A Study On The Effect Of Intergration Of The ZiShenJianPiHuaYu Decoction For The Treatment Of Diabetic Retinopathy

A Study on the effect of intergration of the ZiShenJianPiHuaYu Decoction for the treatment of Diabetic RetinopathyDiabetic Retinopathy (DR) is one of severity complications of Diabetes Mellitus(DM) and becomes one of four main diseases of casuing blind at preasent. There are about 14 millions DM in china, while 25% suffer with DR among them. The pathogenesis of DR isn't completely clarified .we still didn't acquired evolve piercely on it's treatment. In this study, we evaluated the effect of ZiShenJianPiHuaYu Decoction combined with laser on treating DR and undertook experiment on rats to observe effect of Chinese medicine to DR.. Part I Literature ResearchWe summarized the evolve on name, etiology, pathogenesis, prevention and cure, herbs and experimental of DR in Traditional Chinese Medicine (TCM). There was no the name of DR in ancient literature of TCM. According to it's symptoms and signs, DR belongs to the category of "BaoMang"(sudden loss of vision), "ShiZhanHunMiao" (blur ring of vision) and "YuenWuYiJin" (cloudy and mist moving vision ) in TCM. The pathogenesis of this disease is deficiency of both qi and yin and blood stasis and congestion of vessels and it's therapy with syndrome differentiation is mainly nourishing qi, nourishing yin and activating blood. Part II Clinic ResearchObjeective: To evaluate the effect of ZiShenJianPiHuaYu Decoction combined with laser photocoagulation treating DR.Method: 31 cases (54 eyes) in type of deficiency of both qi and yin with DR were divided randomly into two groups: (1) Group l:Treated with laser photocoagulation; (2):Group 2: Treated with oral take of ZiShenJianPiHuaYuDecoction combined with laser photocoagulation from 6 months after theoperation. The effect was evaluated by visual acuity, corrected visual acuity,fundusopathy and fundus fluoresceiii angiography(FFA) performed at beforeoperation and 6 months after it.Results:(l) The disease incidence of Proliferative DR in group which courseof diseases surpassed 20 years is obseversly higher than that of grouplowered 20 years(P<0.05);(2). The effect of Group 2 (TCM combinedwith laser) is better than Group 1 (0.010.05).Conclusions: The effect of ZiShenJianPiHuaYu Decoction combined withlaser photocoagulation on treating DR is significantly better than laserphotocoagulation only.Part III Experiment ResearchObjective: TO observe the effect of ZiShenJianPiHuaYu Decoction onpreventing and curing retinopathy ultrastructure of DM rats.Methods: 81 SD rats were divided into Normal Group (9 rats) and DMGroup (72 rats). DM Group were injected via abdomen with 2%STZsolution (60mg/kg). 68 rats which fast blood sugar were higher than13.88mmol/L were bring into the experiment and divided into four groups:(1) Blank Group(12 rats); (2) Group of lower dosage of TCM (14 rats ); (3)Group of middle dosage of TCM (14 rats ); (4) Group of high dosage ofTCM (14 rats ); (5) Doxium Group (14 rats ) . The rats were extracted righteyeballs respectively at 2, 4, 6 months and taken their retinus to observethe changes of morphologic by electron microscope.Results: The rats with DM emergenced endothelium cell swelt and thecytoplast of pericyte vacuole-like in retinal capillary vessell; In retinal pigment epithelium, the direction of inner ruga of mitchoridria wasn't regulate and rough endoplasmic reticulum dilatated and the nucleus was dyed inanition-like, while there were significantly lighter damages on pathology in Group of high dosage of TCM than Blank Group and Doxium Group. Conclusions: ZiShenJianPiHuaYu Decoction can improve early retinal ultrastructure damage of animal models with DM. It is perhaps good for DR.