不同中医内治法对实验性家兔视网膜血管病变的干预研究

Research of different TCM therapies on experimental rabbit with retinal vasculitis

目的观察犀角地黄汤、桃红四物汤、黄连解毒汤及知柏地黄汤对庆大霉素致家兔视网膜尤其是血管损伤的治疗作用。方法庆大霉素注入青紫蓝兔玻璃体腔造模,24小时后用不同药物灌胃,通过眼底彩照、荧光素眼底血管造影、光镜及电镜检查、免疫组织化学检测细胞间黏附分子-1(ICAM-1)、von Wille-brand因子含量以及视网膜血管消化铺片等方法来观察不同药物作用7天及14天各组兔的眼底表现、组织形态和超微结构等变化情况。结果桃红四物汤中剂量能明显改善庆大霉素致家兔视网膜出血及炎症反应,减少视网膜血管及其周围炎性细胞数量,明显降低视网膜血管区ICAM-1的表达,其对视网膜von Wille-brand因子表达的下调作用并不明显;黄连解毒汤中剂量早期能明显减少庆大霉素致家兔视网膜出血。结论桃红四物汤中剂量能有效控制庆大霉素致家兔视网膜出血及炎症反应,明显改善视网膜微循环功能;黄连解毒汤中剂量早期能明显减少视网膜出血,对临床视网膜血管炎及其相关疾病的中医药治疗有很大的指导作用。

OBJECTIVE To investigate the therapeutic effect of different traditional Chinese medicine on injured rabbits＇ retina especially vascular injury caused by gentamicin intravitreal injection.METHODS Intravitreal injected gentamicin in rabbit eyes and made the model,24 hours later treated them with different TCM medicines,examined changes in clinical findings,fluorescein angiography,retinal vascular digestion,histopathologic finding,electron microscopy,histochemical changes and computerized image analysis on day 7 and 14.RESULTS The medium-dose of Taohong Siwu Decoction was more effective on those animal models,it could partly protect the retina and vessels from the toxicity of gentamicin,and reduce retina ICAM-1 obviously,but the effect of reducing retinal von Willebrand factor was not obvious;the medium-dose of Huanglian Jiedu Decoction could reduce retinal bleeding obviously in early stage.CONCLUSIONS The medium-dose of Taohong Siwu Decoction could partly protect the retina and vessels from the toxicity of gentamicin,improve retinal microcirculation obviously;the medium-dose of Huanglian Jiedu Decoction could reduce retinal bleeding obviously in early stage.Traditional Chinese medicine will be of great value to clinical practices of retinal vasculitis and the similar diseases.