浏览全部资源
扫码关注微信
1.湖南中医药大学,长沙 410000
2.湖南中医药大学 第一附属医院,长沙 410000
Published:20 December 2023,
Published Online:24 April 2023,
Received:30 November 2022,
扫 描 看 全 文
龙辉,喻京生,颜家朝.中西医治疗视网膜色素变性的研究进展[J].中国实验方剂学杂志,2023,29(24):241-249.
LONG Hui,YU Jingsheng,YAN Jiachao.Treatment of Retinitis Pigmentosa with Traditional Chinese and Western Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(24):241-249.
龙辉,喻京生,颜家朝.中西医治疗视网膜色素变性的研究进展[J].中国实验方剂学杂志,2023,29(24):241-249. DOI: 10.13422/j.cnki.syfjx.20232192.
LONG Hui,YU Jingsheng,YAN Jiachao.Treatment of Retinitis Pigmentosa with Traditional Chinese and Western Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(24):241-249. DOI: 10.13422/j.cnki.syfjx.20232192.
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.
视网膜色素变性发病机制中医药治疗西医治疗研究进展
retinitis pigmentosapathogenesistraditional Chinese medicine treatmentWestern medicine treatmentresearch progress
XU L,HU L,MA K,et al.Prevalence of retinitis pigmentosa in urban and rural adult Chinese:The Beijing eye study[J].Eur J Ophthalmol,2006,16(6):865-866.
HUANG Z Y,LIANG L N,LI Y M,et al.Genetic,environmental and other risk factors for progression of retinitis pigmentosa[J].Int J Ophthalmol,2022,15(5):828-837.
MANSERGH F C,MILLINGTON-WARD S,KENNAN A,et al.Retinitis pigmentosa and progressive sensorineural hearing loss caused by a C12258A mutation in the mitochondrial MTTS2 gene[J].Am J Hum Genet,1999,64(4):971-985.
FERRARI S,DI IORIO E,BARBARO V,et al.Retinitis pigmentosa:Genes and disease mechanisms[J].Curr Genomics,2011,12(4):238-249.
ALI M U,RAHMAN M,CAO J,et al.Genetic characterization and disease mechanism of retinitis pigmentosa; current scenario[J].3 Biotech,2017,7(4):251.
DAIGER S P,BOWNE S J,SULLIVAN L S.Perspective on genes and mutations causing retinitis pigmentosa[J].Arch Ophthalmol,2007,125(2):151-158.
REDMOND T M,YU S,LEE E,et al.Rpe65 is necessary for production of 11-cis-vitamin A in the retinal visual cycle[J].Nat Genet,1998,20(4):344-351.
HARTONG D T,BERSON E L,DRYJA T P.Retinitis pigmentosa[J].Lancet,2006,368(9549):1795-1809.
WANG X N,ZHAO Q,LI D J,et al.Quantitative evaluation of primary retinitis pigmentosa patients using colour Doppler flow imaging and optical coherence tomography angiography[J].Acta Ophthalmol,2019,97(7):e993-e997.
MURAKAMI Y,NAKABEPPU Y,SONODA K H.Oxidative stress and microglial response in retinitis pigmentosa[J].Int J Mol Sci,2020,21(19):7170.
PINILLA I,MANEU V,CAMPELLO L,et al.Inherited retinal dystrophies:Role of oxidative stress and inflammation in their physiopathology and therapeutic implications[J].Antioxidants (Basel),2022,11(6):1086.
刘昳,张元钟,章青.银杏明目方治疗原发性视网膜色素变性[J].长春中医药大学学报,2017,33(1):115-117.
姚震,彭俊,王英,等.滋阴明目丸治疗视网膜色素变性临床研究[J].亚太传统医药,2020,16(4):105-107.
曾梅艳,熊萌,仇婧玥,等.滋阴明目丸干预视网膜色素变性的效应与机制研究[J/OL].中国中医药信息杂志.https://doi.org/10.19879/j.cnki.1005-5304.202206658.https://doi.org/10.19879/j.cnki.1005-5304.202206658..
