| Diabetes mellitus is the common disease which severely threaten the human' s health and life. The incidence rate increases every year and then the capillary vessel complication occurred. Diabetic retinopathy is one of the server complication. It belongs to "Xiaokemubing" of traditional Chinese medicine. The blindness ratio is hign. There don' t take Break-through progress in DR' s episode and therapeutics at present. The western medicine therapeutic principle about DR is: nonproliferative phase Internal medicine and have a regular Observation of eyes; proliferative phase rrp, some countries and areas recommend to take Doxim, Severe proliferative diabetic retinopathy need vitrectomy. There have no ideal medicine which can prevent or cure DR, the traditional Chinese medicine can elevate the patients' visual and absorb the hemorrhage hard exudation edema of fundus. After taken the Chinese drug, the patients' symptoms by systems improving, but the most are case reports, not use the case control and lack of drug efficacy study about experimental animal. It' s beneficial control the blood sugar, but it can not prevent DR' s occurrence and development. The Western medicine Doxium Difrarel Methycobal use for DR, but the price are expensive, therapeutic effect disaffect. Laser is an effective method for pre-proliferative DR or PDR, it also have many complications. So the emphasis is early treatment and early prevention.This research is based on Professor Yuyanggui' s clinical practice, use the Zishenjianpihuayufang which can supplementing qi and nourishing yin disperse blood stasis and dredge collateral. The clinic and experiment results proved that laser with this medicine can cure PDR and pre-PDR, this can degenerate the new vessels and absorb the hemorrhage hard exudation edemaof fundus. The experiment discovered that it can improve the DM rats' bloodcapillary' s ultramicrostructure lesion of retina.This research will use this medicine to cure the pristine DR and evaluate it' s efficacy and clarity the relationship of system control and local control through the fundus vision blood sugar blood fat traditional Chinese syndrome penthemeron.Until now, the experimental research most concentrate on telangiosis of retina, but less on nerve tissue of retina. There have many electrophysiology indicate that the early phase of DR has the abnormality of VEP, in order to identify the neuromechanism and retinal vessel pathogenety, we use"Zishenjianpihuayufang" and doxium to cure the STZ rats and observed the vascular tissue and nerve tissue' s change and provide experimental basement on the traditional Chinese medicine' s mechanism of action.The first part: Literature reviewTo review the mechanism, therapeutics of TCM and western medicine, realize that the type of DR' s earlier period is QiYinLiangXu, so TCM always use invigorating SHEN, PI, QI, YIN drugs. Western medicine think DR' s episode is related to general factors, but also to local factors, but don' t find operative methods. This research analysis the effect of Zishenjianpihuayufang to cure the earlier period of DR and use experiment to find out its therapeutics and observed the vascular tissue and nerve tissue' s change and provide experimental basement of the traditional Chinese medicine' s mechanism of action.The second part: The evaluation about Zishenjianpihuayufangto cure early period of DRPurpose: To use this medicine to cure the pristine DR and evaluate it' s efficacy and clarity the relationship of system control and local control through the fundus vision blood sugar blood fat traditional Chinese syndrome penthemeron.Methods: use random, matched control, simple center methods, patients with earlier period of DR who match with the standards diagnosis of deficiency of qi and yin, the cure cause is three months. The two groups compare withequilibrium. The objective markers includes blood sugar, FFA, ERG, blood lipid , traditional Chinese syndrome penthemeron and so on, observe the therapeutic effect of two drugs. All data were analysed by T test, Crosstab analysis and X2 test, Ridit test, spersman correlation analysis with the soft package of SPSS13. 0. P≤0.05 is significant difference or correlation. Results: The two groups have comparability before treatment. Zishenjianpihuayufang have more significant difference in visual, traditional Chinese syndrome penthemeron., ops amplitude than doixum, but have no significant difference in the pathological changes of fundus. The hard exudation has significant correlation with total cholesterol. Microaneurysm, hemorrhage, macular edema have no significant correlation with total cholesterol. The visual of early phase DR has significant correlation with the severity of macular edema. Conclusion:1. The hard exudation has significant correlation with total cholesterol. The step up of TC will raise the risk of hard exudation of retina. It can have significant meaning for DR to ameliorate TC.The visual of early phase DR has significant correlation with the severity of macular edema. This is the important factor in visual of early phase of DR.2. It can improve the blood circulation of entoretina3. Zishenjianpihuayufang which can supplementing qi and nourishing yin and promoting blood circulation to remove meridian obstruction have significant effect on early phase of DR and have more significant effect in visual, traditional Chinese syndrome penthemeron., ops amplitude than doixum, but have no significant effect in the pathological changes of fundus. Zishenjianpihuayufang can not only ameliorate the pathological changes of fundus, but also ameliorate the quality life of pathiets.The third part: the experimental study about Zishenjianpihuayufang to impact experimental diabetic rats' retina.Purpose: To discuss the pathological change about the electron microscope of nerve retina, blood vessel of retina, the digestive enzyme stretched preparation of blood vessel of retina after the post-treatment of Zishenjianpihuayufang and discuss the superiority of TCM protecting blood... |
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