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8中药治疗进展
祖国医学认为DR是中医“消渴病”的眼部并发症。王施红等[20]采用三白止血胶囊其主要成分为鱼膘、三七、熊胆。应用于临床观察表明出血吸收有效率为72.27%，渗出吸收率37.5%，血管瘤减少有效率为13.63%。郑燕林等通过组织病理学观察发现，水蛭素可以抑制增生性DR的进展。目前人们普遍认为细胞Ca2+超载是细胞死亡的最后通路，细胞内Ca2+超载可以引起一系列的功能障碍。银杏叶及其内酯B可以保护小鼠神经元对抗谷胺酸的损害，阻止谷胺酸诱发的Ca2+内流的升高，从而起到保护神经细胞的作用[21]。银杏叶能够抑制自由基产生,清除自由基,对缺血再灌注、光毒作用、炎症等引起的视网膜结构和功能的损害具有保护作用[22]。川芎嗪、葛根素均能够改善微循环，对DR也有肯定的治疗作用。
总之，DR的高发病率、高致盲率、高复发率的特点，严重的威胁着人类的生存质量。虽然医务工作者对DR发病机制的不断深入探索研究，现仍缺乏有效的治疗手段。因此，治疗原发病——DM是根本。
【参考文献】
1 Ishida S，Usui T，Yamashiro K, et al. VEGF164 is proin flammatory in the diabetic retina. Invest Ophthalmol Vis Sci2003；44：21552162
2 Beckman JA，Goldfine AB，Gordon MB, et al. Inhibition of protein kinase C beta prevents impared endotheliumdependent vasodilation caused by hyperglycemia in humans. Circ Res2002；90(1)：107111
3 Campochiaro PA，C99PKC412003 Study Group. Reduction of diabetic macular edema by oral administration of the kinase inhibitorPKC412. Invest Ophthalmol Vis Sci2004；45(3)：922 931
4 The PKCDRS Study Group. The effect of ruboxistaurin on visual oss in patients with moderately severe to very severe nonprol iferative diabetic retinopathy：initial results of the Protein Kinase C beta in hibitor Diabetic Retinopathy Study (PKCDRS)multicenter randomized clinical trial. Diabetes2005;54(7):2188 2197
5 Kern TS. Engerman RL Pharm acological inhibition of diabetic retinopathy aminoguanidine and aspirin. Diabetes2001;50(7):16361642
6郝胜利，徐延山，袁佳琴.糖尿病视网膜病变的药物治疗.国际眼科纵览 2006；30（1）：5861
7 Jacobs ML，Derkx FH，Stljnen T, et al. Efect of longacting somatostatin analog(somatulin)on renal hyperfiltration in patients with IDDM. Diabetes Care1997；20(4)：632636
8 Aiello LP，Cahill MT，Cavallerano JD．Growth factors and protein kinase C inhibitors as novel therapies for the medical management diabetic retinopathy. Eye2004；18(2)：117125
9 Jonas J，Heatley G，Spaide R, et al. Intravitreal triamcino1one acetonide and secondary ocular hypertension. J Glaucoma2005；14(2)：168171
10陈燕燕,孙京华.糖尿病视网膜病变药物治疗的研究进展.临床眼科杂志 2005；13（6）：559563
11 Micelli Ferrari T，Sborgia L，Furino C, et al. Intravitreal triamcinolone acetonide: valuation of retinal thickness changes measured by optical coherence tomography in diffuse diabetic macular edema. Eur J Ophthalmol 2004；14(4)：321324
12 Jonas JB，Degenring RF，Kamppeter BA, et al. Duration of the effect of intravitreal triamcinolone acetonide as treatment for diffuse diabetic macular edema. Am J Ophthalmol2004；138(1)：158160
13 Martidis A，Duker JS，Greenberg PB, et al. Intravitreal triamcin olone for refractory diabetic macular edema. Ophthalmology2002；109(5)：920927
14齐艳秀，于海莲，孟德欣，等.丙酮酸对糖尿病大鼠晶状体多元醇通路及上皮细胞凋亡的影响.中华眼科杂志2007；43：11191124
15 Pta A ，Gupta V ，Thapar S, et al. Lipidlowering drug atorvastatinas an adjunct in the management of diabetic macular edema. Am J Ophthalmol 2004；137(4)：675682
16 Barber AJ. A new view of diabetic retinopathy: a neurodegenerative disease of the eye. Prog Neuropsychopharmacol Biol Psychiatry2003；27(2)：283290
17 Itakura H, Akiyama H, Hagimura N, et al. Triamcinolone acetonide suppresses interleukin1 betamediated increase in vascular endothelial growth factor expression in cultured rat Müller cells. Graefe Arch Clin
Exp Ophthalmol2006； 244(2)：226231
18 Gerhardinger C, Costa MB, Coulombe MC, et al. Expression of acutephase response proteins in retinal Müller cells in diabetes. Invest Ophthalmol Vis Sei2005；46(1)：349357
19 沈玺，徐格致.高糖环境下白介素1β对大鼠视网膜Müller细胞谷氨酰胺合成酶的影响.中华眼科杂志 2007;43（8）：744749
20王施红，刘雪松，李玉权，等.三白止血胶囊治疗糖尿病视网膜病变50例疗效观察.中国误诊学杂志2006；6（3）：454455
21王红星.银杏叶提取物EGb 761 对兔视网膜缺血损伤的保护作用.国际眼科杂志 2005;5(6):11681171
22李才锐,孙曙光,姜德咏,等.银杏叶提取物治疗早期糖尿病视网膜病变观察.国际眼科杂志 2006;6(1):7881
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