| Objective: In this study,Qizhen Jiangtang granules were selected to observe the clinical efficacy of Qizhen Jiangtang granules on early DR with liver and kidney yin deficiency and its effect on serum Hif-1α and VEGF levels in patients with DR through clinical research.Through animal experiments,observe the effects of Qizhen Jiangtang granules on the expression of Hif-1α,VEGF,and VEGFR2 in rat retina tissues,as well as the expression and distribution of Ki67 and PCNA in retina tissues,and explore the effects of Qizhen Jiangtang granules on Hif-1α/VEGF/ The influence of VEGFR2 signaling pathway and the mechanism of prevention and treatment of DR.Methods: 1.Clinical observation: According to the requirements,64 NPDR patients were enrolled and divided into two groups,each with 32 cases.The control group was given calcium dobesilate capsules,and the treatment group was given the same treatment plan as the former,and Qizhen Jiangtang granules were added.Continue the treatment for 24 weeks,compare the two groups of serum indexes and the levels of VEGF and Hif-1α,and observe the symptoms,syndromes,vision,fundus and other related indexes at the same time.2.Animal study: 100 SD rats were selected,15 were selected as the blank group,and the remaining 75 were modeled,and injected with STZ to induce modeled to form DM rats.The blank group was injected with the same amount of buffer.Feed the model with high-fat feed as a DR model.DR rats were divided into model group,western medicine group and Qizhen Jiangtang granule low,medium and high dose groups.Gavage according to requirements respectively.At the end of the intervention,blood samples and eyeball retinal tissues of each rat were taken.Detect FPG content in blood samples;HE staining of retina to observe histological structure;Western Blotting method to measure the expression of VEGF,VEGFR2 and Hif-1α;the expression of Ki67 and PCNA was detected by immunohistochemistry.Results: 1.Clinical research results: the total scores of traditional Chinese medicine decreased after treatment(P<0.01);the Qizhen Jiangtang granule group decreased more significantly(P<0.01).After treatment,the visual acuity score improved more significantly in the Qizhen Jiangtang granule group(P<0.01).The signs of the fundus of Qizhen Jiangtang granules group improved significantly(P<0.01).The effective rate of Qizhen Jiangtang granules group was better(P<0.01).After treatment,FPG,2h PG,and Hb A1 c in the two groups were lower than before treatment(P<0.01);FPG and 2h PG in the Qizhen Jiangtang granule group improved significantly after treatment(P<0.05).Both VEGF and Hif-1α decreased after treatment in the two groups(P<0.01);the Qizhen Jiangtang granule group decreased more significantly(P<0.01).2.Animal experiment results: After drug intervention,the FPG of the western medicine group was consistent with the model group(P>0.05);the FPG of the low,middle and high dose Qizhenjiangtang granules group was better than the model group(P<0.01).The expression levels of Ki67 and PCNA in the retina of the blank group were very small,and the expression levels of the other groups increased to different degrees compared with the blank group.Hif-1α decreased more significantly in the western medicine group and the Qizhen Jiangtang granule high-dose group(P<0.01);the Qizhenjiangtang granule middle-dose Hif-1α group was better than the model group(P<0.05).After intervention in the model group,VEGF and VEGFR2 were higher than those in the blank group(P<0.01);the western medicine group,Qizhenjiangtang granule middle-dose group,and Qizhenjiangtang granule high-dose group VEGF and VEGFR2 decreased better than the model group(P<0.05)).Conclusion: Qizhen Jiangtang Granules can effectively alleviate patients’ symptoms,regulate blood sugar,improve patients’ vision and fundus conditions,improve patients’ quality of life,inhibit Hif-1α/VEGF/VEGFR2 signaling pathway,and delay the development of DR. |
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