[关键词]
[摘要]
目的:观察中药杞精明目汤联合人工泪液治疗对肝肾阴虚型结膜松弛症(CCH)患者泪液中Th17相关细胞因子的改变。 方法:收集56例56眼 Ⅱ~Ⅲ 级肝肾阴虚型CCH患者,随机分为治疗组(杞精明目汤联合人工泪液)26例26眼和对照组(单纯人工泪液) 30例30眼,疗程一月,观察治疗前后患者的国际眼表疾病指数(OSDI)、泪膜破裂时间(BUT)、泪河高度(TMH)、球结膜充血指数。采集治疗前后CCH患者的泪液,通过流式免疫荧光发光法对患者泪液中Th17相关细胞因子进行检测,并对结果行SPSS统计学分析。 结果:治疗组与对照组CCH患者在治疗1个月后OSDI、BUT、球结膜充血指数均较治疗前均明显改善,且差异有统计学意义(p均<0.05),治疗1月后治疗组患者TMH较治疗前显著降低(p<0.05),对照组患者治疗前后TMH差异无统计学意义(p=0.41)。治疗组CCH患者在治疗1月后泪液中Th17相关细胞因子IL-17A、IL-17F、IL-6、IL-22、TNF-α、IFN-γ、IL-1β表达水平较治疗前显著降低(p均<0.05),而对照组泪液中Th17相关细胞因子表达水平治疗前后差异无统计学意义(p均>0.05)。 结论:杞精明目汤联合人工泪液治疗可有效改善肝肾阴虚型结膜松弛症患者眼表微环境,提高泪膜稳定性,抑制眼表炎症,可能与其降低泪液中Th17相关细胞因子的分泌相关。
[Key word]
[Abstract]
AIM: To observe the changes of Th17-related cytokines in tears of patients with Liver-kidney Yin deficiency type conjunctivochalasis(CCH)treated with traditional Chinese medicine Qi Jing Mingmu decoction combined with artificial tears. METHODS: 56 cases of 56 eyes CCH patients with Liver-kidney Yin deficiency type CCH of grade Ⅱ to Ⅲ were collected and randomly divided into treatment group (treated with Qi Jing Mingmu decoction combined with artificial tears) of 26 patients (26 eyes) and the control group (purely treated with artificial tears) of 30 cases (30 eyes). The treatment course was one month, and international ocular surface disease index (OSDI), tear film break-up time (BUT), tear meniscus height (TMH) and conjunctival congestion index of the patients were observed before and after treatment. The patients' tears were collected before and after treatment, and Th17-related cytokines in tears were detected by flow cytometry immunofluorescence luminescence method. All the results were statistically analyzed by SPSS. RESULTS: After one month of treatment, the OSDI, BUT and conjunctival congestion index of CCH patients in the treatment group and control group were significantly improved compared to before treatment, and the differences were statistically significant (all p < 0.05). After one month treatment, the TMH of CCH patients in the treatment group was significantly reduced compared to before treatment (p <0.05), while there was no statistically significant difference in TMH of the control group before and after treatment (p =0.41). After one month treatment, the expression levels of Th17-related cytokines IL-17A, IL-17F, IL-6, IL-22, TNF-α, IFN-γ and IL-1β in tears of CCH patients in the treatment group were significantly decreased compared to before treatment (all p < 0.05), while the expression levels of Th17-related cytokines in tears of control group were not statistically significant (all p > 0.05). CONCLUSION: Qi Jing Mingmu decoction combined with artificial tears can effectively improve the ocular surface microenvironment, enhance tear film stability, and inhibit ocular surface inflammation in CCH patients with Liver-kidney Yin deficiency type. This may be related to its reduction in the secretion of Th17-related cytokines in tears. KEYWORDS: conjunctivochalasis; Liver-kidney Yin deficiency type; Qi Jing Mingmu decoction; Th17; IL-17
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[基金项目]
国家自然科学基金项目(面上项目,重点项目,重大项目),上海市普陀区中心医院匠才计划,上海市东方英才计划拔尖项目