Study On The Application Of Sugar Net No.1 In Intervention Of Diabetic Retinal Vascular Lesions

Part one:The experiment of protective effect from Diabetic RetinopathyOne Decoction on the retinal vessels of diabetic rats.Objective:On the basis of experimental diabetic rats model, we wanted to study the influence of Diabetic Retinopathy One Decoction on the retinal vessels of diabetic rats and expression of Occludin、Claudin and Aquaporin4, then investigate the protective effect of Diabetic Retinopathy One Decoction on the retinal vessels of diabetic rats.Methods:24 male SD rats were chosed for this experiment. The rats were injected STZ (60mg/kg) intraperitoneally except normal group and after 72 hours those with a blood glucose level higher than or equal to 16.7 mmol/L with 3 consecutive days are diabetes mellitus model rats. Diabetes mellitus model rats randomly were divided into model group (6 rats), treatment group (6 rats) and control group (6 rats).Rats in treatment group were with Diabetic Retinopathy One Decoction (10g/kg) and control group were with Calcium Dobesilate Capsules (250mg/kg) each day. Blood glucose level and body weights were measured per 2 weeks. The experiment lasted for 9 months.10% chloral hydrate anesthesia executed rats.The eyeballs were removed and retinal digest preparation were made. Retinal vessels was observed by optical microscope and electron microscopy. Immunological histochemistry assay was used to measure the expression level of Occludin、Claudin and AQP4 and quantitative analysis.Results:(1) Compared with normal group, Capillary network of the model group arranged in disorder and a plurality of capillary torsion gather into cluster with endothelial cell proliferation, pericyte apoptosis. Compared model group.(2) Compared with the normal group, vascular endothelial cell swelling of model group rats appear hobnail kind dash forward to tubal antrum so that tubal antrum is narrow. Swelling pericytes appeared large vacuoles and they can degeneration or even disappear. The basement membrane became thick obviously.(3) Compared with normal group, the number of endothelial cell increased, the number of pericyte decreased and the ratio of endothelial cells and pericyte was significantly increased with model group, treatment group and control group (P<0.05).Compared with model group, the number of endothelial cell decreased,the number of pericyte increased and the ratio of endothelial cells and pericyte was decreased with treatment group and control group (P<0.05). There was no statistical difference between the treatment group and control group in the number of endothelial cell, pericyte and the ratio of endothelial cells and pericyte. (P>0.05) (4) Compared with normal group, the expression of Occudin in model group, treatment group and control group was decreased significantly (P<0.05). Compared with model group, the expression in treatment group and control group was increased (P<0.05). Compared with control group, the expression in treatment group was increased obviously (P<0.05). (5) Compared with normal group, the expression of Claudin in diabetic rats was decreased significantly (P<0.01). Compared with model group, the expression in treatment group and control group was increased (P<0.05). Compared with control group, the expression in treatment group was increased obviously (P<0.05). (6) Compared with normal group, the expression of AQP4 in diabetic rats was decreased significantly(P<0.01). Compared with model group, the expression in treatment group and control group was increased (P<0.05). There was no statistical difference between the treatment group and control group with the expression of AQP4. (P>0.05)Conclusions:(1) There is obvious pathological damage of retinal vessels in experimental diabetic rats. (2) Diabetic Retinopathy One Decoction has protective effect on the?retinal vessels of diabetic rats.(3) Diabetic Retinopathy One Decoction can increase the expression of Occludin Claudin and AQP4. It then reduce the damage of junction with endothelial cells and maintain the function of blood retinal barrier.Part two Observing the clinical effects of Diabetic Retinopathy OneDecoction combine with retinal photocoagulation with laser in the treatment of diabetic macular edemaObjective:Evaluate the clinical effects of retinal photocoagulation with laser combine with macular two decoction in the treatment of diabetic macular edema.Method:All the 80 cases (with 128 eyes) with diabetic macular edema were divided into two groups randomly:49 cases (with 80 eyes) treated with retinal photocoagulation with laser combine with macular two decoction as the treated group and 31 cases (with 48 eyes) treated with retinal photocoagulation as the control group. Compare the change in corrected visual acuity, central macular thickness, microaneurysm number and fluorescent leakage area before and after treatment.Result:The best corrected visual acuity in two groups was significantly improved after one month and three month (P<0.05).But two groups have a similar improvement of it (P>0.05). There was no statistical difference between the two groups in the microaneurysm number after one month treatment (P>0.05). However after three month treatment the effect of treat group is better than the effect of control group (P<0.05). The treatment group is significantly decreased of the central macular thickness and fluorescent leakage area after one month and three month treatment (P<0.05)Conclusion:Retinal photocoagulation with laser combine with macular two decoction in the decrease of the central macular thickness and reduce fluorescent leakage area take more effect than retinal photocoagulation with laser alone.