| Objective:Attempts were made to observe the protective effects of Huwang Mingmusan to the patients with chronic angle-closure glaucoma, so investigation of the influence on vision, view, P-VEP and P-ERG of the patients with chronic angle-closure glaucoma and the content of NO, Glutamic Acid, BDNF and Bcl-xl in the EIOP rabbits’retinal tissue was observed in order to open up a new way for TCM treating chronic angle-closure glaucoma.Clinical ObservationMethods1:Clinical DataThe clinical observation was conducted in the Ophthalmology and Otorhinolaryngology of First Affiliated Hospital of Gui Yang College of Chinese Medicine and ophthalmology of Guizhou People’s Hospital. Adopting the cases of chronic angle-closure glaucoma as the object of study and collecting cases according clinical guidelines, inclusive criteria and exclusion standard.2:Methods of Treatment60cases were randomized into two groups,30cases into the treatment group and30cases, the control one. The treatment group orally given Huwang Mingmu san(consisting of Chishao, Baishao, Shihu, Chongweizi, Caojueming, Gegen, Zelan and so on),three times a day with one dose; The control one orally given nimodipine tablet, three times a day and once with10mg with the duration of30days.(Huwang Mingmusan was provided by Traditional Chinese drug store of First Affiliated Hospital of Gui Yang College of Chinese Medicine and nimodipine table from Tianjing City Central Pharmaceutical Co.,Ltd). Changes of vision, view, P-VEP and P-ERG were observed before and after treatment.3:Observational IndexChanges of vision, view, P-VEP and P-ERG were all observed on two groups before drug administration and one month afterwards. The beginning observation as pretherapeutic score and after the end of therapeutic course, the observation could sign the other score.Results:Statistical analysis was done according the results of grading. There was no significant difference in improvement of retinal function between two groups (P>0.5), and the total effective rate was a significant difference between them (P<0.05), which indicated that the effect of treatment group is higher than control group.1:Experimental StudyMethods1:Animal model-making and grouping48male New Zealands white rabbits were randomly divided into three groups (16cases,32eyes), namely, the first group:a control (model) group, the second group: TCM treating group and the third group:a control (Western medicine) group. Methods:0.25%chloramphenicol in eye drops on the first three days, three times a day. After New Zealand rabbits were anesthetized, puncturing with lml syringe in corneal limbus and pumping0.2ml aqueous humor, then infusing0.2ml2.5%Gonak. The intraocular tension was measured after three days postoperatively and over every week. When the intraocular tension lower than25mmHg,0.1ml2.5%Gonak was refilled and maintained4weeks hypertension.(The animal models of glaucoma refer to the methods of Sun Huaixing from Shang Hai Medical University Eye Center)2:Experimental drug and Medication:The first group was not administering drugs, and the second and the third group was administered drugs after24hours. The second group was administered Huwang Mingmu san suspension with a dose of5ml/Kg.d by gavage. The third second was administered nimodipine tablet with1mg/Kg.d by gavage and two times a day. In order to collect samples, we killed12rabbits at the first, second, third and fourth week of administration and4rabbits a group.ResultAfter one week, there was a significant difference on the content of glutamic acid and NO betwwen TCM treating group and model group.(P<0.05), and there was no difference between TCM treating group and Western medicine treating group,and Western medicine treating group and model group;(P>0.05) After the second, third and fourth week, there was a obvious difference on the content of glutamic acid and NO of retinal tissue between TCM treating group and model group.(P<0.01), and there also was a obvious difference between TCM treating group and Western medicine treating group,and Western medicine treating group and model group.(P<0.05) After drug treatment of four weeks, there was striking difference on the content of BDNF and Bcl-xl in retinal tissue between TCM treating group and control group, and Western medicine treating group and control group.(P<0.01).And then the difference is also significant between TCM treating group and Western medicine treating group.(P<0.05)Conclusion:Based on the clinical and related experimental study, this paper proved the effects of Huwang Mingmu san in treating chronic angle-closure glaucoma, and Huwang Mingmusan could effectively improve the function of retina of chronic angle-closure glaucoma, which based on the principles of nourishing and promoting blood that could further improve eyesight, eyeshot and protect the optic nerve. |
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