年龄相关性黄斑变性中医证型与多焦视网膜电图和血浆同型半胱氨酸及相关因素的关系研究
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摘要
目的：通过检测年龄相关性黄斑变性(AMD)病人和正常人的多焦视网膜电图(mfERG)的一阶响应(FOK) P1、N1波的变化,分析mfERG FOK在AMD中医各证型中的诊断价值；研究血浆同型半胱氨酸(Hcy)及相关因素在AMD各中医证型中的变化及意义,观察Hcy是否为中国人群AMD发病的危险因素。
对象与方法：①66例患者西医分为干性早期、湿性期,中医分为痰浊蕴结型、痰凝瘀滞型、肝肾亏虚型,采用RETI scan (Version 3.11)设备检测记录AMD患者和13例正常人mfERG FOK六个环、四个象限反应波波形。分析P1、N1波的反应密度及潜伏期在中医各证型中的变化特征。②采集51例AMD患者的血液样本,并以19例正常健康者作对照,酶联免疫法测定空腹血浆Hey水平,同时检测超氧化物歧化酶(SOD)、丙二醛(MDA)、血脂等生化指标水平。运用方差分析、多元回归分析、二元logistic回归分析等统计方法分析Hcy等指标与AMD中医证型的关系及相关因素对Hcy的影响,寻找AMD发病的危险因素。应用SPSS15.O软件进行统计学处理。
结果：①mfERG的P1、N1波在痰浊蕴结型组与干性早期组的变化基本一致,在痰凝瘀滞型组、肝肾亏虚型组与湿性组变化相近。痰浊蕴结型组P1波1～3环、N1波1环反应密度下降(P<0.05),P1波1环,N1波2、3、5环潜伏期延迟(P<0.05),其余各环均未见差异(P>0.05)；痰凝瘀滞型组P1波、N1波1～5环、肝肾亏虚型组P1波、N1波各环的反应密度均下降,但均以1～4环变化为主。四个象限的变化没有明显规律,从痰浊蕴结型→痰凝瘀滞型→肝肾亏虚型,P1、N1波平均反应密度逐渐下降,潜伏期逐渐延长,其中N1波潜伏期在各证型中均延长。②湿性对侧健眼组(湿对健组)1、2环处P1反应密度较对照组及干性对侧健眼组(干对健组)降低(P<0.05),各组在其余各环间比较无差异。③单眼湿性对侧干性眼组(湿对干组)与干性早期组比较P1、N1波在各环变化均无差异(P>0.05)。④Hcy水平在痰凝瘀滞型组、肝肾亏虚型组均高于对照组(P<0.05),三证型组间比较无差异(P>0.05)。⑤Hcy水平与SOD呈负相关。⑥SOD水平在痰凝瘀滞型组、肝肾亏虚型组均低于对照组及痰湿蕴结型组。MDA、TC、LDL-C水平在各证型组的均不同程度升高(P>O.05),TC水平在痰凝瘀滞型组、肝肾亏虚型组高于对照组(P<0.05)；HDL-C水平组间比较无差异。
结论：研究显示P1波1～3环、N1波1环反应密度,P1波1环、N1波2、3、5环潜伏期是痰浊蕴结型AMD眼视网膜功能变化的敏感指标；P1波1～4环、N1波1～3环反应密度更能反应痰凝瘀滞型AMD眼后极部视网膜的功能变化。P1、Nl波1～4环反应密度,P1波1～3环、N1波1、2、3、5、6环潜伏期的变化更能反应肝肾亏虚型AMD眼后极部视网膜的功能变化。单眼湿性AMD患者若对侧是健眼则可能发生AMD,若对侧为干性眼,则可能不会加重其干性眼的病情进展。高Hcy可能通过多种致病途径在痰凝瘀滞型与肝肾亏虚型AMD中发挥作用,但未发现是AMD发病的高风险因素；高TC、LDL-C可能是痰浊蕴结型AMD辨证和病程进展的微观指标；高TC、TG、LDL-C可能是痰凝瘀滞型、肝肾亏虚型AMD的生化物质基础；SOD水平减少、MDA生成增多可能为AMD发生发展的提供了病理基础。
Purpose:To analyze the diagnostic value of different AMD TCM syndrome types with mfERG FOK by measuring P1, N1 wave for age-related macular degeneration(AMD) patients and the healthy. Also serum plasma homocysteine (Hcy), superoxide dismutase (SOD), malondialdehyde (MDA) and serum lipid levels were assayed to study the changes and significance with AMD TCM syndrome types. Then to determine if Hcy level is a risk factor in AMD among Chinese population.
Objects and Methods:All 66 AMD patients were divided into early dry form and wet form in western medicine, and phlegm syndrome type, phlegm-blood stasis syndrome type and liver-kidney deficiency syndrome type in TCM. The patients and 13 healthy were measured with RETIscan (Version 3.11) by generating from 6 rings and 4 quadrants of mfERG FOK. Then all the data were analyzed in terms of response density and latency to correlate the variation characteristics among the different TCM syndrome types with response density and latency of P1, N1 waves. Only 51 AMD patients'blood samples were collected and 19 healthy samples. The fasting plasma homocysteine levels were measured by euzyme-linked immunosorbent assay. SOD, MDA, and blood fat concentration were also measured. And then correlated different AMD TCM syndrome types and all these indexes, and to find the influence on Hcy from the related factors and the independent factor of AMD. All the data were analyzed by ANOVA, multiple regression, Binary Logistic regression and so on.
Results:①The magnitude of variations of FOK in phlegm syndrome group were consistent with dry AMD group basically, similar changes were also found between phlegm-blood stasis syndrome group as well as liver-kidney deficiency syndrome group and the wet AMD group. P1 wave in ring 1～3 and N1 wave in ring 1 of response densities decreased and P1 wave in ring 1, N1 wave in ring 2,3,5 of latencies delayed in phlegm group (P<0.05), response densities of P1 and Nl wave in ring 1-5 of phlegm-blood stasis syndrome group and any ring in liver-kidney deficiency syndrome group decreased, but mainly in ring 1-4. Response densities decreased and latencies delayed of PI, N1 waves increasingly from phlegm syndrome group to phlegm-blood stasis syndrome group to liver-kidney deficiency syndrome group, among which latency of N1 wave delayed in all syndrome groups.②The response densities in ring 1 of the asymptomatic fellow eyes of wet AMD group decreased compared with the control and asymptomatic fellow eyes of dry AMD groups(P<0.05). No differences were observed in other rings among the three groups.③No changes in the response densities and latencies were observed between one eye in dry form with contralateral wet AMD group and dry AMD group(P>0.05).④The Hcy levels in phlegm-blood stasis syndrome group and liver-kidney deficiency syndrome group were higher than those of the control(P<0.05), yet no differences were detected among three case groups(P>0.05).⑤My results demonstrated inverse correlation between Hcy and SOD level.⑥SOD levels in phlegm-blood stasis syndrome group and liver-kidney deficiency syndrome group were higher than controls and phlegm syndrome group(P<0.05), while TC level was higher than controls(P<0.05); MDA, TC and LDL-C levels all groups were elevated to different degrees(P<0.05). No difference of HDL-C level among four groups was found.
Conclusions:Response density in ring 1-3 and latency in ring 1 of P1 wave, response density in ring 1 and latency in ring 2,3,5 of N1 wave of phlegm syndrome; response density in ring 1-4 of P1 wave and ring 1-3 of N1 wave of phlegm-blood stasis syndrome; response density in ring 1-4 of P1, N1 wave, latency in ring 1-3 of PI wave and ring 1,2,3,5,6 of N1 wave of liver-kiney deficiency syndrome among AMD eyes. It was also found that the asymptomatic fellow eyes of wet AMD are vulnerable to become dry AMD, while there is no advanced progression in eyes of dry form with contralateral wet AMD in this study. This research suggested that hyperhomocysteine may play roles in phlegm-blood stasis syndrome and liver-kidney deficiency syndrome AMD by various pathogenic mechanisms, but was not a risk factor of AMD in this survey. Increased TG and LDL-C levels may be microscopic indexes of syndrome differentiation and stage increasing in phlegm syndrome group. Increased TC, TG and
LDL-C may be some of the useful markers of phlegm-blood stasis syndrome and
liver-kidney deficiency syndrome. Increased SOD and decreased MDA may be
regarded as pathological basis in AMD.
对象与方法：①66例患者西医分为干性早期、湿性期,中医分为痰浊蕴结型、痰凝瘀滞型、肝肾亏虚型,采用RETI scan (Version 3.11)设备检测记录AMD患者和13例正常人mfERG FOK六个环、四个象限反应波波形。分析P1、N1波的反应密度及潜伏期在中医各证型中的变化特征。②采集51例AMD患者的血液样本,并以19例正常健康者作对照,酶联免疫法测定空腹血浆Hey水平,同时检测超氧化物歧化酶(SOD)、丙二醛(MDA)、血脂等生化指标水平。运用方差分析、多元回归分析、二元logistic回归分析等统计方法分析Hcy等指标与AMD中医证型的关系及相关因素对Hcy的影响,寻找AMD发病的危险因素。应用SPSS15.O软件进行统计学处理。
结果：①mfERG的P1、N1波在痰浊蕴结型组与干性早期组的变化基本一致,在痰凝瘀滞型组、肝肾亏虚型组与湿性组变化相近。痰浊蕴结型组P1波1～3环、N1波1环反应密度下降(P<0.05),P1波1环,N1波2、3、5环潜伏期延迟(P<0.05),其余各环均未见差异(P>0.05)；痰凝瘀滞型组P1波、N1波1～5环、肝肾亏虚型组P1波、N1波各环的反应密度均下降,但均以1～4环变化为主。四个象限的变化没有明显规律,从痰浊蕴结型→痰凝瘀滞型→肝肾亏虚型,P1、N1波平均反应密度逐渐下降,潜伏期逐渐延长,其中N1波潜伏期在各证型中均延长。②湿性对侧健眼组(湿对健组)1、2环处P1反应密度较对照组及干性对侧健眼组(干对健组)降低(P<0.05),各组在其余各环间比较无差异。③单眼湿性对侧干性眼组(湿对干组)与干性早期组比较P1、N1波在各环变化均无差异(P>0.05)。④Hcy水平在痰凝瘀滞型组、肝肾亏虚型组均高于对照组(P<0.05),三证型组间比较无差异(P>0.05)。⑤Hcy水平与SOD呈负相关。⑥SOD水平在痰凝瘀滞型组、肝肾亏虚型组均低于对照组及痰湿蕴结型组。MDA、TC、LDL-C水平在各证型组的均不同程度升高(P>O.05),TC水平在痰凝瘀滞型组、肝肾亏虚型组高于对照组(P<0.05)；HDL-C水平组间比较无差异。
结论：研究显示P1波1～3环、N1波1环反应密度,P1波1环、N1波2、3、5环潜伏期是痰浊蕴结型AMD眼视网膜功能变化的敏感指标；P1波1～4环、N1波1～3环反应密度更能反应痰凝瘀滞型AMD眼后极部视网膜的功能变化。P1、Nl波1～4环反应密度,P1波1～3环、N1波1、2、3、5、6环潜伏期的变化更能反应肝肾亏虚型AMD眼后极部视网膜的功能变化。单眼湿性AMD患者若对侧是健眼则可能发生AMD,若对侧为干性眼,则可能不会加重其干性眼的病情进展。高Hcy可能通过多种致病途径在痰凝瘀滞型与肝肾亏虚型AMD中发挥作用,但未发现是AMD发病的高风险因素；高TC、LDL-C可能是痰浊蕴结型AMD辨证和病程进展的微观指标；高TC、TG、LDL-C可能是痰凝瘀滞型、肝肾亏虚型AMD的生化物质基础；SOD水平减少、MDA生成增多可能为AMD发生发展的提供了病理基础。
Purpose:To analyze the diagnostic value of different AMD TCM syndrome types with mfERG FOK by measuring P1, N1 wave for age-related macular degeneration(AMD) patients and the healthy. Also serum plasma homocysteine (Hcy), superoxide dismutase (SOD), malondialdehyde (MDA) and serum lipid levels were assayed to study the changes and significance with AMD TCM syndrome types. Then to determine if Hcy level is a risk factor in AMD among Chinese population.
