The Clinic And Experimental Research About The Treatment Of Diabetic Optic Neuropathy With Zishenjianpihuayufang Pill

Diabetes mellitus(DM) is a kind of systemic Metabolic disease, which complications are easy to be generated in eyes (retina, optic nerve etc),kidney,heart,blood vessel,nerve etco Diabetic optic neuropathy is a diabetic complication, and include diabetic papillopathy(DP),ischemic optic neuropathy(ION),optic disc neovasculatization (NVD),laser-induced optic disc atrophy and wolfram's syndrome.Traditional Chinese medicine deems that Diabetic optic neuropathy is the result of "GanShenkuixu","Yuxueneiting" and "Zhuzhimuluo" . The Western medicine considers its pathogeny are correlate to microcirculation disturbance,glycometabolism disorder and neurotransmitter, At foundation of controlling serum glucose, the traditional Chinese medicine treat diabetic optic neuropathy by the traditional Chinese drug of "Zhiyangganshen" and "Huoxuehuayu": the Western medicine therapeutics include the local application of corticosteroids, to use the drug of improving microcirculatory,neurotrophy and vitamin preparation; in case occurring optic disc neovasculatization, photocoagulation is needed.We treat diabetic optic neuropathy with Zishenjianpihuayufang pill and illuminate its efficacy by reviewing the improvement of the local disease of ocular fundus, visual acuity, VEP, visual field. We Cure the rats of DM induced by STZ with Zishenjianpihuayufang pill and doxium, then observe the optical nerve shapes and explore its pathogenesis. A safe and effective means to prevent and cure diabetic optic neuropathy is expected to search by this experiment, the basis is also offered to heal the disease in clinic. To summarize the studies of causes, pathogenesis and therapy of diabetic optic neuropathy in the Traditional Chinese and Western medicine, these have been realized that ganshenkuixu, yuxueneiting and zuzhimuluo are its paths, ziyangganshen and huoxuehuayu are its therapeutics.According to the theory of the Chinese medical science and Western medicine, the pathogenesis of Diabetic optic neuropathy includes microcirculation disturbance, chronic glycometabolic disorder and neurotransmitte' s derangement. And should be treated with the local application of corticosteroids, using the drug of improving microcirculatory,neurotrophy and vitamin preparation; in case occurring optic disc neovasculatization, photocoagulation is needed. The empirical study indicates that the diabetic rats appear pathological change at the condition of persistent hyperglycemia and liver and kidney-nourishing blood flow-activating and stasis-removing traditional Chinese medicine could alleviate the pathological damages of optic nerve in experimental diabetic rat.The second part: The evaluation about Zishenjian-pihuayufang pill to cure diabetic optic neuropathyPurpose: To use this medicine to cure the Diabetic optic neuropathy and evaluate its efficacy by reviewing the improvement of the local disease of ocular fundus, visual acuity, VEP, visual field and FFA.Methods: According to the retrospective study, we collect 45 eyes of 25 cases as the observed patients who match with the diagnostic criteria. The course of treatment is 6 months. The objective index includes visual acuity, ocular fundus,FFA,VEP,visual field and so on, observing the therapeutic efficacy. All data were analyzed by the soft package of SPSS13.0. P＜0. 05 is significant difference or correlation.Results:There were 45 eyes of 25 cases in the observed patients. 51.1% of them had significant effect in visual acuity and the other had no effect, but they had the same therapeutic effect in advancing the extinct of the papilledema and VEP,visual field and FFA for the diabetic optic neuropathyConclusions:1,The oculist should think highly of diabetic optic neuropathy and persuade the needed patients to do the related examination in time. The index of diagnose and prognosis includes FFA, visual field, VEP and so on is needed. 2,Zishenjianpihuayufang pill which can improve visual acuity and advance the extinct of the papilledema have significant effect in VEP,visual field and FFA for the diabetic optic neuropathy.The third part :The neuroprotective effect of Zishenjianpihuayufang pills on the tissue of experimental diabetic rats optic nerve.Objective: To study the influence of Zishenjianpihuayufang pills on the experimental diabetic rat optic nervous tissue, then to investigate The neuroprotective effect of Zishenjianpihuayufang pills on the tissue of experimental diabetic rats optic nerve. Methods: 50 experimental SD rats are divided into five groups: normal group, diabetes mellitus group, doxium group, Zishenjianpihuayufang pills low dose group, Zishenjianpihuayufang pills high dose group. 40 rats are abdominal Injection by streptozotocin to make DM, and then the optic nervous tissues of experimental diabetic rats were investigated by light and electron- microscope. Results: The degrees of the degeneralton and the myelinolysis of optic nervous fibers in the treated group were obviously lower than those in both the diabetes mellitus group and doxium group。Conclusion: Zishenjianpihuayufang pills have neuroprotective effect on the optic nervous of experimental diabetic rats and can also relieve the pathological damage of optic nerve in experimental diabetic rats.