弱视与体质的关系及中药对视觉可塑性影响的实验研究

发布时间：2018-02-14 16:13

本文关键词： 形觉剥夺性弱视 NMDAR1 视觉可塑性中药体质　出处：《山东中医药大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：通过临床调查研究弱视的中医体质类型特征，为临床弱视的中医辨证治疗提供思路。通过实验研究从微观上探讨视明宝颗粒对弱视猫的视觉可塑性。方法：临床调查：根据2009年实施的《中华中医药学会标准—中医体质分类与判定标准》(ZYYXH/T157-2009)将纳入的141例弱视患者进行分型，，分为平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质等九种；动物实验：家养幼猫(4-6周龄)30只，随机分为正常组、模型组、对照组、低剂量组、中剂量组、高剂量组六组，每组5只。除正常组外其余各组均左侧眼睑造模，应用视觉诱发电位(P-VEP)验证造模是否成功。通过实时定量PCR(real-time PCR)检测技术,观察视明宝颗粒对弱视猫视皮层谷氨酸受体（NMDAR1）表达的影响。结果：141例弱视患者体质归类及频次依次为：阴虚质：26.24%，平和质：22.70%，湿热质：12.06%，痰湿质：10.64%，阳虚质：9.93%，血瘀质：9.93%，气虚质：9.22%。男性弱视患者常见体质依次为：平和质、阴虚质、湿热质、痰湿质、阳虚质、气虚质、血瘀质。女性弱视患者常见体质依次为：阴虚质、平和质、湿热质、痰湿质、血瘀质、阳虚质、气虚质。屈光不正性弱视多为平和质、阴虚质和湿热质，屈光参差性弱视多为阴虚质和平和质，斜视性弱视多为阳虚质。动物实验：对照组NMDAR1的表达明显低于正常组（P㩳0.05）；高剂量组弱视猫左侧视皮层21区、右侧视皮层17区与对照组相比有意义（P㩳0.05）；模型组NMDAR1的表达明显低于正常组（P㩳0.05）；高剂量组弱视猫左侧视皮层21区、右侧视皮层17区与模型组相比有意义（P㩳0.05）；低剂量、中剂量与对照组和模型组相比均无意义。结论：弱视的发病与体质类型有关,阴虚质、平和质、湿热质、痰湿质、阳虚质对弱视的发病影响显著，对弱视的预防及治疗有一定的临床指导意义。实验研究证明形觉剥夺性弱视猫视皮层17、21区NMDAR1的表达降低，高剂量视明宝颗粒能提高视皮层NMDAR1的表达水平，验证了NMDAR1与弱视患者的视觉可塑性有关，从微观上证明视明宝颗粒对弱视的治疗是有效，视明宝颗粒能改善视觉可塑性。
[Abstract]:Objective: to study the physical characteristics of amblyopia in traditional Chinese medicine (TCM) through clinical investigation, and to provide some ideas for the treatment of amblyopia based on TCM syndrome differentiation, and to explore the visual plasticity of Shimingbao granules on amblyopia cats from the microcosmic point of view. Methods: clinical investigation: 141 amblyopia patients were classified according to the Chinese Association of traditional Chinese Medicine Standard-Chinese Medicine Constitution Classification and judgment Standard (ZYYXH / T157-2009), which were divided into mild, qi deficiency, yang deficiency, yin deficiency, phlegm wet, and so on. Animal experiment: 30 domestic kittens aged 4-6 weeks were randomly divided into normal group, model group, control group, low dose group, middle dose group, high dose group, six groups. There were 5 rats in each group. The left eyelid models were made in all groups except the normal group. Visual evoked potential (VEP) was used to verify whether the model was successful or not. To observe the effect of Shimingbao granule on the expression of glutamate receptor NMDAR1 in visual cortex of amblyopic cats. Results the constitution classification and frequency of 141 amblyopia patients were as follows: Yin deficiency: 26.24; peaceful: 22.70; dampness and heat: 12.06; phlegm: 10.64; Yang deficiency: 9.933; Blood stasis: 9. 93; Qi deficiency: 9.22. The common constitution of male amblyopia patients was peace, yin deficiency, dampness and heat. Phlegm dampness, yang deficiency, qi deficiency and blood stasis. The common constitution of female amblyopia patients is: Yin deficiency, calmness, dampness, phlegm, blood stasis, yang deficiency, qi deficiency. The amblyopia of anisometropia and strabismus amblyopia were mostly yang deficiency. Animal experiment: the expression of NMDAR1 in the control group was significantly lower than that in the normal group. High dose group amblyopia cats left visual cortex 21 area, right visual cortex 17 area compared with the control group, P? The expression of NMDAR1 in model group was significantly lower than that in normal group. High dose group amblyopia cats left visual cortex 21 area, right visual cortex 17 area compared with the model group, P? The low dose and middle dose had no significance compared with the control group and the model group. Conclusion: the onset of amblyopia is related to the type of body constitution. Yin-deficiency, calmness, dampness and heat, phlegm and dampness, Yang deficiency have significant effects on the pathogenesis of amblyopia. The experimental study showed that the expression of NMDAR1 in the visual cortex of the amblyopic cats was decreased, and the high dose of Shimingbao granule could increase the expression of NMDAR1 in the visual cortex of the amblyopia cats. NMDAR1 is related to visual plasticity in amblyopia patients. It is proved that Shimingbao granule is effective in the treatment of amblyopia, and Shimingbao granule can improve visual plasticity.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R777.44

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