Objects and Methods:All 66 AMD patients were divided into early dry form and wet form in western medicine, and phlegm syndrome type, phlegm-blood stasis syndrome type and liver-kidney deficiency syndrome type in TCM. The patients and 13 healthy were measured with RETIscan (Version 3.11) by generating from 6 rings and 4 quadrants of mfERG FOK. Then all the data were analyzed in terms of response density and latency to correlate the variation characteristics among the different TCM syndrome types with response density and latency of P1, N1 waves. Only 51 AMD patients'blood samples were collected and 19 healthy samples. The fasting plasma homocysteine levels were measured by euzyme-linked immunosorbent assay. SOD, MDA, and blood fat concentration were also measured. And then correlated different AMD TCM syndrome types and all these indexes, and to find the influence on Hcy from the related factors and the independent factor of AMD. All the data were analyzed by ANOVA, multiple regression, Binary Logistic regression and so on.
Results:①The magnitude of variations of FOK in phlegm syndrome group were consistent with dry AMD group basically, similar changes were also found between phlegm-blood stasis syndrome group as well as liver-kidney deficiency syndrome group and the wet AMD group. P1 wave in ring 1～3 and N1 wave in ring 1 of response densities decreased and P1 wave in ring 1, N1 wave in ring 2,3,5 of latencies delayed in phlegm group (P<0.05), response densities of P1 and Nl wave in ring 1-5 of phlegm-blood stasis syndrome group and any ring in liver-kidney deficiency syndrome group decreased, but mainly in ring 1-4. Response densities decreased and latencies delayed of PI, N1 waves increasingly from phlegm syndrome group to phlegm-blood stasis syndrome group to liver-kidney deficiency syndrome group, among which latency of N1 wave delayed in all syndrome groups.②The response densities in ring 1 of the asymptomatic fellow eyes of wet AMD group decreased compared with the control and asymptomatic fellow eyes of dry AMD groups(P<0.05). No differences were observed in other rings among the three groups.③No changes in the response densities and latencies were observed between one eye in dry form with contralateral wet AMD group and dry AMD group(P>0.05).④The Hcy levels in phlegm-blood stasis syndrome group and liver-kidney deficiency syndrome group were higher than those of the control(P<0.05), yet no differences were detected among three case groups(P>0.05).⑤My results demonstrated inverse correlation between Hcy and SOD level.⑥SOD levels in phlegm-blood stasis syndrome group and liver-kidney deficiency syndrome group were higher than controls and phlegm syndrome group(P<0.05), while TC level was higher than controls(P<0.05); MDA, TC and LDL-C levels all groups were elevated to different degrees(P<0.05). No difference of HDL-C level among four groups was found.
Conclusions:Response density in ring 1-3 and latency in ring 1 of P1 wave, response density in ring 1 and latency in ring 2,3,5 of N1 wave of phlegm syndrome; response density in ring 1-4 of P1 wave and ring 1-3 of N1 wave of phlegm-blood stasis syndrome; response density in ring 1-4 of P1, N1 wave, latency in ring 1-3 of PI wave and ring 1,2,3,5,6 of N1 wave of liver-kiney deficiency syndrome among AMD eyes. It was also found that the asymptomatic fellow eyes of wet AMD are vulnerable to become dry AMD, while there is no advanced progression in eyes of dry form with contralateral wet AMD in this study. This research suggested that hyperhomocysteine may play roles in phlegm-blood stasis syndrome and liver-kidney deficiency syndrome AMD by various pathogenic mechanisms, but was not a risk factor of AMD in this survey. Increased TG and LDL-C levels may be microscopic indexes of syndrome differentiation and stage increasing in phlegm syndrome group. Increased TC, TG and
LDL-C may be some of the useful markers of phlegm-blood stasis syndrome and
liver-kidney deficiency syndrome. Increased SOD and decreased MDA may be
regarded as pathological basis in AMD.
引文
[1]Rosenthal B, Thompson B. Awareness of age-related macular degeneration in adults:the results of a large-scale international survey. Optometry.2003;74(1):16-24.
[2]AMD Alliance International. Awareness of age related macular degeneration and associated risk factors.AMD Global Report 2005. Toronto:AMD Alliance International,2005
[3]Lau JT, Lee V, Fan D,et al. Knowledge about cataract, glaucoma, and age related macular degeneration in the Hong Kong Chinese population. Br J Ophthalmol.2002;86(10):1080-4
[4]Mukesh BN, Dimitrov PN, Leikin S, et al. Five-year incidence of age-related maculopathy: the Visual Impairment Project. Ophthalmology.2004 Jun;111(6):1176-82
[5]Wang JJ, Rochtchina E, Lee AJ. Ten-year incidence and progression of age-related maculopathy:the blue Mountains Eye Study. Ophthalmology.2007;114(1):92-98
[6]Cackett P, Wong TY, Aung T, et al. Smoking, cardiovascular risk factors, and age-related macular degeneration in Asians:the Singapore Malay Eye Study. Am J Ophthalmol.2008; 146(6): 960-967.
[7]Nirmalan PK, Katz J, Robin AL, et al. Prevalence of vitreoretinal disorders in a rural population of southern India:the Aravind Comprehensive Eye Study. Arch Ophthalmol.2004; 122(4):581-586
[8]Oshima Y, Ishibashi T, Murata T, et al. Prevalence of age related maculopathy in a representative Japanese population:the Hisayama study.Br J Ophthalmol.2001;85(10):1153-1157
[9]Miyazaki M, Kiyohara Y, Yoshida A, et al. The 5-year incidence and risk factors for age-related maculopathy in a general Japanese population:the Hisayama study. Invest Ophthalmol Vis Sci.2005;46(6):1907-1910
[10]Miyazaki M, Nakamura H, Kubo M, et al. Risk factors for age related maculopathy in a Japanese population:the Hisayama study. Br J Ophthalmol.2003;87(4):469-472
[11]Lau JT, Lee V, Fan D, et al. Knowledge about cataract, glaucoma, and age related macular degeneration in the Hong Kong Chinese population. Br J Ophthalmol.2002;86(10):1080-1084.
[12]Hsu WM, Cheng CY, Liu JH, et al. Prevalence and causes of visual impairment in an elderly Chinese population in Taiwan:the Shihpai Eye Study. Ophthalmology 2004; 111:62-69
[13]Xu L, Wang Y, Li Y, Wang Y, Cui T, Li J, Jonas JB. Causes of blindness and visual impairment in urban and rural areas in Beijing:the Beijing Eye Study. Ophthalmology 2006; 113:1141-1143
[14]Huang JD, Curcio CA, Johnson M. Morphometric analysis of lipoprotein-like particle accumulation in aging human macular Bruch's membrane.Invest Ophthalmol Vis Sci.2008; 49(6): 2721-2727.
[15]Schlingemann RO. Role of growth factors and the wound healing response in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol.2004;242(1):91-101.
[16]Grossniklaus HE, Ling JX, Wallace TM, et al. Macrophage and retinal pigment epithelium expression of angiogenic cytokines in choroidal neovascularization. Mol Vis.2002;8:119-126.
[17]Strunnikova NV, Baffi J, Zhang C, et al. Cellular and molecular responses to sublethal oxidative injury in retinal pigment epithelial cells (RPE). Invest Ophthalmol Vis Sci,2003,44: 3145.
[18]Evans JR. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev.2006;(2):CD000254.
[19]Ratanasukon M, et al. Photodynamic therapy for AMD and non-AMD patients:two-year results in Thais. J Med Assoc Thai.2009;92(3):367-72.
[20]Kim IK, Gragoudas ES. Radiation therapy for neovascular age-related macular degeneration revisited. Br J Ophthalmol.2009;93(3):279-80.
[21]Odergren A, Algvere PV, Seregard S, et al. A prospective randomised study on low-dose transpupillary thermotherapy versus photodynamic therapy for neovascular age-related macular degeneration.Br J Ophthalmol.2008;92(6):757-61.
[22]Rothenbuehler SP, Waeber D, Brinkmann CK, et al. Effects of Ranibizumab in Patients with Subfoveal Choroidal Neovascularization Attributable to Age-related Macular Degeneration. Am J Ophthalmol.2009 Feb 11. [Epub ahead of print]
[23]Fong KC, Kirkpatrick N, Mohamed Q, et al. Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration using a variable frequency regimen in eyes with no previous treatment. Clin Experiment Ophthalmol.2008;36(8):748-55.
[24]Augustin A. Anecortave acetate in the treatment of age-related macular degeneration. Clin Interv Aging.2006;1(3):237-46.
[25]Lubinski W, Goslawski W, et al. Evaluation of visual function among patients with exudative AMD treated with an intravitreal injection of triamcinolone acetonide. Ann Acad Med Stetin.2008;54(1):22-27
[26]Nguyen QD, Shah SM, Hafiz G, et al. A phase Ⅰ trial of an Ⅳ-administered vascular endothelial growth factor trap for treatment in patients with choroidal neovascularization due to age-related macular degeneration. Ophthalmology.2006;113(9):1522.el-1522.e14.
[27]Takahashi K, Saishin Y, Ilva RL, et al. Systemic of intraocular administration of VEGF receptor kinase inhibitors causes regression of choroidal neovascularization. Invest Ophthalmol Vis Sci 2005;46:E-Abstract 1423
[28]Shen J, Samul R, Silva RL, et al. Suppression of ocular neovascularization with siRNA targeting VEGF receptor 1.Gene Ther. 2006;13(3):225-34.
[29]Garcia CA, Quiroz-Mercado H, Uwaydat S, et al. A phase Ⅰ/Ⅱ tral of intravenous squalamine lactate for treatment of choroidal neovascularization in age related macular degeneration(ARMD). Invest ophthalmol Vis Sci 2004;45:2362
[30]Nambu H, Nambu R, Melia M, et al. Combretastatin A-4 phosphate suppresses development and induces regression of choroidal neovascularization.Invest Ophthalmol Vis Sci. 2003;44(8):3650-5.
[31]Hawkins BS, Bressler NM, Miskala PH, et al. Surgery for subfoveal choroidal neovascularization in age-related macular degeneration:ophthalmic findings:SST report no.11. Ophthalmology.2004 Nov;111(11):1967-80.
[32]Eandi CM, Giansanti F, Virgili G.Macular translocation for neovascular age-related macular degeneration. Cochrane Database Syst Rev.2008;(4):CD006928
[33]Siqueira RC. Autologous transplantation of retinal pigment epithelium in age related macular degeneration. Arq Bras Oftalmol.2009;72(1):123-30
[34]陈明英.屈进学老师对老年性黄斑变性的中医辨证治疗.医药产业资讯.2006,3(2)：29-30
[35]姚大莉.王明芳用内眼辨证治疗老年性黄斑变性.四川中医.2002,20(6)：7-8
[36]朱惠安,张明亮,喻京生.辨证治疗眼底黄斑病变61例.湖南中医杂志,2000,16(1)：38
[37]崔红培,周尚昆,毛海燕. 益气复明汤治疗湿性脾气虚弱型老年性黄斑变性37例观察.四川中医,2006,24(2)：94-95
[38]吴德正,高汝龙,马娟妹等.黄斑病变的多焦ERG特征.中国实用眼科杂志,2000,18(11)684-689
[39]Vizzardi E, Nodari S, Fiorina C, et al. Plasma homocysteine levels and late outcome in patients with unstable angina. Cardiology.2007;107(4):354-9.
