■白内障是全球最常见的失明原因,一种由晶状体模糊引起的视觉障碍,严重影响人们的日常生活。年龄相关性白内障(ARC)是最常见的白内障类型,由于多种因素的长期综合作用,其发病机制多种多样。目前,手术是白内障的主要治疗方法,但它仍然局限于预防,早期白内障的治疗及术后并发症的护理。同时,其药物治疗仍处于探索和研究阶段。中医(TCM),中国独特的资源,是在中医理论指导下构思的,毒副作用小,但它在治疗和预防ARC方面取得了很大进展。
目的:本文概述了传统和现代医学中ARC的发病机理,并总结了中医药对ARC的历史和治疗作用,包括其配方。原料药和活性成分,以及其他辅助方法。
方法:许多公认的数据库,如SciFinder,PubMed,科学直接,谷歌学者,和中国国家知识基础设施(CNKI)进行了广泛的探索,使用关键词和短语,如“白内障”,“年龄相关性白内障”,“传统医学”,“民族药理学”,\"草药\",“药用植物”,或其他相关条款,以及在年龄相关性白内障模型中评估的植物/植物成分。并对目前中医辅助疗法在临床治疗中的应用进行了总结。
结果:中医在治疗年龄相关性白内障方面发挥着积极作用,通过多途径和多靶标,可以通过抑制葡萄糖代谢异常来治疗或延缓ARC,抗氧化损伤,抑制LEC凋亡,等等,这与中医药在全球临床应用中的良好效果是一致的。关于白内障的早期防治及术后并发症,中医和辅助方法仍需取得较好的临床疗效。
结论:ARC在中医理论中属于“元义内章”的范畴,表明有许多原因导致ARC,包括老化,和肾阳,脾,脾精子和血液缺乏。同时,内脏逐渐衰退,以及阴阳逐渐变弱,尤其是老年人。所以,中医可以以肝脏为主,肾,和脾辨证,个性化诊断和治疗,跟随多个目标,从根本上调节阴阳,从而证明了中医药在预防和治疗ARC方面的优势。
UNASSIGNED: Cataract is the most common cause of blindness worldwide, a visual disorder caused by a clouded lens that seriously affects People\'s Daily lives. Age-related cataract (ARC) is the most common type of cataract due to long-term combined effects of many factors, and its pathogenesis is varied. At present, the surgery is the main treatment for cataracts, but it is still limited to the prevention, treatment of early cataracts and the postoperative complications care. While, its drug treatments are still in the stage of exploration and research. Traditional Chinese Medicine (TCM), a unique resource in China, is conceived under the guidance of traditional Chinese medicine theory and has little toxicity and side effects, but it has made great progress in the treatment and prevention of ARC.
OBJECTIVE: This review presents an overview of the pathogenesis of ARC in both traditional and modern medicines and summarizes the history and therapeutic effect of TCM on ARC including their formula, crude drugs and active components, and also the other auxiliary methods.
METHODS: A number of recognized databases like SciFinder, PubMed, Science Direct, Google Scholar, and China National Knowledge Infrastructure (CNKI) were extensively explored by using keywords and phrases such as \"cataract\", \"age-related cataract\", \"traditional medicine\", \"ethnopharmacology\", \"herbs\", \"medicinal plants\", or other relevant terms, and the plants/phytoconstituents that are evaluated in the models of age-related cataract. As well as the current TCM adjuvant therapy used in the clinical treatment were summarized.
RESULTS: TCM revealed to plays an active role in treating age-related cataract, via multi-pathway and multi-target, and can treat or delay ARC by inhibiting abnormal glucose metabolism, antioxidant damage, inhibiting LEC apoptosis, and so on, which is in concordance with the good effects of the global use of TCM in clinical application. Concerning the early prevention and treatment of cataract and postoperative complications, TCM and auxiliary methods remain to achieve better clinical effects.
CONCLUSIONS: ARC belongs to the category of \"Yuan Yi Nei Zhang\" in TCM theory, showing that there are many causes of ARC including aging, and kidney-yang, spleen, sperm and blood deficiencies. At the same time, the viscera gradually decline, as well as yin or yang progressively become weak, especially in the elder people. So, TCM could be mainly based on liver, kidney, and spleen syndrome differentiation, personalizing diagnosis and treatment, following multiple targets, regulating fundamentally yin and yang, and thus justifying the advantages of Chinese medicine in the prevention and treatment of ARC.