益气通络开窍法对视网膜神经纤维层保护的研究  

Study on the protection effect of Yiqi Tongluo Kaiqiao therapy in retinal nerve fiber layer

作　　者：陈兹满[1] 张梅芳[1] 冀建平[2] 李志英[2] 

机构地区：[1]广东省中医院眼科,广州510120 [2]广州中医药大学第一附属医院眼科,广州510405

出　　处：《中华中医药杂志》2015年第6期2145-2148,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：教育部博士点基金(No.20104425110012)~~

摘　　要：目的:分析益气通络开窍法对前部缺血性视神经病变(AION)的视网膜神经纤维层的影响,评价该法的疗效。方法:SD大鼠40只,随机分成4组,每组10只。在造模成功后,观察组黄芪、川芎嗪以及醒脑静注射液腹腔注射,每天1次;对照组地塞米松注射液腹腔注射,每天1次。7d为1个疗程,共2个疗程。并行OCT扫描、病理以及电镜检查。结果:空白组SD大鼠RNFL厚度(79.80±6.94)μm;模型组造模1d后RNFL厚度为(96.70±5.60)μm,RNFL水肿增厚(P<0.05)。观察组7d后RNFL厚度为(74.75±4.03)μm,14d后RNFL厚度为(80.17±5.12)μm,与空白组比较差异无统计学意义。对照组7d后为(97.50±9.06)μm,14d RNFL厚度为(64.00±6.20)μm,与空白组比较差异显著(P<0.05)。7d和14d观察组与对照组比较,RNFL厚度差异显著(P<0.05)。组织病理学检查表明:对照组观察组视网膜外节水肿消退,排列有序,血管部分再通;对照组标本视网膜外节水肿、疏松,排列紊乱,空泡华,血管闭塞。电镜检查表明:对照组视网膜神经节细胞层出现核固缩、变薄、线粒体肿胀、胞浆脱失、空泡化,内、外丛状层也可以见到细胞轻度水肿、空泡化。经过治疗,该法表现在对视网膜突触复合体、内节神经细胞线粒体以及毛细血管有保护作用。结论:益气活血开窍法对视网膜神经纤维层有保护作用。Objective： To analyse the effects of Yiqi Tongluo Kaiqiao on retinal nerve fiber layer of AION and evaluate the efficacy of this method. Methods： 40 SD rats were randomly divided into 4 groups, 10 rats in each group. After the success of the modeling, in the observation group, Huangqi, Chuanxiongqin, Xingnaojing Injection were given by intraperitoneal injection, once a day; in the control group dexamethasone injection was given once a day, with 7d as one treatment period, a total of 2 courses. Parallel OCT scanning, pathological and electron microscopic examination were used. Results： In normal SD rats group the RNFL thickness was （79.80±6.94） μm; while in model group RNFL thickness was （96.70±5.60） μm ld after model established, edema thickening RNFL （P〈0.05）. In the observation group RNFL thickness was （74.75±4.03）μm 7d after model established, 14 days later, RNFL thickness was （80.17±5.12） μm. There was no significant difference. RNFL was （97.50±9.06）μm 7 days after nodel established, 14 days after that RNFL thickness was （64.0±6.20） μm in the control group （P〈0.05）. At the 7th and 14th day, there was significant difference in RNFL thickness between observation group and control group （P〈0.05）. Histopathological examination showed that the edema of retinal outer segments was disappeared, arranged in an orderly manner, and part of the vessel was recanalized; the control group was with specimens of retinal outer segment edema, osteoporosis, arranged disorder, vacuolar Hua, vascular occlusion. Electron microscopic examination showed that in the control group the retinal ganglion cell layer appeared karyopyknosis, thinning, mitochondrial swelling, vacuolation of cytoplasm loss, and the inner and outer plexiform layer can also see cell mild edema, vacuolization. After treatment, the method showed a protective effect on retinal synaptic complex, mitochondria in inner segment nerve cells and capillary. Conclusion： Yiqi Huoxue Kaiqiao therapy has protective

关 键 词：前部缺血性视神病变 益气通络开窍 电镜 视网膜神经纤维层 

分 类 号：R276.7[医药卫生—中医五官科学]