[40]Moghimi S, Najmi Z, Faghihi H, et al. Hyperhomocysteinemia and central retinal vein occlusion in Iranian population. Int Ophthalmol.2008;28(1):23-28.
[41]Aydin E, Demir HD, Ozyurt H, et al. Association of plasma homocysteine and macular edema in type 2 diabetes mellitus. Eur J Ophthalmol.2008;18(2):226-232.
[42]Rochtchina E, Wang JJ, Flood VM, Mitchell P. Elevated serum homocysteine, low serum vitamin B12, folate, and age-related macular degeneration:the Blue Mountains Eye Study. Am J Ophthalmol.2007;143(2):344-346.
[43]Seddon JM, Gensler G, Klein ML,et al. Evaluation of plasma homocysteine and risk of age-related macular degeneration. Am J Ophthalmol.2006;141(1):201-203.
[44]Vine AK, Stader J, Branham K, et al. Biomarkers of cardiovascular disease as risk factors for age-related macular degeneration. Ophthalmology.2005;112(12):2076-2080.
[45]Kamburoglu G, Gumus K, Kadayifcilar S, et al. Plasma homocysteine,vitamin B12 and folate levels in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol.2006; 244(5):565-569.
[46]Coral K, Raman R, Rathi S, et al. Plasma homocysteine and total thiol content in patients with exudative age-related macular degeneration. Eye.2006;20(2):203-207
[47]Nowak M, Swietochowska E, Wielkoszynski T, et al. Homocysteine,vitamin B12, and folic acid in age-related macular degeneration. Eur J Ophthalmol.2005;15(6):764-767.
[48]Ates O, Azizi S, Alp HH, et al. Decreased serum paraoxonase 1 activity and increased serum homocysteine and malondialdehyde levels in age-related macular degeneration. Tohoku J Exp Med.2009;217(1):17-22
[49]Belda Sanchis JI, Quijada Gonzalez A, Mufloz Ruiz G, et al. Are blood lipids a risk factor for age-related macular degeneration? Arch Soc Esp Oftalmol.2001;76(1):13-17
[50]Nowak M, Swietochowska E, Marek B, et al. Changes in lipid metabolism in women with age-related macular degeneration. Clin Exp Med.2005;4(4):183-187
[51]Javadzadeh A, Ghorbanihaghjo A, Rashtchizadeh N, et al. Enhanced susceptibility of low-density lipoprotein to oxidation in wet type age-related macular degeneration in male patients. Saudi Med J.2007;28(2):221-4.
[52]Rudolf M, Ivandic B, Winkler J, et al. Accumulation of lipid particles in Bruch's membrane of LDL receptor knockout mice as a model of age-related macular degeneration. Ophthalmologe. 2004; 101(7):715-719.
[53]刘家琦,李凤鸣.实用眼科学(第二版).人民卫生出版社(北京),2002,509-511
[54]曾庆华.中医眼科学.中国中医药出版社.2003：209-210
[55]吴乐正.临床多焦视觉电生理学.北京科学技术出版社(北京),2004,5：211
[56]明·王肯堂.证治准绳·眼目集,中医古籍出版社,1993：147
[57]张云昌等.白话黄帝内经.河北人民出版社,1994：148
[58]张云昌等.白话黄帝内经.河北人民出版社,1994：27
[59]金·李果.兰室秘藏.中医古籍出版社(第一版),1986：29
[60]黄霄,曾庆华,高海燕.血脂异常对C57BL小鼠巩膜顺应性的影响.中国中医眼科杂志,2006,16(4)：217-220
[61]清·顾锡.银海指南(第一版).人民卫生出版社,1960：30
[62]任廷革.黄帝内经灵枢.人民军医出版社,2006：251
[63]任廷革.黄帝内经灵枢.人民军医出版社,2006：200
[64]明·龚信.古今医鉴.江西科学技术出版社,1990：270
[65]明·张景岳.景岳全书·杂证谟选读.重庆大学出版社,1988：140
[66]傅景华.黄帝内经素问.中医古籍出版社,1997：1
[67]张云昌等.白话黄帝内经.河北人民出版社,1994：37
[68]张云昌等.白话黄帝内经.河北人民出版社,1994：783
[69]张世英.药王孙思邈医药方集.世界图书出版公司,1999：286
[70]清·王清任(陕西省中医研究院注释).医林改错注释.人民卫生出版社,1985：138
[71]明·傅仁宇.审视瑶函.辽宁科学技术出版社1997：178
[72]清·徐灵胎.慎疾刍言.江苏科学技术出版社,1984：11
[73]金·刘完素.素问病机气宜保命集.人民卫生出版社,1959：106
[74]张云昌等.白话黄帝内经.河北人民出版社,1994：722
[75]清·林佩琴.类证治裁.中国中医药出版社,1997：128
[76]元·朱震亨.丹溪心法.辽宁科学技术出版社,1997：24
[77]关国华.老年性黄斑变性病中医辨证论治之规律性.新中医,1996,8：12～14
[78]梁风鸣,王莉,雷晓琴.王明芳教授治疗老年性黄斑变性的经验.成都中医药大学学报,1997,20(6)：3
[79]宋剑南,刘东远,牛晓红等.高脂血症与中医痰浊关系的实验研究.中国中医基础医学杂志,1995,1(1)：49-51.
[80]陈玮.中医药治疗老年性黄斑变性概况.安徽中医临床杂志,2002,2：150-151
[81]李波,魏燕萍.李传课教授辨治老年黄斑变性经验.中医药导报,2006,12(1)：20-21
[82]邓亚平,谢学军.驻景丸加减治疗老年性黄斑变性的临床初步观察.成都中医学院学报,1989,12(2)：25
[83]蔡静,侯丽辉.痰浊与现代物质基础的关系.辽宁中医杂志,2007,34(6)：742-743
[84]叶勇.高脂血症与痰浊淤血相关性理论基础与研究依据.时珍国医国药,2006,17(8)：1561-1562
[85]宋明锁,王裕颐.试论瘀血与痰浊之关系.中西医结合心脑血管杂志,2005,3(1)：62-63
[86]常国良,常玉.高脂血症从痰浊血瘀论治.光明中医,2007,22(6)：62-63
[87]曾庆华,王春晖,魏爽.血脂异常对小鼠视网膜色素上皮-玻璃膜-脉络膜毛细血管复合体影响的研究.中国中医眼科杂志,2006,16(2)：90-94
[88]黄霄,曾庆华,高海燕.血脂异常对C57BL小鼠巩膜顺应性影响的实验研究,中国中医眼科杂志,2006,16(4)：217-220.
[89]王春晖,曾庆华.黄斑康对实验性血脂异常小鼠色素上皮-玻璃膜-脉络膜毛细血管复合体影响的研究.中国中医眼科杂志,2006,16(4)：212-216
[90]陈明英.屈进学老师对老年性黄斑变性的中医辩证治疗.医药产业资讯.2006,3(2)：29-30
[91]姚大莉.王明芳用内眼辨证治疗老年性黄斑变性.四川中医.2002,20(6)：7-8
[92]朱惠安,张明亮,喻京生.辨证治疗眼底黄斑病变6l例.湖南中医杂志,2000,16(1)：38
[93]Palmowski AM, Sutter EE, Bearse MA Jr, et al. Multifocal electroretinogram (MF-ERG) in diagnosis of macular changes. Example:senile macular degeneration. Ophthalmologe.1999; 96 (3):166-173
[94]严良.多焦视网膜电图的原理与应用.中国眼耳鼻喉科杂志,2002,2：121-130.
[95]Klistorner A, Crewther DP, Crewther SG. Temporal analysis of the topographic ERG: chromatic versus achromatic stimulation.Vision Res,1998;38(7):1047-1062
[96]Seerliger M, Kretschmann U, Apfelstedt-Sylla E. Multifocal electroretino-graghy in retinitis pigmentosa. AmJ Ophthalmol,1998; 125:214-226
[97]Horiguchi M, Suzuki S, Kondo M,et al.Effect of glutamate analogues and inhibitory neurotransmitters on the electroretinograms elicited by random sequence stimuli in rabbits.Invest Ophthalmol Vis Sci,1998;39(11):2171-2176
[98]Hood DC.Assessing retinal function with the multifocal technique.Prog Retin Eye Res, 2000; 19:607-646.
[99]Hara WA, Ton H, Ruiz G, et al. Characterization of retinal injury using ERG measures obtained with both conventional and multifocal methods in chronic ocular hypertensive primates. Invest Ophthalmol Vis Sic,2001;42:127-136.
[100]李海生,潘家普主编.视觉电生理的原理和实践.上海科学普及出版社,2002：l19
[101]吴德正,刘妍主编.罗兰视觉电生理仪测试方法和临床应用图谱学.北京科学技术出版社,2006：96-97
[102]刘家琦,李凤鸣.实用眼科学(第二版),人民卫生出版社(北京),2002：46
[103]吴德正,刘妍主编.罗兰视觉电生理仪测试方法和临床应用图谱学.北京科学技术出版社,2006：5
[104]李海生,潘家普主编.视觉电生理的原理和实践.上海科学普及出版社,2002：257
[105]Nagatomo A, Nao-i N, Maruiwa F, et al. Multifocal electroretinograms in normal subjects. Jpn J Ophthalmol,1998; 42(2):129-135
[106]严良,陆豪,杨蕾等.正常人多焦视网膜电图一阶核反应分析.眼科,2003,12(6)：339-342
[107]曾庆华,王丽英,张玲.年龄相关性黄斑变性发生机制与中医辨证分型的关系.四川中医,2004,22(2)：13-14
[108]Hayreh S, Gartner S. In vivo choroidal circulation and its watershed zones. Eye.1990; 4: 273-289.
[109]刘家琦,李凤鸣.实用眼科学(第二版),人民卫生出版社(北京),2002：26
[110]Huang JD, Presley JB, Chimento MF, et al. Age-related changes in human macular Bruch's membrane as seen by quick-freeze/deepetch. Exp Eye Res,2007;85:202-218
[11]Johnson M, Dabholkar A, Huang JD,et al. Comparison of morphology of human macular and peripheral Bruch's membrane in older eyes. Curr Eye Res.2007 Sep;32(9):791-799
[112]Holz FG, Sheraidah G, Pauleikhoff D, et al. Analysis of lipid deposits extracted from human macular and peripheral Bruch's membrane. Arch Ophthalmol,1994;112:402-406.
[113]Curcio CA, Millican CL, Bailey T, et al. Accumulation of cholesterol with age in human Bruch's membrane. Invest Ophthalmol Vis Sci,2001;42:265-274.
[114]Jackson GR, Owsley C, Curcio CA. Photoreceptor degeneration and dysfunction in aging and agerelated maculopathy. Ageing Res Rev.2002;1:381-396.
[115]Gerth C, Hauser D, Delahunt PB,et al. Assessment of multifocal electroretinogram abnormalities and their relation to morphologic characteristics in patients with large drusen. Arch Ophthalmol.2003;121(10):1404-1414
[116]Gerth C, Delahunt PB, Alam S,et al. Cone-mediated multifocal electroretinogram in age-related macular degeneration:progression over a long-term follow-up. Arch Ophthalmol. 2006;124(3):345-352
[117]李秋明,郑广瑛.眼科应用解剖学(第一版).郑州大学出版社,2002：13I
[118]Maguire MG, Alexander J, Fine SL, et al. Characteristics of choroidal neovascularization in the complications of age-related macular degeneration prevention trial. Ophthalmology. 2008;115(9):1468-73
[119]Ali F, Chan WC, Stevenson MR, et al. Morphometric analysis of angiograms of exudative lesions in age-related macular degeneration. Arch Ophthalmol.2004;122(5):710-5.