蒋鹏飞,彭俊,曾志成,等.益气明目丸对视网膜色素变性患者眼部血流动力学的影响[J].南京中医药大学学报,2020,36(1):24-27.
吴晗晗,徐静,卞敏娟,等.石斛夜光丸光感受器细胞保护效应的研究[J].上海中医药杂志,2018,52(8):83-86,97.
吴晗晗.石斛夜光丸的光感受器细胞保护效应及视网膜重塑相关机制研究[D] .上海:上海中医药大学,2019(3):3-33.
李雪丽,唐由之,许凯,等.补肾益精方对外周血干细胞在RCS大鼠视网膜上的募集及睫状神经营养因子表达的影响[J].中华眼视光学与视觉科学杂志,2018,20(8):475-483.
CHAN H H,LAM H I,CHOI K Y,et al.Delay of cone degeneration in retinitis pigmentosa using a 12-month treatment with Lycium barbarum supplement[J].J Ethnopharmacol,2019,236:336-344.
宋厚盼,曾梅艳,彭俊,等.枸杞子-丹参药对治疗视网膜色素变性的分子机制探讨[J].中国实验方剂学杂志,2019,25(14):199-206.
宋厚盼,曾梅艳,彭俊,等.丹参对视网膜色素变性病理过程Müller细胞特征性基因变化及关键蛋白表达的影响[J].中草药,2019,50(8):1863-1872.
江承.针刺联合明目地黄汤治疗视网膜色素变性的疗效观察[D] .长沙:湖南中医药大学,2020(3):7-12.
余兆安,叶晓红,彭俊,等.针刺结合穴位注射治疗原发性视网膜色素变性患者的临床观察[J].辽宁中医杂志,2019,46(4):816-818.
方胜.四物五子汤加减联合针刺治疗视网膜色素变性的临床疗效观察[D] .南昌:江西中医药大学,2020(5):16-27.
武丹蕾,吴烈.健脾益肾通络法联合针刺治疗原发性视网膜色素变性临床观察[J].北京中医药,2018,37(9):882-884.
刘健,亢泽峰,刘洁,等.中医综合疗法周期性治疗原发性视网膜色素变性的临床疗效观察[J].中国中医眼科杂志,2018,28(1):33-35.
彭俊,杨毅敬,李波,等.中医综合治疗视网膜色素变性患者973例疗效观察[J].辽宁中医杂志,2021,48(5):95-97,后插2.
彭俊,杨毅敬,李波,等.中医综合疗法治疗日本籍视网膜色素变性297例回顾性分析[J].湖南中医药大学学报,2020,40(7):788-791.
SAHNI J N,ANGI M,IRIGOYEN C,et al.Therapeutic challenges to retinitis pigmentosa:From neuroprotection to gene therapy[J].Curr Genomics,2011,12(4):276-284.
DANG Y,LOEWEN R,PARIKH H A,et al.Gene transfer to the outflow tract[J].Exp Eye Res,2017,158:73-84.
DICARLO J E,DEECONDA A,TSANG S H.Viral vectors,engineered cells and the CRISPR revolution[J].Adv Exp Med Biol,2017,1016:3-27.
BAINBRIDGE J W,SMITH A J,BARKER S S,et al.Effect of gene therapy on visual function in Leber's congenital amaurosis[J].N Engl J Med,2008,358(21):2231-2239.
CEHAJIC-KAPETANOVIC J,XUE K,MARTINEZ-FERNANDEZ DE LA CAMARA C,et al.Initial results from a first-in-human gene therapy trial on X-linked retinitis pigmentosa caused by mutations in RPGR[J].Nat Med,2020,26(3):354-359.
GHAZI N G,ABBOUD E B,NOWILATY S R,et al.Treatment of retinitis pigmentosa due to MERTK mutations by ocular subretinal injection of adeno-associated virus gene vector:Results of a phase I trial[J].Hum Genet,2016,135(3):327-343.
