逍生散颗粒剂对干眼杯状细胞影响的临床及实验研究
发布时间：2018-11-22 11:04
【摘要】：目的：主要通过观察干眼患者的治疗前后自觉症状、泪膜破裂时间、泪液分泌及角膜荧光素钠染色、结膜印迹细胞学等检查,评价逍生散颗粒剂之临床疗效,探讨其对杯状细胞的影响,同时进一步结合动物模型以进行更加深入验证及探讨。方法：1.符合纳入标准30例干眼患者(共60只眼),随机分入A、B两组。其中A组对照组,使用玻璃酸钠滴眼液。B组中药组：使用逍生散颗粒剂。玻璃酸钠滴眼液为日本参天株式会社生产,每次一滴,每天三次。逍生散药物主要成分为：柴胡、白芍、当归、党参、五味子、麦冬等。每日两次,每次一袋,温水冲服。观察并记录患者治疗前及治疗后第1、2、3、4周之自觉症状、泪液分泌、泪膜破裂时间、荧光素钠染色、结膜印迹细胞学检查。2.将180只健康C57BL/6小鼠,雌性5周,体重20-25g,小鼠随机分6组：分别为正常对照、模型对照、生理盐水、低剂量药物、中剂量药物、高剂量药物六组,每组30只。每天于小鼠后肢根部,皮下注射氢溴酸东莨菪碱造成干眼模型。造模成功后于造模前、造模后、治疗后第1周、第2周、第3周、第4周,测定其泪膜破裂时间、泪液分泌量、角膜染色、结膜杯状细胞数量等情况。结果：1.观察到治疗组患者在自觉症状、泪膜破裂时间、泪液分泌及角膜荧光染色、杯状细胞数量及等级方面具有较为明显的改善,均具有统计学意义(p0.05)。对照组对于自觉症状、角膜荧光染色、杯状细胞数量之方面有改善作用,具有统计学意义(p0.05),而在泪液分泌、泪膜破裂时间、杯状细胞之等级方面虽有所改善,但不具有统计学意义(p0.05)。治疗后将治疗组及对照组在自觉症状、泪膜破裂时间、泪液分泌、角膜荧光染色、杯状细胞数量及等级方面进行比较,有所改善且具有统计学意义(p0.05)。2.造模后B、C、D、 E、F五组在泪液分泌、泪膜破裂时间、杯状细胞数量方面均有明显下降,角膜荧光染色具有明显增加,与造模前有差异(p0.05),A组与造模前无明显改变,无统计学意义(p0.05)。治疗后E、F组在泪液分泌、泪膜破裂时间、杯状细胞数量方面均有明显改善,具有统计学意义。D组在泪膜破裂时间有所延长,角膜荧光染色分数有所下降,具有统计学意义(p0.05),而在泪液分泌及杯状细胞数量方面虽有所增加,但不具有统计学意义(p0.05)。A、B、C组在治疗后与造模后有所改变,不具有统计学意义(p0.05)。结论：逍生散颗粒剂可明显改善患者的自觉症状,同时增加泪液分泌量,延长泪膜破裂时间,提高泪膜稳定性,减少杯状细胞凋亡,减轻眼表损伤等作用。作用机制可能通过免疫调节,降低或抑制炎性反应强度,减少促炎细胞因子释放,防止杯状细胞之凋亡以发挥其药理作用,从而达到治疗干眼之目的.