[120]赵玲,魏海峰,张丽,等.中医痰浊血瘀证候的生物学基础研究.中华中医药杂志,2008,23(8)：680-683
[121]李亚萍,王玲,李光宇.老年性黄斑变性脉络膜新生血管的组织病理变化研究.中国老年学杂志,2008,28(24)：2443-2445
[122]Curcio CA. Photoreceptor topography in ageing and age-related maculopathy. Eye.2001; 15(Pt 3):376-383
[123]Scholl HP, Bellmann C, Dandekar SS, et al. Photopic and scotopic fine matrix mapping of retinal areas of increased fundus autofluorescence in patients with age-related maculopathy. Invest Ophthalmol Vis Sci 2004;45:574-583
[124]Nishihara H, Kondo M, Ishikawa K, et al. Focal Macular Electroretinograms in Eyes with Wet-type Age-Related Macular Degeneration. Invest. Ophthalmol. Vis Sci.2008; 49:3121-3125.
[125]Ciulla T, Harris A, Martin B. Ocular perfusion and age-related macular degeneration. Acta Ophthalmol Scand.2001;79:108-115.
[126]Remky A, Elsner AE. Blue on yellow perimetry with scanning laser ophthalmoscopy in patients with age related macular disease. Br J Ophthalmol.2005;89:464-469.
[127]Mori F,Konno S, Hikichi T.Pulsatile ocular blood flow study:decrease in exudative age-related macular degeneration.Br J Ophthalmol,2001,85(5):510-512
[128]梁晓颖,王景昭,李根林.多焦视网膜电图用于年龄相关性黄斑变性视网膜功能的研究.中国实用眼科杂志,2005,23(9)：902-906
[129]Li J, Tso MO, Lam TT. Reduced amplitude and delayed latency in foveal response of multifocal electroretinogram in early age related macular degeneration. Br J Ophthalmol.2001; 85(3):287-290
[130]Liu X, Shen J, Zhan R, et al. Proteomic analysis of homocysteine induced proliferation of cultured neonatal rat vascular smooth muscle cells. Biochim Biophys Acta.2009; 1794(2):177-84.
[131]Jiang X, Yang F, Tan H, et al. Hyperhomocystinemia impairs endothelial function and eNOS activity via PKC activation. Arterioscler Thromb Vasc Biol.2005;25(12):2515-21.
[132]Cabezas-Leon MM, Garcia-Montero MR, Morente-Matas P. Hyperhomocysteinemia as a risk factor for central retinal vein thrombosis in a young patient.Rev Neurol.2003;37(5):441-443
[133]Ni M, Zhang XH, Jiang SL, et al. Homocysteinemia as an independent risk factor in the Chinese population at a high risk of coronary artery disease. Am J Cardiol.2007; 100 (3): 455-458.
[134]丁旭东,肖红琼,张贵斌等.血浆同型半胱氨酸与血管性痴呆的相关性研究.中国医师杂志,2007,9(1)：9-11
[135]Antoniades C, Antonopoulos AS, Tousoulis D,et al. Homocysteine and coronary atherosclerosis:from folate fortification to the recent clinical trials. Eur Heart J.2009;30(1):6-15.
[136]Lukiw WJ, Zhao Y, Mukherjee PK, et al. Common Pathogenic Mechanism Involving Altered Beta-Amyloid Precursor Protein ((?)APP) Processing in Alzheimer's Disease (AD) and Age-Related Macular Degeneration (AMD). Invest Ophthalmol Vis Sci,2007;48:17.
[137]Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology,1992,99:933-943.
[138]Zarbin MA. Current concepts in the pathogenesis of age-related macular degeneration. Arch Ophthalmol.2004; 122 (4):598-614.
[139]Bailey TA, Kanuga N, Romero IA, et al. Oxidative stress affects the junctional integrity of retinal pigment epithelial cells. Proc Natl Acad Sci U S A. 2004; 103 (30):11282-1287.
[140]Haddad WM, Coscas G, Soubrane G. Age-related macular degeneration and apoptosis. J Fr Ophtalmol,2003,26:307-311.
[141]Ezzat MK, Hann CR, Vuk-Pavlovic S, et al. Immune cells in the human choroids. Br J Ophthalmol.2008;92(7):976-980
[142]Lommatzsch A, Hermans P, Muller KD, et al. Are low inflammatory reactions involved in exudative age-related macular degeneration? Morphological and immunhistochemical analysis of AMD associated with basal deposits. Graefes Arch Clin Exp Ophthalmol.2008;246(6):803-810
[143]Anderson DH, Talaga KC, Rivest AJ, et al. Characterization of beta amyloid assemblies in drusen:the deposits associated with aging and age-related macular degeneration. Exp Eye Res. 2004;78(2):243-56.
[144]Ding JD, Lin J, Mace BE, et al. Targeting age-related macular degeneration with Alzheimer's disease based immunotherapies:anti-amyloid-beta antibody attenuates pathologies in an age-related macular degeneration mouse model. Vision Res.2008;48(3):339-345.
[145]Johnson LV, Leitner WP, Staples MK, et al. Complement activation and inflammatory processes in Drusen formation and age related macular degeneration. Exp Eye Res.2001; 73(6): 887-896
[146]Ramrattan RS, van der Schaft TL, Mooy CM, et al. Morphometric analysis of Bruch's membrane, the choriocapillaris, and the choroid in aging. Invest Ophthalmol Vis Sci.1994; 35(6): 2857-2864
[147]Moore DJ, Clover GM. The effect of age on the macromolecular permeability of human Bruch's membrane. Invest Ophthalmol Vis Sci.2001;42(12):2970-2975
[148]Matsuoka M, Ogata N, Otsuji T, et al. Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathyl. Br J Ophthalmol.2004;88(6):809-815
[149]Ueland PM, Refsum H, Stabler SP, et al. Total homocysteine in plasma or serum:methods and clinical applications. Clin Chem.1993;39(9):1764-1779.
[150]Hankey GJ, Eikelboom JW. Homocysteine and vascular disease. Lancet.1999; 354 (9176): 407-413.
[151]桂兴芬.生物化学与分子生物学.郑州大学出版社,2006：191-192
[152]徐晓利,马涧泉.医学生物化学.北京：人民卫生出版社,1998：348-353
[153]Cattaneo M. Hyperhomocysteinemia and venous thromboembolism. Semin Thromb Hemost.2006;32(7):716-23.
[154]Lalouschek W, Aull S, Serles W, et al. Genetic and nongenetic factors influencing plasma homocysteine levels in patients with ischemic cerebrovascular disease and in healthy control subjects. J Lab Clin Med.1999;133(6):575-82.
[155]高慧娟,李新毅.红细胞变形性与缺血性脑损伤的研究进展.中西医结合心脑血管病杂志,2006,4(1)：64-65
[156]Cattaneo M. Hyperhomocysteinemia and venous thromboembolism.Semin Thromb Hemost.2006;32(7):716-23.
[157]Zhang L, Jin M, Hu XS, et al. Homocysteine stimulates nuclear factor kappaB activity and interleukin-6 expression in rat vascular smooth muscle cells.Cell Biol Int.2006;30(7):592-597.
[158]Poddar R, Sivasubramanian N, DiBello PM, et al. Homocysteine Induces Expression and Secretion of Monocyte Chemoattractant Protein-1 and Interleukin-8 in Human Aortic Endothelial Cells:Implications for Vascular Disease. Circulation.2001;103(22):2717-2273
[159]Ni M, Holland M, Jarstadmarken H,et al. Time-course of experimental choroidal neovascularization in Dutch-Belted rabbit:clinical and histological evaluation. Exp Eye Res. 2005;81(3):286-97
[160]Sakurai E, Anand A, Ambati BK,et all. Macrophage depletion inhibits experimental choroidal neovascularization. Invest Ophthalmol Vis Sci.2003;44(8):3578-85
[161]Gu X, Shadrach K, Sun M, et al. Identification of lipid oxidation products and proteins in bruch's membrane from normal and AMD donor Eyes. Invest Ophthalmol Vis Sci,2003,44: 1622.
[162]Crabb JW, Mlyagi M, Gu X, et al. Drusen proteome analysis:an approach to the etiology of age-related macular degeneration. Pro Natl Acad Sci USA,2002,99:14682-14687.
[163]Metelitsina TI, Grunwald JE, DuPont JC, et al. Foveolar choroidal circulation and choroidal neovascularization in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2008; 49(1):358-63.
[164]宋剑南.从生物化学角度看痰及痰瘀相关.中国中医基础医学杂志,2000,6(3)：40-43
[165]明·张景岳.景岳全书·杂证谟选读.重庆大学出版社,1988：41
[166]Garibotto G, Sofia A, Valli A,et al. Causes of hyperhomocysteinemia in patients with chronic kidney diseases. Semin Nephrol.2006;26(1):3-7
[167]Duan W, Ladenheim B, Cutler RG, et al. Dietary folate deficiency and elevated homocysteine levels endanger dopaminergic neurons in models of Parkinson's disease. Neurochem.2002; 80(1):101-10.
[168]刘敏,彭海.同型半胱氨酸对黑质细胞凋亡及NF-κB表达的影响.脑与神经疾病杂志,2006,14(1)：31-34
[169]Ganji V, Kafai MR. Demographic, health, lifestyle, and blood vitamin determinants of serum total homocysteine concentrations in the third National Health and Nutrition Examination Survey,1988-1994. Am J Clin Nutr.2003;77(4):826-33
[170]Haan MN, Miller JW, Aiello AE, et al. Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment:results from the Sacramento Area Latino Study on Aging. Am J Clin Nutr.2007;85(2):511-517.
[171]Fakhrzadeh H, Ghotbi S, Pourebrahim R, et al. Total plasma homocysteine, folate, and vitamin B12 status in healthy Iranian adults:the Tehran homocysteine survey (2003-2004)/a cross-sectional population based study. BMC Public Health.2006;6:29
[172]Bednarek-Tupikowska G, Tupikowski K, Bohdanowicz-Pawlak A, et al.Evaluation of the influence of sex hormones on homocysteine concentration in pre-and postmenopausal women. Pol Merkur Lekarski.2005; 18(104):189-91.
[173]Jiang Y, Jiang J, Xiong J, et al. Homocysteine-induced extracellular superoxide dismutase and its epigenetic mechanisms in monocytes. J Exp Biol.2008;211(Pt 6):911-920
[174]Yan SK, Chang T, Wang H, et al. Effects of hydrogen sulfide on homocysteine-induced oxidative stress in vascular smooth muscle cells. Biochem Biophys Res Commun.2006; 351(2): 485-491.
[175]甘伟杰,刘俊田,林蓉.槲皮素对高同型半胱氨酸血症家兔血管内皮细胞的保护作用.中国药理学通报,2004,20(6)：647-65l
[176]Paul A, Belton A, Nag S, et al.Reduced mitochondrial SOD displays mortality characteristics reminiscent of natural aging. Mech Ageing Dev.2007;128(11-12):706-716.
[177]童坦君,张宗玉.医学老年学.北京：人民卫生出版社,1995：155.160
[178]Hollyfield J G, Bonilha VL, Rayborn ME, et al. Oxidative damage and age-related macular degeneration. Nat Med.2008;14(2):194-198. [179] Hyman L, Schachat AP, He Q, et al. Hypertension, cardiovascular disease, and age-related macular degeneration. Age-related Macular Dege(?)ration Risk Factors Study Group. Arch Ophthalmol.2000; 118(3):351-358.
[180]Friedman E. Update of the vascular model of AMD. Br J Ophthalmol,2004,88:161-163.
[181]Vine AK, Stader J, Branham K, et al. Biomarkers of cardiovascular disease as risk factors for age-related macular degeneration. Ophthalmology.2005; 112(12):2076-2080.
