Clinical Observation And Experimental Study On The Effect Of Yiqi Huoxue Tongluo Recipe On Anterior Ischemic Optic Neuropathy

Part One Clinical observation of YiQi HuoXue TongLuo Decoction combined with acupuncture treatment for nonarteritic anterior ischemic optic neuropathyObjective To observe the clinical efficacy of YiQi HuoXue TongLuo Decoction (YHTD) combined with acupuncture on nonarteritic anterior ischemic optic neuropathy (NAION).Methods 88 eyes (65 cases) with nonarteritic anterior ischemic optic neuropathy had been treated by YHTD and acupuncture. The best corrected visual acuity, visual field and visual evoked potential (VEP) were compared before and after treatment.Results (1) After 2,4 and 8 weeks of treatment, the total effective rates of visual acuity improvement were 740.91%、60.47% and 69.51% respectively. (2) After 2,4 and 8 weeks of treatment, the decreased mean defect (MD) and increased mean light sensitivity (MS) of visual field were both statistically significant (P<0.01). (3) When compared with the situation before treatment, the average latency of the VEP-P100 wave was reduced and the average amplitude was improved significantly (P<0.05).Conclusions YHTD combined with acupuncture treatment could obviously improve the visual acuity, the visual field and the latency of VEP in NAION patients and prevent the aggravation of optic atrophy.Part Two The experiment of protective effect from YiQi HuoXue TongLuo Decoction on the tissue of diabetic rats optic nerveObjective; We observed that the occurrence and development of nonarteritic ischemic optic neuropathy has a close relationship with diabetes mellitus (DM). Therefore, on the basis of experimental diabetic rats model, we wanted to study the influence of YHTD on the diabetic rats optic nervous tissue and expression of neurofilament protein (NF) and oligodendrocyte myelin glycoprotein (OMG), then to investigate the protective effect of YHTD on the diabetic optic neuropathy (DON).Methods:25 male SD rats were randomly divided into 4groups:normal group (6 rats), model group (7 rats), treatment group (6 rats) and control group (6 rats). The rats were injected STZ (60mg/kg) intraperitoneally and after 72 hours those with a blood glucose level higher than or equal to 16.7 mmol/L with 3 consecutive days are DM model rats. Rats in treatment group were with YHTD (10g/kg) and control group were with DuoBeishi (250mg/kg) each day. Blood glucose level and body weights were measured per 2 weeks. Experiment lasts for 300days. 10% chloral hydrate anesthesia executed rats. The eyeballs were removed and optic nerve expression level of NF and OMG, and quantitative analysis.Results:(1) There is no significant difference in glucose between different groups before building DM model (P>0.05) and glucose of diabetic rats were markedly higher than normal group after building DM model (P<0.01). (2) There is no significant difference in weight between different groups before building DM model (P>0.05) and weight of diabetic rats were significantly lower than normal group after 6 weeks of building DM model (P<0.01). (3) Compared with normal group, the optic nerve fibers of model group rats atrophied and arranged disordered with dilated or bleeding capillaries, a large number of destroyed filament in axon, demyelination and proliferation of glial cells. The optic nerve fibers of YHTD treated group arranged orderly and the degeneration of axon, demyelination and the proliferation of glial cells were significantly reduced. (4) Compared with normal group, the expression of NF in model group, treatment group and control group was reduced significantly (P<0.01). Compared with model group, the expression in treatment group and control group was enhanced (P<0.05). Compared with control group, the expression in treatment group was enhanced obviously (P<0.05). (5) Compared with normal group, the expression of OMG in diabetic rats was increased significantly (P<0.01). Compared with model group and control group, the expression in treatment group was decreased (P<0.05).Conclusions1 There is obvious pathological damage of optic nerve in experimental diabetic rats.2 YHTD has protective effect on the optic nervous tissue of diabetic rats.3 YHTD can enhance the expression of NF and decrease the expression of OMG, and then reduce the damage and promote the regeneration of axon.