| Objective: In this study,QiZhen Jiangtang granules,a traditional Chinese medicine with the functions of nourishing liver and kidney and nourishing astringency and eyesight,was used to observe the clinical effect of QiZhen Jiangtang granules on early diabetic retinopathy and its effects on serum levels of VEGF,ICAM-1 and IL-1β.The effects of QiZhen Jiangtang granules on the expression of VEGF,ICAM-1 and NF-κB in retina of DR model rats at early stage and the contents of serum VEGF,ICAM-1 and IL-1β were observed by animal experiments.To investigate the mechanism of QiZhen Jiangtang granules in preventing early DR.Method: 1.Clinical study: 60 patients with early diabetic retinopathy were divided into control group and treatment group according to random numbers,30 cases in each group.The two groups were given basic treatment such as diabetes education,diabetes diet and hypoglycemic therapy.The control group was given calcium dobesilate,while the treatment group was given QiZhen Jiangtang granules on the basis of the control group.The course of treatment was 24 weeks.The changes of TCM syndrome score,visual acuity,fundus symptoms,fasting blood glucose(FPG),2h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),serum levels of VEGF,ICAM-1 and IL-1βwere observed before and after treatment.To explore the clinical intervention effect of QiZhen Jiangtang granules on early diabetic retinopathy.2.Animal study: 100 SD male rats were selected and fed adaptively for one week.According to the principle of randomized control,they were divided into 18 rats in the blank group and 82 rats in experimental group.Rats were fed with common diet in the blank group and rats were fed with high-fat diet in the experimental group.After 4 weeks of feeding,rats were injected with streptozotocin(STZ)intraperitoneally to induce diabetic rat model in the experimental group.After 10 weeks of feeding with high fat diet,rats could be identified as early diabetic retinopathy rat model in the experimental group.Seventy rats were successfully modeled were randomly divided into model group(18 rats),western medicine group(17 rats),high dose group(18 rats)and low dose group(17 rats).The blank group and model group were administered intragastrically with normal saline,the western medicine group was perfused intragastrically with calcium dobesilate,and the high and low dose groups of traditional Chinese medicine groups were administered intragastrically with different doses of QiZhen Jiangtang granules,drug intervention for 12 weeks.The general condition,body weight and FPG of rats were observed before and after treatment.After 12 weeks,rats were killed and their eyes were taken out to observe the retina.Serum levels of VEGF,ICAM-1 and IL-1β were detected by ELISA.The expressions of VEGF,ICAM-1 and NF-κB in retina tissue of rats were detected by Western Blotting.Result: 1.Clinical observation results: After 24 weeks of treatment,the total effective rate of the treatment group was 79.31%,and that of the control group was 60.71%.The difference was statistically significant(P<0.05).After treatment,the scores of TCM syndromes of the two groups decreased compared with those before the treatment(P<0.05 or P<0.01).Compared with the groups,the improvement of the treatment group was better than that of the control group(P<0.01).After treatment,visual acuity and fundus symptoms improved in both groups,and the treatment group was better than the control group(P<0.05).Compared with before treatment,FPG and 2hPG in the two groups decreased significantly(P<0.05 or P<0.01),and the decrease in the treatment group was better than that in the control group(P<0.05).The level of HbA1 c in the two groups was lower than that before treatment,but the difference was not statistically significant(P>0.05).The serum levels of VEGF,ICAM-1 and IL-1β in the two groups were significantly lower than those before treatment(P<0.05),and the serum levels of VEGF,ICAM-1 and IL-1β in the treatment group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).2.Animal experiment results: Compared with the blank group,the weight of DR rats decreased significantly before intervention(P<0.01);after 12 weeks of drug intervention,the weight of DR rats in each medication group increased compared with that of the model group(P<0.01).Before drug intervention,the content of FPG in each DR group was significantly higher than that in the blank group(P<0.01);after intervention,compared with the model group,FPG in the high and low dose groups of traditional Chinese medicine decreased(P<0.01),while FPG in the western medicine group had no significant difference(P>0.05).Compared with the model group,the serum levels of VEGF,ICAM-1 and IL-1β in each medication group decreased significantly(P<0.05 or P<0.01).The declination level of the high dose group was more obvious than that of the western medicine group and the low dose group of traditional Chinese medicine(P<0.05 or P<0.01).Compared with the model group,the expression of VEGF,ICAM-1 and NF-κB decreased significantly in retina tissue of rats in each medication group(P<0.01);the high-dose group of traditional Chinese medicine was superior to the low-dose group of traditional Chinese medicine and Western medicine group(P<0.05).Conclusion: QiZhen Jiangtang granules can alleviate the syndrome of liver and kidney yin deficiency in patients with early diabetic retinopathy,reduce blood sugar,improve visual acuity and fundus symptoms,and reduce serum levels of VEGF,ICAM-1 and IL-1β.The mechanism of QiZhen Jiangtang granules may be to inhibit the progress of DR by down-regulating the expression of VEGF,ICAM-1 and NF-κB,and reducing the contents of VEGF,ICAM-1 and IL-1β,and alleviating the degree of inflammation in the body and tissues. |
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