目的：研究蛴螬提取物不同途径给药对对激光诱导鼠眼CNV模型的影响及作用机制。方法：将BN大鼠32只随机分成空白组、模型组、口服组、滴眼组。采用激光诱导建立CNV活体模型，口服组、滴眼组分别予以蛴螬提取物口服和滴眼干预。分别在用药后1W、2W、3W、4W行眼底照相、FFA、OCT检查，观察CNV的形成情况，在2W、4W时对视网膜Ang1、HTRA1、VEGF进行检测。结果：两种给药方式均能有效减轻眼底视网膜血管荧光渗漏，促进瘢痕形成，稳定视网膜各层正常的结构及功能，减少激光对视网膜外屏障的损伤，减少新生血管形成，促进有效侧支循环的建立。新生血管形成率比较有统计学差异（P＜0.05）。2W时，造模各组视网膜组织中Ang1、VEGF表达增强，模型组与其他三组比较均有统计学差异（P＜0.01，P＜0.05），口服组、滴眼组比较均无统计学差异（P＞0.05）。HTRA1表达各组间比较均无统计学差异（P＞0.05）。4W时，Ang1表达水平下降，各组间比较均无统计学差异（P＞0.05），HTRA1、VEGF仍维持高表达。模型组与其他三组比较均有统计学差异（P＜0.05），口服组与滴眼组比较均无统计学差异（P＞0.05）。结论：蛴螬提取物对激光诱导CNV活体模型不同时期Ang1、HTRA1、VEGF的高表达具有明显抑制作用。进而表明蛴螬提取物对激光诱导的CNV形成的早期及晚期均有抑制作用，且口服和滴眼效用一致。

This paper was aimed to study the mechanism of different routes of medication of grub extract on wet agerelated macular degeneration (AMD). A total of 32 BN rats were randomly divided into four groups, which included the healthy control group (A group), model group (B group), oral administration group (C group), and eye drops group (D group). B, C, D group were made the wet AMD model induced in laser. C, D group were given grubs extract oral administration and eye drops, respectively. After 1 week, 2 weeks, 3 weeks and 4 weeks, fundus photography, FFA and OCT were conducted. The production of CNV and the influence of retinal Ang1, HTRA1, VEGF expression in the 2nd week and 4th week were observed. The results showed that two medications could effectively reduce the leakage of fluorescence of retinal blood vessel, promote scar formation, stabilize normal structure and function of retinal layers, reduce the laser on retinal barrier injury, decrease neovascularization formation, promote the establishment of effective collateral circulation. There was significant difference on neovascularization rate (P < 0.05). In 2 weeks, expressions of Ang1 and VEGF in retinal tissues were up-regulated. Comparing with Ang1 and VEGF retinal tissues of the model group and the other three groups, there was extremely significant difference (P < 0.01, P < 0.05). There was no statistical difference between C group and D group (P > 0.05). There was no statistical difference on HTRA1 expression among different groups (P > 0.05). In 4 weeks, Ang1 level decreased. There was no statistical difference among different groups (P > 0.05). HTRA1 and VEGF still maintained at a high expression level. There was statistical difference between the model group and three other groups (P < 0.05). There was no statistical difference between C group and D group (P > 0.05). It was concluded that grubs extract had obvious inhibitory effect on high expression of Ang1, HTRA1 and VEGF in different periods of wet AMD model, which showed that grubs extract had inhibition on CNV formation of wet AMD model of the early and late period induced by laser. Meanwhile, the oral administration achieved the same effect as the eye drops.

湖南省中医药科研重点项目（201438）：湖南省研究生创新课题（CX2014B352）；湖南省高层次卫生人才“225”工程培养项目资助；国家中医药管理局中医眼科学重点学科建设项目。