The Etiology And Pathogenesis Of Diabetic Retinopathy Study

This research investigated the pathogenic factors and TCM(traditional Chinesemedicine) syndrome's transformation of DR (type 2 diabetic retinopathy) byadopting retrospecting method. By discussing pathogenic mechanism and thecharacteristics of clinical syndrome in TCM of this disease, it provides some basisfor clinical syndrome model of DR and provides theoretic reference of practicalvalue for clinical applications and also provides theoretic and practical foundationsfor the application of detailed methods and the choice of opportunity in the preventionand cure of DR by TCM.Results: 1. The incidence of type 2 DR occupies 58.3%, in which simple type accounts for 87.6%; 2. the onset of DR has no relation with the age and gender but is related to the course of disease and the level of blood sugar.The longer the course and the worse the control of blood sugar, the higher the incidence of DR. 3. DM nephropathy, DM retinopathy and DM neuropathy often emerge at the same time or one after the other and usually parallel in severity due to common pathogenesis. 4. Yin-deficiency is the most common syndrome type of DR, followed by qi-deficiency and the two are usually seen together. Deficiency of both qi and yin occupies 75.4% and 77.8% in patients with retinopathy and patients without. 5. Simultaneous occurrence of deficiency and excess syndromes is theTCM pathogenesis of DR, in which deficiency syndrome is fundamental. The deficiency syndromes consist of yin- deficiency , deficiency of both qi and yin , deficiency of both yin and yang while excess syndromes include blood stasis , phlegm-dampness, dampness-heat. 6. With the development of retinopathy ,the syndrome types are changing, in which the deficiency of qi and yin are abating but yang- deficiency , blood stasis, phlegm-dampness are aggravating.Conclusions: 1. Though the pathogenesis of DR is very complex and is not clearly known now , it can be confirmed that the long time of high level of blood sugar is the most important risk factor. Therefore, controlling blood sugar within the ideal range (7.9mmol/l before breakfast ) is key to prevent the DR. 2. Yin-deficiency is the pathological basis of DR,which is a complication of DM ,marked by a long course and complex pathogenesis. While qi and yin deficiency is the most important pathogenesis(deficiency of both yin and yang can be developed), blood stasis and phlegm-dampness(phlegm-dampness accompanied by heat are more common) are direct causing factors. Superficially-excess and originally-deficiency ,or simultaneous occurrence ofIV 糖尿病视网膜病变的病因病机研究 both ,are the typical syndrome of DR .Active prevention should be taken for those who haven't developed DR yet, mainly by means of replenishing qi and yin . Treatment methods such as promoting circulation of blood and removing phlegm should be used to prevent it's aggravation for those who have had DR . This research is targeted to study the TCM pathogenesis and pathogenic factorsof DR systematically and deeply. This is significant for DR's prevention and cure bythe combination of TCM and western medicine.