补肾健脾中药对兔后巩膜加固术后巩膜重塑影响的实验研究

Experimental Study of Kidney -reinforcing and Spleen-strengthening Chinese Herbal Medicine in Influencing Scleral Remodeling in Rabbits After Posterior Scleral Reinforcement Operation

目的:探讨后巩膜加固术后配合补肾健脾中药防治高度近视的机理。方法:新西兰家兔随机分为空白对照组、单纯手术组、手术配合中药1组、手术配合中药2组。分别行后巩膜加固手术,手术配合中药1组、2组术后分别灌食近视Ⅰ号方、近视Ⅱ号方,术后6周、12周分别取标本,行大体标本、光镜动态观察。结果:发现术后早期表现为强烈的炎症反应,主要为炎性细胞和成纤维细胞浸润,随后出现异物巨噬细胞,并向植入片内浸润,植入片成纤维细胞及胶原纤维组织增多,植入的巩膜也开始了修复过程。至术后12周,大量胶原纤维形成,充满间隙,使植入片与巩膜融合为一,形成"新巩膜",手术加中药组的术后炎症反应明显轻微,而单纯手术组炎症反应明显强烈。结论:后巩膜加固术阻止局部眼球后扩张,并用补肾健脾中药促使局部后巩膜再建新的血管以改善巩膜脉络膜营养供应,在中药协同下起到良性组织刺激作用,改善全身状态的同时改善后极部微循环,防止组织变性萎缩。

Objective:To study the preventive and therapeutic mechanism of posterior scleral reinforcement operation plus Chinese herbal medicine with the actions of reinforcing the kidney and strengthening the spleen(RKSS) for high myopia.Methods:New Zealand rabbits after posterior scleral reinforcement operation(PSRO) were given gastric gavage of Chinese herbal decoction of Myopia Recipe Ⅰand Myopia Recipe Ⅱ,respectively.The sclera was sampled 6 and 12 weeks after PSRO for the macroscopic and microscopic observation.Results:Severe inflammatory response occurred early after surgery,which was mainly manifested as lymphocyte infiltration.And then macrophages appeared and began to infiltrate through the implanted slice.Collagenous fibers in the top layer of implanted slice became degeneration.Twelve weeks after PSRO,repair processes began.A large number of collagenous fibers formed and filled in the gaps,which caused the fusion of implanted slice to host sclera.New sclera appeared.Inflammatory response was much more milder in herbal medicine groups than the control group.Conclusion:Posterior scleralre inforcement operation(PSRO) has an effect on preventing the progressing of ocular axial length,and the use of kidney-reinforcing and spleen-strengthening prescription promotes the formation of new vessels in focal posterior sclera and improves the choroidal nutrient supplies.PSRO plus Chinese herbal medicine has synergistic action on improving both body function and posterior microcirculation,which play an important role in preventing the tissue from degenerating and atrophying.