[182]汤志梅,李秀钧.代谢综合片与脂代谢异常.中华老年多疾病杂志,2005,4(1)：6-9
[183]Griffin BA. The effect of n-3 fatty acids on low density lipoprotein subfractions. Lipids. 2001;36 Suppl:S91-97
[184]Lee CY, Kim KC, Park HW, et al. Rheological properties of erythrocytes from male hypercholesterolemia. Microvasc Res.2004;67(2):133-138
[185]谢滨萱,牟莉.血脂异常与血液流变学、甲襞微循环关系探讨.中国现代医学杂志,2002,12(12)：64-65.
[186]钱小奇.试论高脂血症的病因病机.天津中医,2002,19(6)：50-52.
[187]Grossniklaus HE, Green WR. Choroidal neovascularization. Am J Ophthalmol.2004; 137 (3):496-503.
[188]陈扬荣,江明,李庆阳.老年脾肾虚证LPO、SOD、血脂关系的探讨.中国中医基础医学杂志,2002,8(7)：44-45
[189]林炳辉,方素钦等.中老年人脾肾虚证实质的探讨.中国中西医结合杂志,2002,22(1)：33-36
[190]俞军,徐泳.肾病听力损害及血脂水平与肾虚证关系探讨.辽宁中医杂志,1999,26(4)：150-15l
[191]白芝兰,任百超,杨建刚等.中国陕西省农村年龄相关性黄斑变性流行病学调查.国际眼科杂志,2005,5(6)：1114-112l
[192]关国华,詹宇坚,黄仲委等.老年性黄斑变性流行病学调查(附1091例调查结果分析).眼底病,1989,4：218-212
[193]Francis PJ, George S, Schultz DW, et al.The LOC387715 gene, smoking, body mass index, environmental associations with advanced age-related macular degeneration.Hum Hered.2007; 63 (3-4):212-218.
[194]Seddon JM, Cote J, Davis N, et al. Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. Arch Ophthalmol, 2003,121:785-792
[195]Fraser-Bell S, Wu J, Klein R, et al. Smoking, alcohol intake, estrogen use, and age-related macular degeneration in Latinos:the Los Angeles Latino Eye Study. Am J Ophthalmol,2006,141: 79-87
[196]DeAngelis MM, Lane AM, Shah CP, et al. Extremely discordant sib-pair study design to determine risk factors for neovascular age-related macular degeneration. Arch Ophthalmol,2004, 122:575-580
[197]Clemons TE, Milton RC, Klein R, et al. Risk factors for the incidence of advanced age-related macular degeneration in the Age-Related Eye Disease Study (AREDS) AREDS report no.19.Ophthalmology,2005,112:533-539.
[198]Umeda S, Suzuki MT, Okamoto H, et al. Molecular composition of drusen and possible involvement of anti-retinal autoimmunity in two different forms of macular degeneration in cynomolgus monkey (Macaca fascicularis). FASEB J.2005;19(12):1683-1685
[1]明·王肯堂.证治准绳·眼目集.中医古籍出版社,1993：147
[2]任廷革.黄帝内经灵枢.人民军医出版社,2006：126
[3]清·薛雪.医经原旨.上海中医学院出版社,1992：310
[4]任廷革.黄帝内经灵枢.人民军医出版社,2006：647
[5]任廷革.黄帝内经灵枢.人民军医出版社,2006：847
[6]清·唐宗海.血证论.天津科学技术出版社,2003：51
[7]任廷革.黄帝内经灵枢.人民军医出版社,2006：249
[8]明·傅仁宇.审视瑶函.辽宁科学技术出版社,1997：8
[9]金·李杲.兰室秘藏.中医古籍出版社,1986：29
[10]傅景华.黄帝内经素问.中医古籍出版社,1997：25
[11]傅景华.黄帝内经素问.中医古籍出版社,1997：1
[12]傅景华.黄帝内经素问.中医古籍出版社,1997：153
[13]明·李中梓.医宗必读.山西科学技术出版社,2006：377
[14]明·张景岳.景岳全书·杂证谟选读.重庆大学出版社,1988：141
[15]清·顾锡.银海指南(第一版).人民卫生出版社,1960：30
[16]明·王纶.明医杂著.江苏科学技术出版社,1985：73
[17]明·虞抟.医学正传.人民卫生出版社,1965：88
[18]任廷革.黄帝内经灵枢.人民军医出版社,2006：251
[19]任廷革.黄帝内经灵枢.人民军医出版社,2006：200
[20]任廷革.黄帝内经灵枢.人民军医出版社,2006：131
[21]清·王清任.医林改错.上海卫生出版社,1956：16
[22]金·刘完素.素问病机气宜保命集.人民卫生出版社,1959：106
[23]隋·巢元方.诸病源候论.辽宁科学技术出版社,1997：102
[24]清·唐宗海.血证论.天津科学技术出版社,2003：98
[25]清·周学海.读医随笔.江苏科学技术出版社,1983：40
[26]任廷革.黄帝内经灵枢.人民军医出版社,2006：176
[27]傅景华.黄帝内经素问.中医古籍出版社,1997：96
[28]清·叶天士.临证指南医案.华夏出版社,1995：430
[29]清·叶天士.临证指南医案.华夏出版社,1995：178
[30]清·何梦瑶.医碥.上海科学技术出版社,1982：116
[31]程志清.治痰心法.陆芷青内科精华评述.北京：中医古籍出版社,1998：110
[32]李军.颅脑痰瘀证治论.陕西中医学院学报,2002,25(2)：1-3
[33]孟庆刚.试论“痰瘀同源”.新疆中医药,1994(1)：9
[34]沈浪泳.论痰瘀同病.上海中医药杂志,2002(1)：40-41
[35]程小曲.痰浊型冠心病与血脂、脂蛋白、载脂蛋白的关系及痰浊形成机理探讨.新中医,1994(3)：7
[36]林晓忠,吴焕林,严夏,等.邓铁涛教授论治冠心病规律探要.中医药学刊,2001(19)：412-414
[37]胡炜.从痰瘀互结论治冠心病探析.江苏中医药,2004,25(5)：16-17
[38]宋剑南,刘东远,牛晓红,等.高脂血症与中医痰浊关系的实验研究.中国中医基础医学杂志,1995,1：49
[39]周瑕菁,宋剑南,吕爱平,等.中医不同治法对实验性高脂血症兔主动脉内膜脂斑形成的影响.中医杂志,1996,37：174-175
[40]宋剑南.从生物化学角度看痰及痰瘀相关.中国中医基础医学杂志,2000,6：40-43
[41]陈炳旺,蔺德明.冠心病中医实证血液流变学变化的临床研究.福建中医学院学报,2000,10(1)：1-2
[42]李小兵,方永奇,黄可儿.痰瘀证型的临床分析.辽宁中医杂志,2000,27(2)：53-55
[43]孙建芝,牛晓亚,韩丽华,等.痰浊证微观辨证指标的实验研究.河南中医,1996,16(2)：21-22
[44]Leslie Hyman, Andrew P, Qimei He, et al. Hypertension, Cardiovascular Disease, and Age-Related Macular Degeneration.美国医学会眼科杂志中文版,2001,13(1)：25-29.
[45]Miceli MV, Newsome D A, Tate D J Jr, et al. Pathologic changes in the retinal pigment epithelium and Bruch's membrane of fat-fed atherogenic mice. Curr Eye Res,2000,20 (1):8-16.
[46]曾庆华,王春晖,魏爽·实验性血脂异常小鼠色素上皮-玻璃膜-脉络膜毛细血管复合体的研究[J]·中国中医眼科杂志,2006,16(2)：90.
[47]王春晖,曾庆华.黄斑康对实验性血脂异常小鼠色素上皮-玻璃膜-脉络膜毛细血管复合体影响的研究.中国中医眼科杂志,2006,16(4)：212-216
[48]Grossniklaus HE, Green WR. Choroidal neovascularization. Am J Ophthalmol.2004; 137 (3):496-503.
[49]Friedman E. A hemodynamic model of the pathogenesis of age-related macular degeneration. Am J Ophthalmol,2000,130(5):658～663
[50]曾庆华,王丽英,张玲.年龄相关性黄斑变性发生机制与中医辨证分型的关系.四川中医,2004,22(2)：13-14
[51]李珍,周培兰,马汀等.海军老年性黄斑变性血液流变学改变.张家口医学院学报.1997,14(2)：44～45
[2]AMD Alliance International. Awareness of age related macular degeneration and associated risk factors.AMD Global Report 2005. Toronto:AMD Alliance International,2005
[3]Lau JT, Lee V, Fan D,et al. Knowledge about cataract, glaucoma, and age related macular degeneration in the Hong Kong Chinese population. Br J Ophthalmol.2002;86(10):1080-4
[4]Mukesh BN, Dimitrov PN, Leikin S, et al. Five-year incidence of age-related maculopathy: the Visual Impairment Project. Ophthalmology.2004 Jun;111(6):1176-82
[5]Wang JJ, Rochtchina E, Lee AJ. Ten-year incidence and progression of age-related maculopathy:the blue Mountains Eye Study. Ophthalmology.2007;114(1):92-98
[6]Cackett P, Wong TY, Aung T, et al. Smoking, cardiovascular risk factors, and age-related macular degeneration in Asians:the Singapore Malay Eye Study. Am J Ophthalmol.2008; 146(6): 960-967.
[7]Nirmalan PK, Katz J, Robin AL, et al. Prevalence of vitreoretinal disorders in a rural population of southern India:the Aravind Comprehensive Eye Study. Arch Ophthalmol.2004; 122(4):581-586
[8]Oshima Y, Ishibashi T, Murata T, et al. Prevalence of age related maculopathy in a representative Japanese population:the Hisayama study.Br J Ophthalmol.2001;85(10):1153-1157
[9]Miyazaki M, Kiyohara Y, Yoshida A, et al. The 5-year incidence and risk factors for age-related maculopathy in a general Japanese population:the Hisayama study. Invest Ophthalmol Vis Sci.2005;46(6):1907-1910
[10]Miyazaki M, Nakamura H, Kubo M, et al. Risk factors for age related maculopathy in a Japanese population:the Hisayama study. Br J Ophthalmol.2003;87(4):469-472
[11]Lau JT, Lee V, Fan D, et al. Knowledge about cataract, glaucoma, and age related macular degeneration in the Hong Kong Chinese population. Br J Ophthalmol.2002;86(10):1080-1084.
[12]Hsu WM, Cheng CY, Liu JH, et al. Prevalence and causes of visual impairment in an elderly Chinese population in Taiwan:the Shihpai Eye Study. Ophthalmology 2004; 111:62-69
[13]Xu L, Wang Y, Li Y, Wang Y, Cui T, Li J, Jonas JB. Causes of blindness and visual impairment in urban and rural areas in Beijing:the Beijing Eye Study. Ophthalmology 2006; 113:1141-1143
[14]Huang JD, Curcio CA, Johnson M. Morphometric analysis of lipoprotein-like particle accumulation in aging human macular Bruch's membrane.Invest Ophthalmol Vis Sci.2008; 49(6): 2721-2727.
[15]Schlingemann RO. Role of growth factors and the wound healing response in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol.2004;242(1):91-101.
[16]Grossniklaus HE, Ling JX, Wallace TM, et al. Macrophage and retinal pigment epithelium expression of angiogenic cytokines in choroidal neovascularization. Mol Vis.2002;8:119-126.
[17]Strunnikova NV, Baffi J, Zhang C, et al. Cellular and molecular responses to sublethal oxidative injury in retinal pigment epithelial cells (RPE). Invest Ophthalmol Vis Sci,2003,44: 3145.
[18]Evans JR. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev.2006;(2):CD000254.
[19]Ratanasukon M, et al. Photodynamic therapy for AMD and non-AMD patients:two-year results in Thais. J Med Assoc Thai.2009;92(3):367-72.
[20]Kim IK, Gragoudas ES. Radiation therapy for neovascular age-related macular degeneration revisited. Br J Ophthalmol.2009;93(3):279-80.
