| 1 ObjectiveTo observe the effect of Yiqi Yangyin Huoxue Decoction on hemodynamic parameters of central retinal artery(CRA) 、 fundus lesions, hypoxia inducible factor-1a(HIF-1a) and vascular endothelial growth factor(VEGF) and other indicators in patients with early diabetic retinopathy(DR).And we discuss its protective mechanisms on DR in the molecular point of view by animal experiments to provide a wealth of experience and theoretical basis for prevention and treatment of DR in traditional Chinese Medicine.2 Methods2.1 Clinical researchAccording to the random number Tab method,the patients were divided into control group and treatment group.There were 32 cases in each group.All patients received basic treatments,likes diabetes education, diabetes diet, physical exercise,use of hypoglycemic drugs.The patients were treated with calcium dobesilate capsule and Danzhijiangtang Capsule powerd with the functions of invigorating qi,nourishing Yin,and activating Blood in the treatment group,The patients only were treated with calcium dobesilate capsule in the control group.Before and after treatment, All patients were detected hemodynamic parameters of CRA、fundus and eyesight、symptom integral、blood glucose、glycosylated hemoglobin、blood lipid、HIF-1a、VEGF and so on.The treatment time of the two groups was 3 months.2.2 Animal experiments70 SD rats were randomly grouped by weight, 10 of them were selected as the blank group that was fed with normal diet in he whole course of the experimen.Another 60 rats were were created Diabetic rat model by feeding high fat diet and injecting small dose of streptozotocin(STZ). After 10 weeks of feeding,Diabetic rat model rats were divided into Chinese medicine high, middle and lowdose group,model group,and continuous medication for 12 weeks. We observed the general situation of rats, blood glucose, blood lipids and the expression of HIF-1a,VEGF, VEGFR in retinal tissue.3 Results3.1 Clinical research results(1)Two groups after treatment of PSV, EDV and Vm than before treatment rise significantly(P<0.01), PI and RI than before treatment were decreased significantly(P<0.01),There were significant differences in the indexes of the treatment group and the control group(P<0.01).(2)Two groups after 3 months of treatment of VEGF and HIF-1α level than before treatment decreased, the differences were statistically significant(P<0.01); after treatment,the serum HIF-1、VEGF level in the treatment group were obviously lower than the control group(P<0.01).(3)After 3 months of treatment,two groups of FPG、2h PG、Hb A1、TG level than before treatment statistically decreased(P<0.01),compared with the control group,the treatment group FPG, 2h PG, Hb A1 c were significantly different(P< 0.01); There was no significant difference between the two groups in BMI, TC before and after therapy(P> 0.05).(4)The clinical symptoms and signs of the patients in the treatment group could be significantly improved,and the improvement effect was significantly better than that of the control group(P<0.01).(5)In treatment group,s total effective rate was 81.67%,and the control group,s was65.0%; Compared with the control group,there was a significant difference in the visual integral,and a obvious difference in the eye ground integral between them(P<0.01);(6)During the treatment,abnormal liver function、renal function and ECG were not found in patients of two groups.3.2 Animal experimental results(1)Effect on general condition and body weight in DR rats. During the whole experiment the rats in the blank group lively, a good mental state,Daily intake of moderate intake of water.With the experiment,body weight of rats in the blank group continued to grow.High, medium and low dose group of Traditional Chinese Medicine and rats in the model group were significantly lower than that in the blank group, the growth was slow, and the weight gain tendency decreased with the course of disease progression.Model rats were successfully made one weeks after the beginning of the emergence of more drink more urine symptoms,Spontaneous activity reduction,hair lacks luster,listlessness;After the end of the experiment,Traditional Chinese medicine high, medium and low dose group DR rats condition was better than the model group.(2)Effect on blood glucose in DR rats. After the success of the model,Compared the fasting blood glucose of the rats in the blank group,High, medium and low dose group and model group rats were significantly elevated fasting blood glucose(P<0.01);Traditional Chinese medicine high, medium and low dose group after treatment for 12 weeks,the blood glucose levels were significantly reduced,compared with model group, there were significant differences(P<0.01);The fasting blood glucose was significantly lower in the traditional Chinese medicine high and medium dose group than in the low dose group,the difference was statistically significant(P<0.01);Comparison of blood glucose in high and medium dose group of Traditional Chinese medicine,the difference was not statistically significant(P>0.05).(3)Effect on VEGF and VEGFR2 m RNA expression in DR rats retinal tissue.Compared with the blank group,the contents of VEGFR2 and VEGF m RNA in model group were significantly increased;After the treatment of traditional Chinese medicine high, medium and low dose group, the expression level of VEGF,VEGFR2 m RNA was significantly decreased(P<0.01);Compared with the low dose group, the expression of traditional Chinese medicine high,medium dose group, down-regulated expression of VEGF,VEGFR2 was more obvious(P<0.01).(4)Effects on HIF-1a, VEGF and VEGFR2 protein expression in DR rats retinal tissue. In the blank group, the expression of HIF-1a, VEGF and VEGFR2 protein was significantly lower than that of the model group(P<0.01);Traditional Chinese medicine high, medium and low dose group, the expression level of HIF-1a, VEGF and VEGFR2 protein was significantly decreased(P<0.01);Traditional Chinese medicine high,medium dose group VEGF, VEGFR2 protein expression showed no significant difference.4 ConclusionYiqi Yangyin Huoxue Recipe can improve the DR of patients with Central Retinal Artery Hemodynamics,improve the retinal microcirculation disorder,improve the visual acuity and fundus retinopathy,effectively improve the clinical symptoms and signs of traditional Chinese Medicine.And reduce patients, blood glucose and lipid. It is safe and effective in clinical use and can effectively down regulate the expression of HIF-1a/VEGF/VEGFR2,having a certain role in the regulation and control the HIF-1a/VEGF/VEGFR2,improving endothelial dysfunction,mitigating Diabetic retinal damage, retarding the progression of disease. |
PDF Full Text Request