益气养阴活血化瘀中药复方抗糖尿病视网膜病变代谢记忆的研究

Diabetic retinopathy (DR) is one of the main causes of blindness and visual impairment in adults, and it continue to develop in "metabolic memory" in the patients whose blood sugar is controlled.The mechanism remains unclear. Our previous studies showed that the main pathogenesis of DR is Qi and yin deficiency and vein stasis, treated by the principle of Supplementing Qi and nourishing Yin, promoting blood circulation to remove blood stasis, so compound prescription for supplementing qi, nourishing yin and promoting blood circulation and removing blood stasis. This method has achieved good clinical efficacy. Previous studies have also found that the retinal microvascular pericytes play an important role in the pathogenesis of DR. So based in the PDGF-BB , our study attempts to use retinal pericytes participate in the mechanism of Yiqi Yangyin and Huoxue huayu method treating DR's "metabolic memory" in miRNA net .

糖尿病视网膜病变(diabetic retinopathy，DR)是成年人视力损伤和致盲的主要原因之一，“代谢记忆”现象可让DR在血糖已控制的患者中继续发展，但其作用机制尚不明了。我们的前期研究表明，DR的主要病机为气阴两虚、脉络瘀滞，治疗采用益气养阴、活血化瘀的原则，故组方益气养阴活血化瘀中药复方，取得了较好的临床疗效。前期研究还发现，视网膜微血管周细胞在DR的发病机制中起重要的作用。故本研究旨在利用视网膜微血管周细胞参与DR“代谢记忆”的机制，从PDGF-BB等方面着手，进行益气养阴活血化瘀中药复方调控miRNA网络的研究，初步探索其治疗DR“代谢记忆”机制。

高糖引起的代谢记忆现象是导致糖尿病视网膜病变的主要原因，但是目前仍未找到干预代谢记忆的有效手段。黄芪多糖，作为一种传统的中药成分，已被报道能有效缓解糖尿病症状，但是黄芪多糖与代谢记忆研究还未有人报道过。在我们的课题中，我们发现黄芪多糖缓解糖尿病视网膜病变代谢记忆的两条有效途径：1）黄芪多糖通过抑制miR-195的表达上调Bcl-2抑制代谢记忆模型中线粒体损伤诱导的凋亡。2）黄芪多糖通过抑制miR-204的表达上调SIRT1抑制代谢记忆模型中内质网应激诱导的凋亡。此课题首次揭露黄芪多糖能够缓解高糖引起的代谢记忆现象，为黄芪多糖治疗糖尿病视网膜病变提供了有效的理论的基础。