[21]Odergren A, Algvere PV, Seregard S, et al. A prospective randomised study on low-dose transpupillary thermotherapy versus photodynamic therapy for neovascular age-related macular degeneration.Br J Ophthalmol.2008;92(6):757-61.
[22]Rothenbuehler SP, Waeber D, Brinkmann CK, et al. Effects of Ranibizumab in Patients with Subfoveal Choroidal Neovascularization Attributable to Age-related Macular Degeneration. Am J Ophthalmol.2009 Feb 11. [Epub ahead of print]
[23]Fong KC, Kirkpatrick N, Mohamed Q, et al. Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration using a variable frequency regimen in eyes with no previous treatment. Clin Experiment Ophthalmol.2008;36(8):748-55.
[24]Augustin A. Anecortave acetate in the treatment of age-related macular degeneration. Clin Interv Aging.2006;1(3):237-46.
[25]Lubinski W, Goslawski W, et al. Evaluation of visual function among patients with exudative AMD treated with an intravitreal injection of triamcinolone acetonide. Ann Acad Med Stetin.2008;54(1):22-27
[26]Nguyen QD, Shah SM, Hafiz G, et al. A phase Ⅰ trial of an Ⅳ-administered vascular endothelial growth factor trap for treatment in patients with choroidal neovascularization due to age-related macular degeneration. Ophthalmology.2006;113(9):1522.el-1522.e14.
[27]Takahashi K, Saishin Y, Ilva RL, et al. Systemic of intraocular administration of VEGF receptor kinase inhibitors causes regression of choroidal neovascularization. Invest Ophthalmol Vis Sci 2005;46:E-Abstract 1423
[28]Shen J, Samul R, Silva RL, et al. Suppression of ocular neovascularization with siRNA targeting VEGF receptor 1.Gene Ther. 2006;13(3):225-34.
[29]Garcia CA, Quiroz-Mercado H, Uwaydat S, et al. A phase Ⅰ/Ⅱ tral of intravenous squalamine lactate for treatment of choroidal neovascularization in age related macular degeneration(ARMD). Invest ophthalmol Vis Sci 2004;45:2362
[30]Nambu H, Nambu R, Melia M, et al. Combretastatin A-4 phosphate suppresses development and induces regression of choroidal neovascularization.Invest Ophthalmol Vis Sci. 2003;44(8):3650-5.
[31]Hawkins BS, Bressler NM, Miskala PH, et al. Surgery for subfoveal choroidal neovascularization in age-related macular degeneration:ophthalmic findings:SST report no.11. Ophthalmology.2004 Nov;111(11):1967-80.
[32]Eandi CM, Giansanti F, Virgili G.Macular translocation for neovascular age-related macular degeneration. Cochrane Database Syst Rev.2008;(4):CD006928
[33]Siqueira RC. Autologous transplantation of retinal pigment epithelium in age related macular degeneration. Arq Bras Oftalmol.2009;72(1):123-30
[34]陈明英.屈进学老师对老年性黄斑变性的中医辨证治疗.医药产业资讯.2006,3(2)：29-30
[35]姚大莉.王明芳用内眼辨证治疗老年性黄斑变性.四川中医.2002,20(6)：7-8
[36]朱惠安,张明亮,喻京生.辨证治疗眼底黄斑病变61例.湖南中医杂志,2000,16(1)：38
[37]崔红培,周尚昆,毛海燕. 益气复明汤治疗湿性脾气虚弱型老年性黄斑变性37例观察.四川中医,2006,24(2)：94-95
[38]吴德正,高汝龙,马娟妹等.黄斑病变的多焦ERG特征.中国实用眼科杂志,2000,18(11)684-689
[39]Vizzardi E, Nodari S, Fiorina C, et al. Plasma homocysteine levels and late outcome in patients with unstable angina. Cardiology.2007;107(4):354-9.
[40]Moghimi S, Najmi Z, Faghihi H, et al. Hyperhomocysteinemia and central retinal vein occlusion in Iranian population. Int Ophthalmol.2008;28(1):23-28.
[41]Aydin E, Demir HD, Ozyurt H, et al. Association of plasma homocysteine and macular edema in type 2 diabetes mellitus. Eur J Ophthalmol.2008;18(2):226-232.
[42]Rochtchina E, Wang JJ, Flood VM, Mitchell P. Elevated serum homocysteine, low serum vitamin B12, folate, and age-related macular degeneration:the Blue Mountains Eye Study. Am J Ophthalmol.2007;143(2):344-346.
[43]Seddon JM, Gensler G, Klein ML,et al. Evaluation of plasma homocysteine and risk of age-related macular degeneration. Am J Ophthalmol.2006;141(1):201-203.
[44]Vine AK, Stader J, Branham K, et al. Biomarkers of cardiovascular disease as risk factors for age-related macular degeneration. Ophthalmology.2005;112(12):2076-2080.
[45]Kamburoglu G, Gumus K, Kadayifcilar S, et al. Plasma homocysteine,vitamin B12 and folate levels in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol.2006; 244(5):565-569.
[46]Coral K, Raman R, Rathi S, et al. Plasma homocysteine and total thiol content in patients with exudative age-related macular degeneration. Eye.2006;20(2):203-207
[47]Nowak M, Swietochowska E, Wielkoszynski T, et al. Homocysteine,vitamin B12, and folic acid in age-related macular degeneration. Eur J Ophthalmol.2005;15(6):764-767.
[48]Ates O, Azizi S, Alp HH, et al. Decreased serum paraoxonase 1 activity and increased serum homocysteine and malondialdehyde levels in age-related macular degeneration. Tohoku J Exp Med.2009;217(1):17-22
[49]Belda Sanchis JI, Quijada Gonzalez A, Mufloz Ruiz G, et al. Are blood lipids a risk factor for age-related macular degeneration? Arch Soc Esp Oftalmol.2001;76(1):13-17
[50]Nowak M, Swietochowska E, Marek B, et al. Changes in lipid metabolism in women with age-related macular degeneration. Clin Exp Med.2005;4(4):183-187
[51]Javadzadeh A, Ghorbanihaghjo A, Rashtchizadeh N, et al. Enhanced susceptibility of low-density lipoprotein to oxidation in wet type age-related macular degeneration in male patients. Saudi Med J.2007;28(2):221-4.
[52]Rudolf M, Ivandic B, Winkler J, et al. Accumulation of lipid particles in Bruch's membrane of LDL receptor knockout mice as a model of age-related macular degeneration. Ophthalmologe. 2004; 101(7):715-719.
[53]刘家琦,李凤鸣.实用眼科学(第二版).人民卫生出版社(北京),2002,509-511
[54]曾庆华.中医眼科学.中国中医药出版社.2003：209-210
[55]吴乐正.临床多焦视觉电生理学.北京科学技术出版社(北京),2004,5：211
[56]明·王肯堂.证治准绳·眼目集,中医古籍出版社,1993：147
[57]张云昌等.白话黄帝内经.河北人民出版社,1994：148
[58]张云昌等.白话黄帝内经.河北人民出版社,1994：27
[59]金·李果.兰室秘藏.中医古籍出版社(第一版),1986：29
[60]黄霄,曾庆华,高海燕.血脂异常对C57BL小鼠巩膜顺应性的影响.中国中医眼科杂志,2006,16(4)：217-220
[61]清·顾锡.银海指南(第一版).人民卫生出版社,1960：30
[62]任廷革.黄帝内经灵枢.人民军医出版社,2006：251
[63]任廷革.黄帝内经灵枢.人民军医出版社,2006：200
[64]明·龚信.古今医鉴.江西科学技术出版社,1990：270
[65]明·张景岳.景岳全书·杂证谟选读.重庆大学出版社,1988：140
[66]傅景华.黄帝内经素问.中医古籍出版社,1997：1
[67]张云昌等.白话黄帝内经.河北人民出版社,1994：37
[68]张云昌等.白话黄帝内经.河北人民出版社,1994：783
[69]张世英.药王孙思邈医药方集.世界图书出版公司,1999：286
[70]清·王清任(陕西省中医研究院注释).医林改错注释.人民卫生出版社,1985：138
[71]明·傅仁宇.审视瑶函.辽宁科学技术出版社1997：178
[72]清·徐灵胎.慎疾刍言.江苏科学技术出版社,1984：11
[73]金·刘完素.素问病机气宜保命集.人民卫生出版社,1959：106
[74]张云昌等.白话黄帝内经.河北人民出版社,1994：722
[75]清·林佩琴.类证治裁.中国中医药出版社,1997：128
[76]元·朱震亨.丹溪心法.辽宁科学技术出版社,1997：24
[77]关国华.老年性黄斑变性病中医辨证论治之规律性.新中医,1996,8：12～14
[78]梁风鸣,王莉,雷晓琴.王明芳教授治疗老年性黄斑变性的经验.成都中医药大学学报,1997,20(6)：3
[79]宋剑南,刘东远,牛晓红等.高脂血症与中医痰浊关系的实验研究.中国中医基础医学杂志,1995,1(1)：49-51.
[80]陈玮.中医药治疗老年性黄斑变性概况.安徽中医临床杂志,2002,2：150-151
[81]李波,魏燕萍.李传课教授辨治老年黄斑变性经验.中医药导报,2006,12(1)：20-21
[82]邓亚平,谢学军.驻景丸加减治疗老年性黄斑变性的临床初步观察.成都中医学院学报,1989,12(2)：25
[83]蔡静,侯丽辉.痰浊与现代物质基础的关系.辽宁中医杂志,2007,34(6)：742-743
[84]叶勇.高脂血症与痰浊淤血相关性理论基础与研究依据.时珍国医国药,2006,17(8)：1561-1562
[85]宋明锁,王裕颐.试论瘀血与痰浊之关系.中西医结合心脑血管杂志,2005,3(1)：62-63
[86]常国良,常玉.高脂血症从痰浊血瘀论治.光明中医,2007,22(6)：62-63
[87]曾庆华,王春晖,魏爽.血脂异常对小鼠视网膜色素上皮-玻璃膜-脉络膜毛细血管复合体影响的研究.中国中医眼科杂志,2006,16(2)：90-94
[88]黄霄,曾庆华,高海燕.血脂异常对C57BL小鼠巩膜顺应性影响的实验研究,中国中医眼科杂志,2006,16(4)：217-220.
[89]王春晖,曾庆华.黄斑康对实验性血脂异常小鼠色素上皮-玻璃膜-脉络膜毛细血管复合体影响的研究.中国中医眼科杂志,2006,16(4)：212-216
[90]陈明英.屈进学老师对老年性黄斑变性的中医辩证治疗.医药产业资讯.2006,3(2)：29-30
[91]姚大莉.王明芳用内眼辨证治疗老年性黄斑变性.四川中医.2002,20(6)：7-8
[92]朱惠安,张明亮,喻京生.辨证治疗眼底黄斑病变6l例.湖南中医杂志,2000,16(1)：38
[93]Palmowski AM, Sutter EE, Bearse MA Jr, et al. Multifocal electroretinogram (MF-ERG) in diagnosis of macular changes. Example:senile macular degeneration. Ophthalmologe.1999; 96 (3):166-173
[94]严良.多焦视网膜电图的原理与应用.中国眼耳鼻喉科杂志,2002,2：121-130.
[95]Klistorner A, Crewther DP, Crewther SG. Temporal analysis of the topographic ERG: chromatic versus achromatic stimulation.Vision Res,1998;38(7):1047-1062
[96]Seerliger M, Kretschmann U, Apfelstedt-Sylla E. Multifocal electroretino-graghy in retinitis pigmentosa. AmJ Ophthalmol,1998; 125:214-226
[97]Horiguchi M, Suzuki S, Kondo M,et al.Effect of glutamate analogues and inhibitory neurotransmitters on the electroretinograms elicited by random sequence stimuli in rabbits.Invest Ophthalmol Vis Sci,1998;39(11):2171-2176
[98]Hood DC.Assessing retinal function with the multifocal technique.Prog Retin Eye Res, 2000; 19:607-646.
[99]Hara WA, Ton H, Ruiz G, et al. Characterization of retinal injury using ERG measures obtained with both conventional and multifocal methods in chronic ocular hypertensive primates. Invest Ophthalmol Vis Sic,2001;42:127-136.
[100]李海生,潘家普主编.视觉电生理的原理和实践.上海科学普及出版社,2002：l19
[101]吴德正,刘妍主编.罗兰视觉电生理仪测试方法和临床应用图谱学.北京科学技术出版社,2006：96-97
[102]刘家琦,李凤鸣.实用眼科学(第二版),人民卫生出版社(北京),2002：46
[103]吴德正,刘妍主编.罗兰视觉电生理仪测试方法和临床应用图谱学.北京科学技术出版社,2006：5
[104]李海生,潘家普主编.视觉电生理的原理和实践.上海科学普及出版社,2002：257
[105]Nagatomo A, Nao-i N, Maruiwa F, et al. Multifocal electroretinograms in normal subjects. Jpn J Ophthalmol,1998; 42(2):129-135
[106]严良,陆豪,杨蕾等.正常人多焦视网膜电图一阶核反应分析.眼科,2003,12(6)：339-342
[107]曾庆华,王丽英,张玲.年龄相关性黄斑变性发生机制与中医辨证分型的关系.四川中医,2004,22(2)：13-14
[108]Hayreh S, Gartner S. In vivo choroidal circulation and its watershed zones. Eye.1990; 4: 273-289.
[109]刘家琦,李凤鸣.实用眼科学(第二版),人民卫生出版社(北京),2002：26
[110]Huang JD, Presley JB, Chimento MF, et al. Age-related changes in human macular Bruch's membrane as seen by quick-freeze/deepetch. Exp Eye Res,2007;85:202-218
[11]Johnson M, Dabholkar A, Huang JD,et al. Comparison of morphology of human macular and peripheral Bruch's membrane in older eyes. Curr Eye Res.2007 Sep;32(9):791-799
[112]Holz FG, Sheraidah G, Pauleikhoff D, et al. Analysis of lipid deposits extracted from human macular and peripheral Bruch's membrane. Arch Ophthalmol,1994;112:402-406.
[113]Curcio CA, Millican CL, Bailey T, et al. Accumulation of cholesterol with age in human Bruch's membrane. Invest Ophthalmol Vis Sci,2001;42:265-274.
[114]Jackson GR, Owsley C, Curcio CA. Photoreceptor degeneration and dysfunction in aging and agerelated maculopathy. Ageing Res Rev.2002;1:381-396.
[115]Gerth C, Hauser D, Delahunt PB,et al. Assessment of multifocal electroretinogram abnormalities and their relation to morphologic characteristics in patients with large drusen. Arch Ophthalmol.2003;121(10):1404-1414
[116]Gerth C, Delahunt PB, Alam S,et al. Cone-mediated multifocal electroretinogram in age-related macular degeneration:progression over a long-term follow-up. Arch Ophthalmol. 2006;124(3):345-352
[117]李秋明,郑广瑛.眼科应用解剖学(第一版).郑州大学出版社,2002：13I
[118]Maguire MG, Alexander J, Fine SL, et al. Characteristics of choroidal neovascularization in the complications of age-related macular degeneration prevention trial. Ophthalmology. 2008;115(9):1468-73
[119]Ali F, Chan WC, Stevenson MR, et al. Morphometric analysis of angiograms of exudative lesions in age-related macular degeneration. Arch Ophthalmol.2004;122(5):710-5.
[120]赵玲,魏海峰,张丽,等.中医痰浊血瘀证候的生物学基础研究.中华中医药杂志,2008,23(8)：680-683
[121]李亚萍,王玲,李光宇.老年性黄斑变性脉络膜新生血管的组织病理变化研究.中国老年学杂志,2008,28(24)：2443-2445
[122]Curcio CA. Photoreceptor topography in ageing and age-related maculopathy. Eye.2001; 15(Pt 3):376-383
[123]Scholl HP, Bellmann C, Dandekar SS, et al. Photopic and scotopic fine matrix mapping of retinal areas of increased fundus autofluorescence in patients with age-related maculopathy. Invest Ophthalmol Vis Sci 2004;45:574-583
[124]Nishihara H, Kondo M, Ishikawa K, et al. Focal Macular Electroretinograms in Eyes with Wet-type Age-Related Macular Degeneration. Invest. Ophthalmol. Vis Sci.2008; 49:3121-3125.
[125]Ciulla T, Harris A, Martin B. Ocular perfusion and age-related macular degeneration. Acta Ophthalmol Scand.2001;79:108-115.
[126]Remky A, Elsner AE. Blue on yellow perimetry with scanning laser ophthalmoscopy in patients with age related macular disease. Br J Ophthalmol.2005;89:464-469.
[127]Mori F,Konno S, Hikichi T.Pulsatile ocular blood flow study:decrease in exudative age-related macular degeneration.Br J Ophthalmol,2001,85(5):510-512
[128]梁晓颖,王景昭,李根林.多焦视网膜电图用于年龄相关性黄斑变性视网膜功能的研究.中国实用眼科杂志,2005,23(9)：902-906
[129]Li J, Tso MO, Lam TT. Reduced amplitude and delayed latency in foveal response of multifocal electroretinogram in early age related macular degeneration. Br J Ophthalmol.2001; 85(3):287-290
[130]Liu X, Shen J, Zhan R, et al. Proteomic analysis of homocysteine induced proliferation of cultured neonatal rat vascular smooth muscle cells. Biochim Biophys Acta.2009; 1794(2):177-84.
[131]Jiang X, Yang F, Tan H, et al. Hyperhomocystinemia impairs endothelial function and eNOS activity via PKC activation. Arterioscler Thromb Vasc Biol.2005;25(12):2515-21.
[132]Cabezas-Leon MM, Garcia-Montero MR, Morente-Matas P. Hyperhomocysteinemia as a risk factor for central retinal vein thrombosis in a young patient.Rev Neurol.2003;37(5):441-443
[133]Ni M, Zhang XH, Jiang SL, et al. Homocysteinemia as an independent risk factor in the Chinese population at a high risk of coronary artery disease. Am J Cardiol.2007; 100 (3): 455-458.
[134]丁旭东,肖红琼,张贵斌等.血浆同型半胱氨酸与血管性痴呆的相关性研究.中国医师杂志,2007,9(1)：9-11
[135]Antoniades C, Antonopoulos AS, Tousoulis D,et al. Homocysteine and coronary atherosclerosis:from folate fortification to the recent clinical trials. Eur Heart J.2009;30(1):6-15.
[136]Lukiw WJ, Zhao Y, Mukherjee PK, et al. Common Pathogenic Mechanism Involving Altered Beta-Amyloid Precursor Protein ((?)APP) Processing in Alzheimer's Disease (AD) and Age-Related Macular Degeneration (AMD). Invest Ophthalmol Vis Sci,2007;48:17.
[137]Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology,1992,99:933-943.
[138]Zarbin MA. Current concepts in the pathogenesis of age-related macular degeneration. Arch Ophthalmol.2004; 122 (4):598-614.
[139]Bailey TA, Kanuga N, Romero IA, et al. Oxidative stress affects the junctional integrity of retinal pigment epithelial cells. Proc Natl Acad Sci U S A. 2004; 103 (30):11282-1287.
[140]Haddad WM, Coscas G, Soubrane G. Age-related macular degeneration and apoptosis. J Fr Ophtalmol,2003,26:307-311.
[141]Ezzat MK, Hann CR, Vuk-Pavlovic S, et al. Immune cells in the human choroids. Br J Ophthalmol.2008;92(7):976-980
[142]Lommatzsch A, Hermans P, Muller KD, et al. Are low inflammatory reactions involved in exudative age-related macular degeneration? Morphological and immunhistochemical analysis of AMD associated with basal deposits. Graefes Arch Clin Exp Ophthalmol.2008;246(6):803-810
[143]Anderson DH, Talaga KC, Rivest AJ, et al. Characterization of beta amyloid assemblies in drusen:the deposits associated with aging and age-related macular degeneration. Exp Eye Res. 2004;78(2):243-56.
[144]Ding JD, Lin J, Mace BE, et al. Targeting age-related macular degeneration with Alzheimer's disease based immunotherapies:anti-amyloid-beta antibody attenuates pathologies in an age-related macular degeneration mouse model. Vision Res.2008;48(3):339-345.
[145]Johnson LV, Leitner WP, Staples MK, et al. Complement activation and inflammatory processes in Drusen formation and age related macular degeneration. Exp Eye Res.2001; 73(6): 887-896
[146]Ramrattan RS, van der Schaft TL, Mooy CM, et al. Morphometric analysis of Bruch's membrane, the choriocapillaris, and the choroid in aging. Invest Ophthalmol Vis Sci.1994; 35(6): 2857-2864
[147]Moore DJ, Clover GM. The effect of age on the macromolecular permeability of human Bruch's membrane. Invest Ophthalmol Vis Sci.2001;42(12):2970-2975
[148]Matsuoka M, Ogata N, Otsuji T, et al. Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathyl. Br J Ophthalmol.2004;88(6):809-815
[149]Ueland PM, Refsum H, Stabler SP, et al. Total homocysteine in plasma or serum:methods and clinical applications. Clin Chem.1993;39(9):1764-1779.
[150]Hankey GJ, Eikelboom JW. Homocysteine and vascular disease. Lancet.1999; 354 (9176): 407-413.
[151]桂兴芬.生物化学与分子生物学.郑州大学出版社,2006：191-192
[152]徐晓利,马涧泉.医学生物化学.北京：人民卫生出版社,1998：348-353
[153]Cattaneo M. Hyperhomocysteinemia and venous thromboembolism. Semin Thromb Hemost.2006;32(7):716-23.
[154]Lalouschek W, Aull S, Serles W, et al. Genetic and nongenetic factors influencing plasma homocysteine levels in patients with ischemic cerebrovascular disease and in healthy control subjects. J Lab Clin Med.1999;133(6):575-82.
[155]高慧娟,李新毅.红细胞变形性与缺血性脑损伤的研究进展.中西医结合心脑血管病杂志,2006,4(1)：64-65
[156]Cattaneo M. Hyperhomocysteinemia and venous thromboembolism.Semin Thromb Hemost.2006;32(7):716-23.
[157]Zhang L, Jin M, Hu XS, et al. Homocysteine stimulates nuclear factor kappaB activity and interleukin-6 expression in rat vascular smooth muscle cells.Cell Biol Int.2006;30(7):592-597.
[158]Poddar R, Sivasubramanian N, DiBello PM, et al. Homocysteine Induces Expression and Secretion of Monocyte Chemoattractant Protein-1 and Interleukin-8 in Human Aortic Endothelial Cells:Implications for Vascular Disease. Circulation.2001;103(22):2717-2273
[159]Ni M, Holland M, Jarstadmarken H,et al. Time-course of experimental choroidal neovascularization in Dutch-Belted rabbit:clinical and histological evaluation. Exp Eye Res. 2005;81(3):286-97
[160]Sakurai E, Anand A, Ambati BK,et all. Macrophage depletion inhibits experimental choroidal neovascularization. Invest Ophthalmol Vis Sci.2003;44(8):3578-85
[161]Gu X, Shadrach K, Sun M, et al. Identification of lipid oxidation products and proteins in bruch's membrane from normal and AMD donor Eyes. Invest Ophthalmol Vis Sci,2003,44: 1622.
[162]Crabb JW, Mlyagi M, Gu X, et al. Drusen proteome analysis:an approach to the etiology of age-related macular degeneration. Pro Natl Acad Sci USA,2002,99:14682-14687.
