Study On The Effect Of Chinese Herbs In Treatment Of Retinal Injury Induced By Argon Laser Photocoagulation And Its Mechanism

Objective: To investigate the curative effect of Chinese herbs with the function of nourishing yin and clearing pathogenic fire, aimed at the character of injury induced by laser photocoagulation. The study takes measures from two ways including experimental research and clinic observation, to offer a new effective method in treatment of laser injury, and improve the clinical curative effect of retinal vascular diseases. Method: The study includes the two parts of the experiment and clinical. 1.Experimental study: 60 pigmented mice were divided into four groups randomly with 15 mice in each one, and then the retinal photocoagulation was performed. The experimental groups were treated with zhibaidihuang decoction in different doses, while the control group with physiological saline. The changes of FFA, histopathology, immunohistochemistry, including the expression of VEGF and ICAM-1 in the retina in different days (3, 5 days and 1, 2, 4 weeks after treatment) were detected, and contrasted with the control group. 2.Clinical observation: The patients with DR (38 case, 59 eyes) were divided into two groups, the treatment group was treated with Chinese herbs combining with laser photocoagulation, and the other control group with laser photocoagulation simply, and the clinical therapeutic effect was observed by means of comparing the changes of visual acuity, visual field and intraocular pressure, before and after the treatments. Result: 1.The experimental results indicate that the experimental group had obvious advantage compared with the comparison group in FFA, pathology and immunohistochemistry. Chinese herbs could alleviate leakage, restrain CNV; markedly inhibit inflammatory cell accumulation; down-regulate the expression of VEGF and ICAM-1. The high-dose group demonstrates better result than the middle and the lower dose ones, which come to the conclusion that Chinese herbs could provent retinal injury induced by lazer photocoagulation, and the protective effect was correlated with dose.2.The clinical observation shows that Chinese herbs with laser photocoagulation in DR demonstrates more advantages in improving vision function, lowing pathological changes, lessening symptoms etc. The total effiacious rate of the treatment group was 82.76% after therapy, the visual acuity and the absorbtion time of the treatment group of hemorrhage, edema, exudatation of was preponderant(P<0.05), the fadeaway rate of CNV(P<0.05)compared with the control group, retinal circulation time was preponderant(P<0.05), the eye sensitivity had advantage(P<0.05).Conclusion: 1.Based on the clinical observation, we hold the point that heat-poison injuring yin, pathogenic fire due to yin deficiency is most of pathogenesis characteristic. 2. The way of nourishing yin and clearing pathogenic fire cloud down-regulate VEGF and ICAM-1, decrease inflammatory reaction, restrain CNV. 3.Chinese herbs with laser photocoagulation was more effective in the course of DR treatment. 4.The mechanism of Chinese herbs in treatment of DR may contribute to the fact that it can enhance heat-resistance, adjust immunity mechanism, inhibited the expression of VEGF and ICAM-1 to advance absorbability of oedema and hemorrhage, promote retinal blood circulation to realize its curative effect. 5.Chinese herbs with laser photocoagulation had the function of reducing poison and improving curative effect, incarnating the advantage of Chinese medicine integrated with Western medicine.