目的：探讨健脾补肾益视方对碘酸钠诱导的小鼠干性年龄相关性黄斑变性(dARMD)的保护作用及其机制。

方法：将27只SPF级雄性C57BL/6小鼠随机分为空白组、模型组和中药组，每组各9只，通过苏木精-伊红(HE)染色观察视网膜的结构形态，二氢乙锭(DHE)荧光染色观察小鼠视网膜细胞内活性氧(ROS)水平，生化试剂盒检测小鼠视网膜丙二醛(MDA)、超氧化物歧化酶(SOD)表达水平，Western blot检测小鼠视网膜沉默信息调节因子相关蛋白1(SIRT1)、过氧化物酶体增殖物激活受体γ共激活因子1-α(PGC-1α)蛋白表达。

结果：视网膜结构形态：模型组视网膜结构见外核层细胞数量轻微或轻度减少，外核层局部区域变薄，外界膜分界不明显，视网膜色素上皮细胞轻微或轻度肿胀，视网膜细胞排列轻微或轻度紊乱； 中药组视网膜色素上皮细胞层及光感受器层明显改善。氧化应激：DHE荧光染色结果显示，造模14 d后，模型组的ROS水平明显高于空白组(P<0.01)； 中药组的ROS水平明显低于模型组(P<0.001)。ELISA结果显示，造模14 d后，模型组与空白组相比，SOD水平明显降低(P<0.01)，MDA水平明显升高(P<0.01)； 中药组与模型组比较，SOD水平明显升高(P<0.01)，MDA水平明显降低(P<0.01)。SIRT1/PGC-1α蛋白表达：Western blot结果显示，造模7、14 d，与空白组比较，模型组SIRT1和PGC-1α表达均显著降低(P<0.01)； 与模型组比较，中药组SIRT1和PGC-1α表达均显著升高(P<0.01)。

结论：中药健脾补肾益视方可改善碘酸钠诱导的小鼠视网膜氧化应激状态，减少对视网膜组织的损伤，可能是通过PGC-1α/SIRT1信号通路发挥抗氧化应激作用。

METHODS: A total of 27 SPF male C57BL/6 mice were randomly divided into blank, model and traditional Chinese medicine groups, with 9 in each group, the structure and morphology of the retina were observed by Hematoxylin-Ehong(HE)staining, and the intracellular reactive oxygen species(ROS)in the retina were observed by fluorescence staining with dihydroethidium(DHE). In addition, malondialdehyde(MDA)and superoxide dismutase(SOD)expression levels in mouse retina were detected by biochemical kit, and expression levels of silent information regulator type 1(SIRT1)and peroxisome proliferator-activated receptor-γ coactivator 1-α(PGC-1α)protein in mouse retina were detected by Western blot.

RESULTS: Retinal structure and morphology of the model group showed a slight or mild decrease in the number of cells in the outer nuclear layer, a localized thinning of the outer nuclear layer, an inconspicuous demarcation between the outer and outer membranes, a slight or mild swelling of retinal pigment epithelial cells, and a slight or mild disturbance in the arrangement of retinal cells; while retinal pigment epithelial cells and photoreceptor layers in the traditional Chinese medicine group were significantly improved. DHE staining fluorescence results showed that the ROS level in the model group was significantly higher than that in the blank group at 14 d after modeling(P<0.01); the ROS level in the traditional Chinese medicine group was significantly lower than that in the model group(P<0.001). ELISA showed that the SOD level of the model group was significantly lower than that of the blank group at 14 d after modeling(P<0.01), and the MDA level was significantly increased(P<0.01)in the model group compared with the blank group; the SOD level was significantly higher(P<0.01), and the MDA level was significantly lower(P<0.01)in the traditional Chinese medicine group compared with the model group. Western blot results showed that the expression of SIRT1 and PGC-1α in the model group was significantly lower compared with that in the blank group(P<0.01), and the expression of SIRT1 and PGC-1α in the traditional Chinese medicine group was significantly higher compared with that in the model group at 7 and 14 d after modeling(P<0.01).

CONCLUSION: The Chinese herbal medicine, which strengthens the spleen, tonifies the kidney and benefits the eyesight, can improve the oxidative stress state of the retina induced by sodium iodate in mice and reduce the damage to the retinal tissues, which may exert the anti-oxidative stress effect through the PGC-1α/SIRT1 signaling pathway.