Study On TCM Syndromes Of Diabetic Macular Edema And IBRB Injury Model In Early Diabetic Rats

Objective:1、To study the distribution of TCM syndromes symptom on diabetic macular edema (DME) with mild to moderate and severe group through the syndrome elements of disease location and nature, so as to provide a basis for the treatment of DME with traditional Chinese medicine.2、To investigate the High glucose and high fat diet and STZ induced early diabetic retina barrier (iBRB) damage rat model and the influence of nourishing kidney and activating blood flow Chinese herbal compound on iBRB leakage.Methods:1、Alalyzing the distribution of TCM syndrome sypmptom in patients with DME,through TCM syndrome data of DME patients collected by the questionnaire survey,and according to the "TCM syndrome in patients with DME Disease Evaluation Form".from the two aspects of the TCM syndrome elements ofdisease location and of nature.2、High glucose and high fat diet and STZ induced rat model, after the successful modeling,all rats were randomly divided into 6 groups:model group (negative control group), positive control group(calcium dobesilate), Chinese herbal compound high, medium and low dose group, normal SD rats as the normal control group. Each group were observed in 1 week, 2 weeks,4 weeks,8 week.3、At the end of the experiment, rats in vivo perfusion fixation, retinal digest preparations, observing the change of retinal vascular morphology under light microscope. Examining the blood retinal barrier leakage with RHIC.Results:1、In DME mild-to-moderate group,the highest frequency of disease syndrome elements appears followed by yin deficiency, blood stasis, and phlegm dampness, while the severe DME group had the highest frequency of blood stasis, phlegm,yang deficiency. In DME mild-to-moderate group,the highest frequency of the location syndrome elements appears followed by kidney, liver, spleen, and the highest frequency in DME severe group is the kidney, spleen, liver.2、At 8 weeks,the retinal morphology of DM rat hadn’t obvious change.3、The diabetes ats retinal blood vessels are RHIC leakage at 2 weeks,4 weeks,8 weeks, leakage is located within the limiting membrane to the outer plexiform layer, while outer plexiform layer RHIC leakage most significantly. Compareing the leakage among groups from few to many, followed by:calcium dobesilate group< compound Chinese medicine for nourishing kidney and activating blood flow, low dose group< compound Chinese medicine for nourishing kidney and activating blood flow, moderate dose group= compound Chinese medicine for nourishing kidney and activating blood flow, high dose group< negative control group.Conclusion:1、The main factor of the syndrome factors of disease nature in the severe DME is Blood stasis and phlegm dampness. While Kidney, spleen and liver is the mainfactor in severe group of DME syndrome elements of disease location.2、High fat and high sugar diet combined with mild pathogenic dose of STZ had a highly success of inducing early diabetic IBRB injury rat animal model and low mortality.3、DM rats for 1 weeks,2weeks,4weeks,8weeks showed no vascular morphological changes ofretina. IBRB damage began to appear at 2 weeks.4、Nourishing kidney and activating blood flow Chinese herbal compound with low dose can reduce the leakage of iBRB in DM rats,while the mechanism needs further study.