Sugar Head Ning Treatment Of Early Diabetic Retinopathy Clinical And Experimental Research

With the increasing of diabetes mellitus disease incident, diabetic retinopathy, as the main and serious complication is becoming the primary disease causing blindness in western countries. The pathogenesy of DR is not very clear now, and the therapeutic efficacy is not satisfying yet. Especially when disease develop to later stage, therapy would more difficult and cost would higher. It is important and essential to prevent and cure in morning stage, which is of great social significance.This study was based on the academic ideas of researcher Gao Jiansheng. We had studied the therapeutic efficacy of diabetic retinopathy with Tang Mu Ning and the molecular mechanism. We found that Tang Mu Ning could improve the eyesight, visual function and the fundus process of the patients. Techniques such as cell culture, flow cytometry and real-time polymerase chain reaction were used to study the molecular mechanism. We studied the apoptosis rate and the expression of apoptosis factor such as Bax, Bcl-2, caspase-3,caspase-9 and Cytochrome C. We have obtained findings of high academic value.Theoretical StudiesThere are many literatures about the prevention and cure of DR now, but the therapeutic ideas has not been broke through. Prof. Gao Jiansheng preferred new opinion on the treatment of DR after a great deal of clinical and experimental research and the experience of the predecessors.1 Diabetic retinopathy occured in the intermediate and later stage of diabetes mellitus when transformation between yin and yang, chills and fever, deficiency and excess occurred. We should treat the patients with the method of supplementing qi and nourishing yin for their elemental syndrome, on the other hand, we should treat with the method of warming yang and keeping heart and kidney in balance for disease feather of DR, which is the interlacing of yin and yang, chills and fever, deficiency and excess.2 The haemorrhage, dropsy and effusion caused by DR is different from what caused by sthenia fire of heart, liver and gall. Process caused by DR has some link to apoptosis while what caused by sthenia fire of heart, liver and gall has some link to cellular necrosis. So we should not use much medicine of cooling blood to stop bleeding to treat DR like what we usually do to the sthenia fire.3 It was helpful when we use berberine or cassia singly to control patients' blood glucose, but there was some adverse effect to some of patients. This is because we only aimed directly at disease or sign instead of syndrome. But it showed better effect using both berberine and cassia without the adverse effect because of restricting each other. This is the reason of Jiao Tai Pill (both berberine and cassia are used) why it could be used to treat DR.4 It has already been confirmed through experiments that Jiao Tai Pill could effectively delay the occurrence and development of retinal microangiopathy in STZ-diabetic rats. It could inhibit retinal vascular endothelial apoptosis and relieve pathological changes of acellular capillaries. Jiao Tai Pill could improve general status of STZ-diabetic rats and postpone or stop cataract. It has also been confirmed buddlejae could inhibit the proliferation of human umbilical vein vascular endothelial cell.5 On the bases of above clinical and experimental experience, Prof. Gao Jiansheng constructed Tang Mu Ning composed by Astragalus mongholicus, ligustri lucidi, herba leonuri, fructus mume, coptidis rhizoma, cassia and flos buddlejae.Clinical researchWe separated the patients consistent with our diagnostic criteria into two groups: treatment group and control group, giving them Tang Mu Ning and calcium dobesilate for 3 months respectively.Results:1 Eyesight of the patients in treatment group was greatly improved, and the fundus processes were much better after treatment than that of control group.2 Amplitude of ocillatry potentials and mean photaesthesia of treatment group patients were elevated signifficantly after 3 months' treatment.3 Glycosylated hemoglobin, indexes of blood biochemistry and blood rheology showed no mark chang after treatment both treatment group and control group.4 Tang Mu Ning could greatly improve DR patients' symptoms, such as debility, buming sensation of five centers, alvo adstricto, et al.Experimental researchApoptosis rate and corrected apoptosis factors were checked of cattle retinal capillary endothelium cell (CRCEC) through the technique of flow cytometry and real-time polymerase chain reaction.Results:1Tang Mu Ning could degrade the apoptosis rate of CRCEC in high glucose condition.2 Tang Mu Ning could degrade the express of Bax, Caspase-3, Caspase-9 and Cytochrome C of CRCEC in high glucose condition and elevate the express of Bcl-2 of CRCEC in high glucose condition.New ideas:1 Treating DR from the angle of heart and kindney, providing a new idea of recognizing and treating DR.2 Treating DR with Tang Mu Ning, evaluating the effect with several kinds of objective examinations, and approaching the mechanism in molecular level.