中西医治疗视网膜色素变性的研究进展

Treatment of Retinitis Pigmentosa with Traditional Chinese and Western Medicine:A Review

视网膜色素变性(RP)是一组以视网膜光感受器细胞和视网膜色素上皮受损为特征的进行性可致盲遗传性眼底疾病。其主要临床表现为夜盲及进行性视野缺损,因而RP具有高致盲性的特点,严重影响着患者的生活质量。近年来,对RP发病机制及治疗的研究文献逐渐增多。基于此,该文总结出RP的发病主要与遗传基因相关,而视网膜血流灌注、氧化应激损伤及炎症级联反应均不同程度影响着疾病进展。分析RP治疗现状,中医药治疗主要包括中药复方、中药提取物、针药结合、中医综合治疗;西医治疗包括基因、干细胞治疗、光遗传学治疗、视网膜假体、药物、并发症治疗及其他治疗。其中西医治疗干预机制常包括基因修饰、替代治疗、改善视网膜血流灌注、抗氧化损伤及营养支持等多个方面。笔者通过归纳中西医治疗RP的具体方法及作用效果或机制,希望为RP的管理及治疗提供参考。

Retinitis pigmentosa(RP)is a group of progressive and blinding hereditary fundus diseases characterized by damaged retinal photoreceptor cells and retinal pigment epithelium.With the clinical manifestations of night blindness and progressive visual field defect,RP has a high possibility of developing into blindness,which seriously affects the quality of life of the patients.The recent years have witnessed increasing studies about the pathogenesis and treatment of RP.By reviewing the relevant articles,we conclude that the pathogenesis of RP is mainly related to genes,and retinal blood perfusion,oxidative stress injury,and inflammatory cascade all affect the progression of this disease.The traditional Chinese medicine(TCM)therapies for RP mainly include TCM compound prescriptions,Chinese medicine extract,acupuncture combined with medicine,and comprehensive TCM treatment.The Western medicine therapies include gene therapy,stem cell therapy,optogenetic therapy,retinal prosthesis,drugs,treatment of complications and other therapies.The intervention mechanisms of traditional Chinese and Western medicine often involve gene modification,alternative therapy,improvement of retinal blood perfusion,antioxidant damage,and nutritional support.By summarizing the specific methods and effects of traditional Chinese and Western medicine in treating RP,we hope to provide a reference for the management and treatment of RP.