The Clinical And Experimental Research About Traditional Chinese Medicine Combined With Iontophoresis In The Treatment Of Retinal Vein Occlusion

Retinal vein occlusion is caused by arterial sclerosis;due to retinal vein receiving compression of arteria retina,vascular endothelial cell multiplication,Lumen of blood vessel angusty,fluidity and haemodynamics change,at last they form into thrombus of retinal blood vessel.It belongs to "sudden blindness","shi Than hun miao",and "hemorrhagic diseases" of ophthalmology.Medical doctor consider that the cause of RVO is complicated,pathogenesis is not identify,drug treatment is notsatisfactory,and laser therapy is just to deal with complication.Traditional Chinese medicine consider it there are many causes of RVO,pattern of syndrome is different,the capital patho-component is blood stasis,so activating blood circulation to dissipate blood stasis is indispensable therapy.We studied information of hospital patients with RVO in the first affiliated hospital of Guangzhou University of Traditiongal Chinese Medicine in the last 7 years.We analyzed distinguish on different pattern of syndrome and curative effect,compared patients who accepted iontophoresis combined with traditional Chinese medicine and the other ones who did not.lt is confirmed that iontophoresis combined with traditional Chinese medicine which activate blood circulation to dissipate blood stasis is effective treatment by reviewing,the improvement of visual acuity,the focal deflate of eye ground and so on. Part one Literature reviewFirst,the discussion of traditional Chinese medicine about RVO.They think it the gas and fire is the main factor which due to running disorder of blood vessel,there are many causes of RVO but at last they lead to running disorder of blood vessel and ocolas veins.Blood stasis exist in the procedure of RVO all the time.We distinguish pattern of syndrome and stages to heal it,and we applicate Chinese herb to dissipate blood stasis.Second,advancement of modern medical research on RVO.Medical doctor consider that the pathogenesis is complicated,not identify,systematic factor include sexuality,age,hypertensive disease,diabetas mellitus and fluidity change,local factor include ocolas opography structure,type of retinal AtV crosswise,refraction,axis oculi,glaucoma or ocular hypertention.The main methods to cure RVO are laser therapy and operation.Third,the present condition and advancement of iontophoresis combined with medicine to cure RVO.The method of oculas iontophoresis is to utilize rejection of the same charges and attraction of the opposite charges in electrical field,then drug ion and colloid particle of inorganic compound or organic compound come into the eye to treat the disease.There are some experimental and clinical study.Part two the experimental study on iontophoresis combined with ligustrazineinjectionPurpose:Use High performance Liquid Chromatography to determine contents of Ligustrazine in the aqueous humor and vitreous body of rabbit eyes,to get information of absorption,distribution and metabolism of active component after iontophoresis combined with ligustrazine injection.Method:After iontophoresis combined with ligustrazine injection,choose different time,draw off a little aqueous and vitreous, carry out vortex shork and centrifugalization,select clear supernatant liquid to sample introduction,Use High performance Liquid Chromatography to determine contents of Ligustrazine in the aqueous and vitreous.Waters Company symmetryC18(Sum,4.6×150mm),mobile phase:methanol:water=40: 60,SDS0.9130g per 1000ml,potassium dihydrogen phosphate0.6770g,glacial acetic acid 1ml,wave length:294nm,flow rate:1ml/min,operation in room temperature. Result:In the rage of 1.25ug/ml to 36ug/ml in aqueous,the peak areas and concentration of Ligustrazine show favourable linear relationship;r= 0.999974,average recovery is around 80%,the daily degree of precision is around 5%,the degree of precision at the same time of Different days is around 10%;In the rage of 0.3125ug/ml to 10ug/ml in vitreous,the peak areas and concentration of Ligustrazine show favourable linear relationship,r=0.99464,average recovery is around 80%,the daily degree of precision is around 10%,the degree of precision at the same time of different days is around 10%too。Conclusion:It provides levis detect method(HPLC),and establishes found to approach effective mechanism of ligustrazine in the eye. According to the theory,people can use iontophoresis combined with Chinese herb to treat oculas disease.Part three The treatment evaluation of oculas iontophoresis combined with Chinese medicine to Retinal vein occlusionPurpose:use iontophoresis combined with Chinese medicine-injection of activating blood circulation to dissipate blood stasis to heal RVO,evaluate efficacy by observing the vision,Retina and retinal fluorescein angiography (FFA)changes about t therapic group and control group before and after the treatment.Method:Using retrospective survey method,choosing in-patients of Ophthalmology of First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine in Jan,2000 to June,2007 who are in line with the diagnostic code.All patients are on the basis of Blood pressure-lowering, lowering blood glucose and other medical treatment,Chinese herb and retinal laser treatment are systemic applied.They were divided into iontophoresis treatment group and non-iontophoresis control group by whether using of iontophoresis treatment of Ligustrazine or Danshen injection.Deal with Statistics with the statistical processing software SPSS 11.5 and Epitable from the vision,retina and the FFA,and so on.Result:1.Observation of a total of 64 eyes 62 cases,distinguish pattern of syndrome of patients are:30 cases are "qi-stagnancy and blood stasis", 8 cases are "asthenic yin causing predominant yang",12 cases are "sputum and blood stasis",and 12 cases are "cardiosplenic asthenia".2.38 patients(38 eyes)of Iontophoresis group:apart from five cases before and after treatment did not change,three cases have decreased vision after treatment,the remaining cases are different degrees of vision improved.24 patients(26 eyes)of Non-iontophoresis group:six cases of vision did not change before and after treatment,one case of declining eyesight after treatment,and the remaining 21 eyes of 19 cases have varying degrees of eye vision improved.3.During the treatment,the majority of cases have varying degrees reduction and absorption in retinal hemorrhage,retinal edema and exudation.Conclusion:The low-frequency iontophoresis joint Chinese medicine of activating blood circulation to dissipate blood stasis,help improve the eyesight,can promote the abortion and dispersion of the retinal hemorrhage and reduce retinal edema and exudation.The difference is statistically significant by contrast the vision and eyes of iontophoresis group and non-iontophoresis group after treatment.