DIAKATOU M,MANES G,BOCQUET B,et al.Genome editing as a treatment for the most prevalent causative genes of autosomal dominant retinitis pigmentosa[J].Int J Mol Sci,2019,20(10):2542.
BIASUTTO P,ADAMSON P,DULLA K,et al.Allele specific knock-down of human P23H rhodopsin mRNA and prevention of retinal degeneration in humanized P23H rhodopsin knock-in mouse,following treatment with an intravitreal GAPmer antisense oligonucleotide (QR-1123)[J].Invest Ophthalmol Vis Sci,2019,60:5719.
刘红丽,吴继红.视网膜色素变性的诊断和治疗进展[J].中华眼底病杂志,2021,37(11):896-900.
中国眼科遗传联盟,中国眼遗传病诊疗小组,中国医师协会眼科医师分会遗传眼病学组.视网膜色素变性治疗循证指南(2021年)[J].眼科,2021,30(4):249-258.
MATHUR P,YANG J.Usher syndrome:Hearing loss,retinal degeneration and associated abnormalities[J].Biochim Biophys Acta,2015,1852(3):406-420.
YANG J Y,LU B,FENG Q,et al.Retinal protection by sustained nanoparticle delivery of oncostatin M and ciliary neurotrophic factor into rodent models of retinal degeneration[J].Transl Vis Sci Technol,2021,10(9):6.
BIRCH D G,WELEBER R G,DUNCAN J L,et al.Randomized trial of ciliary neurotrophic factor delivered by encapsulated cell intraocular implants for retinitis pigmentosa[J].Am J Ophthalmol,2013,156(2):283-292.e1.
HOFFMAN D R,HUGHBANKS-WHEATON D K,PEARSON N S,et al.Four-year placebo-controlled trial of docosahexaenoic acid in X-linked retinitis pigmentosa (DHAX trial):A randomized clinical trial[J].JAMA Ophthalmol,2014,132(7):866-873.
CHEN W J,MA L,LI M S,et al.Valproic acid's effects on visual acuity in retinitis pigmentosa:A systemic review and Meta-analysis[J].Int J Ophthalmol,2019,12(1):129-134.
LIEW G,STRONG S,BRADLEY P,et al.Prevalence of cystoid macular oedema,epiretinal membrane and cataract in retinitis pigmentosa[J].Br J Ophthalmol,2019,103(8):1163-1166.
CHEN C,LIU X,PENG X.Management of cystoid macular edema in retinitis pigmentosa:A systematic review and Meta-analysis[J].Front Med (Lausanne),2022,9:895208.
HE H,SONG H,MENG X,et al.Effects and prognosis of cataract surgery in patients with retinitis pigmentosa[J].Ophthalmol Ther,2022,11(6):1975-1989.
喻京生,彭清华,李波,等.中西医结合治疗原发性视网膜色素变性并发白内障的临床观察[J].中国中医眼科杂志,2005,15(1):34-35.
MORIMOTO T,FUJIKADO T,CHOI J S,et al.Transcorneal electrical stimulation promotes the survival of photoreceptors and preserves retinal function in royal college of surgeons rats[J].Invest Ophthalmol Vis Sci,2007,48(10):4725-4732.
SCHATZ A,RöCK T,NAYCHEVA L,et al.Transcorneal electrical stimulation for patients with retinitis pigmentosa:A prospective,randomized,sham-controlled exploratory study[J].Invest Ophthalmol Vis Sci,2011,52(7):4485-4496.
SCHATZ A,PACH J,GOSHEVA M,et al.Transcorneal electrical stimulation for patients with retinitis pigmentosa:A prospective,randomized,sham-controlled follow-up study over 1 year[J].Invest Ophthalmol Vis Sci,2017,58(1):257-269.
BITTNER A K,SEGER K,SALVESON R,et al.Randomized controlled trial of electro-stimulation therapies to modulate retinal blood flow and visual function in retinitis pigmentosa[J].Acta Ophthalmol,2018,96(3):e366-e376.
0
Views
27
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution