Liu Xiao-Min, Shi Hui, Li Wei
College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun, 130118, China; College of Life Sciences, Jilin Agricultural University, Changchun, 130118, China; Jilin Provincial International Joint Research Center for the Development and Utilization of Authentic, China.
The First Hospital, Jilin University, Changchun, 130118, China.
J Ethnopharmacol. 2024 Apr 24;324:117786. doi: 10.1016/j.jep.2024.117786. Epub 2024 Jan 20.
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.
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.
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.
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.
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.
白内障是全球最常见的致盲原因，是一种由晶状体混浊引起的视觉障碍，严重影响人们的日常生活。年龄相关性白内障（ARC）是由于多种因素长期综合作用导致的最常见的白内障类型，其发病机制多种多样。目前，手术是治疗白内障的主要方法，但仍局限于早期白内障的预防、治疗及术后并发症护理。而其药物治疗仍处于探索研究阶段。中药作为我国独特的资源，在中医理论指导下组方，毒性和副作用小，在年龄相关性白内障的防治方面取得了很大进展。
本综述概述了年龄相关性白内障在传统医学和现代医学中的发病机制，并总结了中药治疗年龄相关性白内障的历史和治疗效果，包括其方剂、药材和活性成分，以及其他辅助方法。
通过使用“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”等关键词和短语，广泛检索了多个知名数据库，如SciFinder、PubMed、ScienceDirect、Google Scholar和中国知网（CNKI），以及在年龄相关性白内障模型中评估的植物/植物成分。同时总结了目前临床治疗中使用的中药辅助疗法。
中药在治疗年龄相关性白内障方面显示出积极作用，通过多途径、多靶点发挥作用，可通过抑制糖代谢异常、抗氧化损伤、抑制晶状体上皮细胞凋亡等治疗或延缓年龄相关性白内障，这与中药在临床应用中的良好效果相一致。在白内障的早期预防和治疗以及术后并发症方面，中药及辅助方法仍有待取得更好的临床效果。
年龄相关性白内障在中医理论中属于“圆翳内障”范畴，表明年龄相关性白内障病因众多，包括衰老以及肾阳、脾、精、血亏虚等。同时，脏腑功能逐渐衰退，阴阳渐亏，尤以老年人为甚。因此，中医可主要基于肝、肾、脾辨证论治，个体化诊断和治疗，多靶点调节，从根本上调整阴阳，从而彰显中医在年龄相关性白内障防治中的优势。
