of 9, 12month diabetic rats showed pericyte and endothclial cell apoptosis with TUNEL reaction and PAS stain. At 12 months, endothelial cell apoptosis were more serious, and each of the pictures showed TUNEL+ endothelial cell or apoptotic bodies with the light microscopic view. These findings indicated the more the extending of DM course, The more conspicuous the pathological changes of diabetic retinal microvessels, DM leads to accelerated death in situ of pericyte in the early stages of retinopathy, and with the advance of disease, the endothelial cell apoptosis would occur, and the FN and...