本文關(guān)鍵詞： 形覺剝奪性弱視 NMDAR1 視覺可塑性 中藥 體質(zhì)　出處：《山東中醫(yī)藥大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過臨床調(diào)查研究弱視的中醫(yī)體質(zhì)類型特征，為臨床弱視的中醫(yī)辨證治療提供思路。通過實(shí)驗(yàn)研究從微觀上探討視明寶顆粒對弱視貓的視覺可塑性。 方法：臨床調(diào)查：根據(jù)2009年實(shí)施的《中華中醫(yī)藥學(xué)會標(biāo)準(zhǔn)—中醫(yī)體質(zhì)分類與判定標(biāo)準(zhǔn)》(ZYYXH/T157-2009)將納入的141例弱視患者進(jìn)行分型，，分為平和質(zhì)、氣虛質(zhì)、陽虛質(zhì)、陰虛質(zhì)、痰濕質(zhì)、濕熱質(zhì)、血瘀質(zhì)、氣郁質(zhì)、特稟質(zhì)等九種；動物實(shí)驗(yàn)：家養(yǎng)幼貓(4-6周齡)30只，隨機(jī)分為正常組、模型組、對照組、低劑量組、中劑量組、高劑量組六組，每組5只。除正常組外其余各組均左側(cè)眼瞼造模，應(yīng)用視覺誘發(fā)電位(P-VEP)驗(yàn)證造模是否成功。通過實(shí)時定量PCR(real-time PCR)檢測技術(shù),觀察視明寶顆粒對弱視貓視皮層谷氨酸受體（NMDAR1）表達(dá)的影響。 結(jié)果：141例弱視患者體質(zhì)歸類及頻次依次為：陰虛質(zhì)：26.24%，平和質(zhì)：22.70%，濕熱質(zhì)：12.06%，痰濕質(zhì)：10.64%，陽虛質(zhì)：9.93%，血瘀質(zhì)：9.93%，氣虛質(zhì)：9.22%。男性弱視患者常見體質(zhì)依次為：平和質(zhì)、陰虛質(zhì)、濕熱質(zhì)、痰濕質(zhì)、陽虛質(zhì)、氣虛質(zhì)、血瘀質(zhì)。女性弱視患者常見體質(zhì)依次為：陰虛質(zhì)、平和質(zhì)、濕熱質(zhì)、痰濕質(zhì)、血瘀質(zhì)、陽虛質(zhì)、氣虛質(zhì)。屈光不正性弱視多為平和質(zhì)、陰虛質(zhì)和濕熱質(zhì)，屈光參差性弱視多為陰虛質(zhì)和平和質(zhì)，斜視性弱視多為陽虛質(zhì)。動物實(shí)驗(yàn)：對照組NMDAR1的表達(dá)明顯低于正常組（P㩳0.05）；高劑量組弱視貓左側(cè)視皮層21區(qū)、右側(cè)視皮層17區(qū)與對照組相比有意義（P㩳0.05）；模型組NMDAR1的表達(dá)明顯低于正常組（P㩳0.05）；高劑量組弱視貓左側(cè)視皮層21區(qū)、右側(cè)視皮層17區(qū)與模型組相比有意義（P㩳0.05）；低劑量、中劑量與對照組和模型組相比均無意義。 結(jié)論：弱視的發(fā)病與體質(zhì)類型有關(guān),陰虛質(zhì)、平和質(zhì)、濕熱質(zhì)、痰濕質(zhì)、陽虛質(zhì)對弱視的發(fā)病影響顯著，對弱視的預(yù)防及治療有一定的臨床指導(dǎo)意義。實(shí)驗(yàn)研究證明形覺剝奪性弱視貓視皮層17、21區(qū)NMDAR1的表達(dá)降低，高劑量視明寶顆粒能提高視皮層NMDAR1的表達(dá)水平，驗(yàn)證了NMDAR1與弱視患者的視覺可塑性有關(guān)，從微觀上證明視明寶顆粒對弱視的治療是有效，視明寶顆粒能改善視覺可塑性。
[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.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R777.44

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