[163]Metelitsina TI, Grunwald JE, DuPont JC, et al. Foveolar choroidal circulation and choroidal neovascularization in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2008; 49(1):358-63.
[164]宋剑南.从生物化学角度看痰及痰瘀相关.中国中医基础医学杂志,2000,6(3)：40-43
[165]明·张景岳.景岳全书·杂证谟选读.重庆大学出版社,1988：41
[166]Garibotto G, Sofia A, Valli A,et al. Causes of hyperhomocysteinemia in patients with chronic kidney diseases. Semin Nephrol.2006;26(1):3-7
[167]Duan W, Ladenheim B, Cutler RG, et al. Dietary folate deficiency and elevated homocysteine levels endanger dopaminergic neurons in models of Parkinson's disease. Neurochem.2002; 80(1):101-10.
[168]刘敏,彭海.同型半胱氨酸对黑质细胞凋亡及NF-κB表达的影响.脑与神经疾病杂志,2006,14(1)：31-34
[169]Ganji V, Kafai MR. Demographic, health, lifestyle, and blood vitamin determinants of serum total homocysteine concentrations in the third National Health and Nutrition Examination Survey,1988-1994. Am J Clin Nutr.2003;77(4):826-33
[170]Haan MN, Miller JW, Aiello AE, et al. Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment:results from the Sacramento Area Latino Study on Aging. Am J Clin Nutr.2007;85(2):511-517.
[171]Fakhrzadeh H, Ghotbi S, Pourebrahim R, et al. Total plasma homocysteine, folate, and vitamin B12 status in healthy Iranian adults:the Tehran homocysteine survey (2003-2004)/a cross-sectional population based study. BMC Public Health.2006;6:29
[172]Bednarek-Tupikowska G, Tupikowski K, Bohdanowicz-Pawlak A, et al.Evaluation of the influence of sex hormones on homocysteine concentration in pre-and postmenopausal women. Pol Merkur Lekarski.2005; 18(104):189-91.
[173]Jiang Y, Jiang J, Xiong J, et al. Homocysteine-induced extracellular superoxide dismutase and its epigenetic mechanisms in monocytes. J Exp Biol.2008;211(Pt 6):911-920
[174]Yan SK, Chang T, Wang H, et al. Effects of hydrogen sulfide on homocysteine-induced oxidative stress in vascular smooth muscle cells. Biochem Biophys Res Commun.2006; 351(2): 485-491.
[175]甘伟杰,刘俊田,林蓉.槲皮素对高同型半胱氨酸血症家兔血管内皮细胞的保护作用.中国药理学通报,2004,20(6)：647-65l
[176]Paul A, Belton A, Nag S, et al.Reduced mitochondrial SOD displays mortality characteristics reminiscent of natural aging. Mech Ageing Dev.2007;128(11-12):706-716.
[177]童坦君,张宗玉.医学老年学.北京：人民卫生出版社,1995：155.160
[178]Hollyfield J G, Bonilha VL, Rayborn ME, et al. Oxidative damage and age-related macular degeneration. Nat Med.2008;14(2):194-198. [179] Hyman L, Schachat AP, He Q, et al. Hypertension, cardiovascular disease, and age-related macular degeneration. Age-related Macular Dege(?)ration Risk Factors Study Group. Arch Ophthalmol.2000; 118(3):351-358.
[180]Friedman E. Update of the vascular model of AMD. Br J Ophthalmol,2004,88:161-163.
[181]Vine AK, Stader J, Branham K, et al. Biomarkers of cardiovascular disease as risk factors for age-related macular degeneration. Ophthalmology.2005; 112(12):2076-2080.
[182]汤志梅,李秀钧.代谢综合片与脂代谢异常.中华老年多疾病杂志,2005,4(1)：6-9
[183]Griffin BA. The effect of n-3 fatty acids on low density lipoprotein subfractions. Lipids. 2001;36 Suppl:S91-97
[184]Lee CY, Kim KC, Park HW, et al. Rheological properties of erythrocytes from male hypercholesterolemia. Microvasc Res.2004;67(2):133-138
[185]谢滨萱,牟莉.血脂异常与血液流变学、甲襞微循环关系探讨.中国现代医学杂志,2002,12(12)：64-65.
[186]钱小奇.试论高脂血症的病因病机.天津中医,2002,19(6)：50-52.
[187]Grossniklaus HE, Green WR. Choroidal neovascularization. Am J Ophthalmol.2004; 137 (3):496-503.
[188]陈扬荣,江明,李庆阳.老年脾肾虚证LPO、SOD、血脂关系的探讨.中国中医基础医学杂志,2002,8(7)：44-45
[189]林炳辉,方素钦等.中老年人脾肾虚证实质的探讨.中国中西医结合杂志,2002,22(1)：33-36
[190]俞军,徐泳.肾病听力损害及血脂水平与肾虚证关系探讨.辽宁中医杂志,1999,26(4)：150-15l
[191]白芝兰,任百超,杨建刚等.中国陕西省农村年龄相关性黄斑变性流行病学调查.国际眼科杂志,2005,5(6)：1114-112l
[192]关国华,詹宇坚,黄仲委等.老年性黄斑变性流行病学调查(附1091例调查结果分析).眼底病,1989,4：218-212
[193]Francis PJ, George S, Schultz DW, et al.The LOC387715 gene, smoking, body mass index, environmental associations with advanced age-related macular degeneration.Hum Hered.2007; 63 (3-4):212-218.
[194]Seddon JM, Cote J, Davis N, et al. Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. Arch Ophthalmol, 2003,121:785-792
[195]Fraser-Bell S, Wu J, Klein R, et al. Smoking, alcohol intake, estrogen use, and age-related macular degeneration in Latinos:the Los Angeles Latino Eye Study. Am J Ophthalmol,2006,141: 79-87
[196]DeAngelis MM, Lane AM, Shah CP, et al. Extremely discordant sib-pair study design to determine risk factors for neovascular age-related macular degeneration. Arch Ophthalmol,2004, 122:575-580
[197]Clemons TE, Milton RC, Klein R, et al. Risk factors for the incidence of advanced age-related macular degeneration in the Age-Related Eye Disease Study (AREDS) AREDS report no.19.Ophthalmology,2005,112:533-539.
[198]Umeda S, Suzuki MT, Okamoto H, et al. Molecular composition of drusen and possible involvement of anti-retinal autoimmunity in two different forms of macular degeneration in cynomolgus monkey (Macaca fascicularis). FASEB J.2005;19(12):1683-1685
[1]明·王肯堂.证治准绳·眼目集.中医古籍出版社,1993：147
[2]任廷革.黄帝内经灵枢.人民军医出版社,2006：126
[3]清·薛雪.医经原旨.上海中医学院出版社,1992：310
[4]任廷革.黄帝内经灵枢.人民军医出版社,2006：647
[5]任廷革.黄帝内经灵枢.人民军医出版社,2006：847
[6]清·唐宗海.血证论.天津科学技术出版社,2003：51
[7]任廷革.黄帝内经灵枢.人民军医出版社,2006：249
[8]明·傅仁宇.审视瑶函.辽宁科学技术出版社,1997：8
[9]金·李杲.兰室秘藏.中医古籍出版社,1986：29
[10]傅景华.黄帝内经素问.中医古籍出版社,1997：25
[11]傅景华.黄帝内经素问.中医古籍出版社,1997：1
[12]傅景华.黄帝内经素问.中医古籍出版社,1997：153
[13]明·李中梓.医宗必读.山西科学技术出版社,2006：377
[14]明·张景岳.景岳全书·杂证谟选读.重庆大学出版社,1988：141
[15]清·顾锡.银海指南(第一版).人民卫生出版社,1960：30
[16]明·王纶.明医杂著.江苏科学技术出版社,1985：73
[17]明·虞抟.医学正传.人民卫生出版社,1965：88
[18]任廷革.黄帝内经灵枢.人民军医出版社,2006：251
[19]任廷革.黄帝内经灵枢.人民军医出版社,2006：200
[20]任廷革.黄帝内经灵枢.人民军医出版社,2006：131
[21]清·王清任.医林改错.上海卫生出版社,1956：16
[22]金·刘完素.素问病机气宜保命集.人民卫生出版社,1959：106
[23]隋·巢元方.诸病源候论.辽宁科学技术出版社,1997：102
[24]清·唐宗海.血证论.天津科学技术出版社,2003：98
[25]清·周学海.读医随笔.江苏科学技术出版社,1983：40
[26]任廷革.黄帝内经灵枢.人民军医出版社,2006：176
[27]傅景华.黄帝内经素问.中医古籍出版社,1997：96
[28]清·叶天士.临证指南医案.华夏出版社,1995：430
[29]清·叶天士.临证指南医案.华夏出版社,1995：178
[30]清·何梦瑶.医碥.上海科学技术出版社,1982：116
[31]程志清.治痰心法.陆芷青内科精华评述.北京：中医古籍出版社,1998：110
[32]李军.颅脑痰瘀证治论.陕西中医学院学报,2002,25(2)：1-3
[33]孟庆刚.试论“痰瘀同源”.新疆中医药,1994(1)：9
[34]沈浪泳.论痰瘀同病.上海中医药杂志,2002(1)：40-41
[35]程小曲.痰浊型冠心病与血脂、脂蛋白、载脂蛋白的关系及痰浊形成机理探讨.新中医,1994(3)：7
[36]林晓忠,吴焕林,严夏,等.邓铁涛教授论治冠心病规律探要.中医药学刊,2001(19)：412-414
[37]胡炜.从痰瘀互结论治冠心病探析.江苏中医药,2004,25(5)：16-17
[38]宋剑南,刘东远,牛晓红,等.高脂血症与中医痰浊关系的实验研究.中国中医基础医学杂志,1995,1：49
[39]周瑕菁,宋剑南,吕爱平,等.中医不同治法对实验性高脂血症兔主动脉内膜脂斑形成的影响.中医杂志,1996,37：174-175
[40]宋剑南.从生物化学角度看痰及痰瘀相关.中国中医基础医学杂志,2000,6：40-43
[41]陈炳旺,蔺德明.冠心病中医实证血液流变学变化的临床研究.福建中医学院学报,2000,10(1)：1-2
[42]李小兵,方永奇,黄可儿.痰瘀证型的临床分析.辽宁中医杂志,2000,27(2)：53-55
[43]孙建芝,牛晓亚,韩丽华,等.痰浊证微观辨证指标的实验研究.河南中医,1996,16(2)：21-22
[44]Leslie Hyman, Andrew P, Qimei He, et al. Hypertension, Cardiovascular Disease, and Age-Related Macular Degeneration.美国医学会眼科杂志中文版,2001,13(1)：25-29.
[45]Miceli MV, Newsome D A, Tate D J Jr, et al. Pathologic changes in the retinal pigment epithelium and Bruch's membrane of fat-fed atherogenic mice. Curr Eye Res,2000,20 (1):8-16.
[46]曾庆华,王春晖,魏爽·实验性血脂异常小鼠色素上皮-玻璃膜-脉络膜毛细血管复合体的研究[J]·中国中医眼科杂志,2006,16(2)：90.
[47]王春晖,曾庆华.黄斑康对实验性血脂异常小鼠色素上皮-玻璃膜-脉络膜毛细血管复合体影响的研究.中国中医眼科杂志,2006,16(4)：212-216
[48]Grossniklaus HE, Green WR. Choroidal neovascularization. Am J Ophthalmol.2004; 137 (3):496-503.
[49]Friedman E. A hemodynamic model of the pathogenesis of age-related macular degeneration. Am J Ophthalmol,2000,130(5):658～663
[50]曾庆华,王丽英,张玲.年龄相关性黄斑变性发生机制与中医辨证分型的关系.四川中医,2004,22(2)：13-14
[51]李珍,周培兰,马汀等.海军老年性黄斑变性血液流变学改变.张家口医学院学报.1997,14(2)：44～45