[Abstract]:Objective: to evaluate the clinical efficacy of Xiao Sheng San granule by observing the conscious symptoms, tear film rupture time, tear secretion, corneal fluorescein sodium staining and conjunctival imprinting cytology before and after treatment. To study the effect of goblet cells on the goblet cells, and further combine animal models for further verification and discussion. Method 1: 1. Thirty patients (60 eyes) with dry eye according to the inclusion criteria were randomly divided into two groups. Group A was treated with sodium hyaluronate eye drops and group B was treated with Xiao Sheng San granules. Sodium hyaluronate eye drops are produced by Japan Shentian Co., Ltd., one drop at a time, three times a day. The main ingredients of Xiao Sheng San are: Bupleurum, Radix Paeoniae Alba, Angelica sinensis, Codonopsis pilosula, Schisandra chinensis, Ophiopogon. Take a bag twice a day with warm water. The conscious symptoms, tear secretion, lacrimal film rupture time, fluorescein sodium staining, conjunctival blotting cytology were observed and recorded before and after treatment. 2. 180 healthy C57BL/6 mice were randomly divided into 6 groups: normal control, model control, normal saline, low dose drug, middle dose drug and high dose drug group. A dry eye model was established by subcutaneous injection of scopolamine hydrobromide into the roots of the hind limbs of mice. The time of lacrimal film rupture, the amount of tear secretion, corneal staining and the number of conjunctival goblet cells were measured at the first week, the second week, the third week and the fourth week after the establishment of the model. Results: 1. It was observed that the patients in the treatment group had significant improvement in conscious symptoms, tear film rupture time, tear secretion and corneal fluorescence staining, the number and grade of goblet cells (p0.05). In the control group, the symptoms, corneal fluorescence staining and the number of goblet cells were significantly improved (p0.05), while the tear secretion, tear film rupture time, and the grade of goblet cells were improved. But not statistically significant (p0.05). After treatment, the treatment group and the control group in the conscious symptoms, tear film rupture time, tear secretion, corneal fluorescence staining, the number and grade of goblet cells were improved, with statistical significance (p0.05). 2. The tear secretion, tear film rupture time and the number of goblet cells were significantly decreased, and the corneal fluorescence staining was significantly increased (p0.05). There was no significant difference between group A and model (p 0.05). After treatment, the tear secretion, tear film rupture time and the number of goblet cells were significantly improved in group D. Group D prolonged the time of tear film rupture and decreased the fluorescent staining fraction of cornea. There was statistical significance (p0.05), but there was no significant difference in tear secretion and goblet cell count (p0.05). There was no statistical significance (p0.05). Conclusion: Xiao Sheng San granule can obviously improve the conscious symptoms, increase the amount of tear secretion, prolong the time of tear film rupture, improve the stability of tear film, reduce the apoptosis of goblet cells and alleviate the injury of ocular surface. The mechanism may be through immune regulation, reduce or inhibit the intensity of inflammatory response, reduce the release of pro-inflammatory cytokines, prevent goblet cell apoptosis to play its pharmacological role, so as to achieve the purpose of treating dry eye.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R276.7
本文编号：2349158
[Abstract]:Objective: to evaluate the clinical efficacy of Xiao Sheng San granule by observing the conscious symptoms, tear film rupture time, tear secretion, corneal fluorescein sodium staining and conjunctival imprinting cytology before and after treatment. To study the effect of goblet cells on the goblet cells, and further combine animal models for further verification and discussion. Method 1: 1. Thirty patients (60 eyes) with dry eye according to the inclusion criteria were randomly divided into two groups. Group A was treated with sodium hyaluronate eye drops and group B was treated with Xiao Sheng San granules. Sodium hyaluronate eye drops are produced by Japan Shentian Co., Ltd., one drop at a time, three times a day. The main ingredients of Xiao Sheng San are: Bupleurum, Radix Paeoniae Alba, Angelica sinensis, Codonopsis pilosula, Schisandra chinensis, Ophiopogon. Take a bag twice a day with warm water. The conscious symptoms, tear secretion, lacrimal film rupture time, fluorescein sodium staining, conjunctival blotting cytology were observed and recorded before and after treatment. 2. 180 healthy C57BL/6 mice were randomly divided into 6 groups: normal control, model control, normal saline, low dose drug, middle dose drug and high dose drug group. A dry eye model was established by subcutaneous injection of scopolamine hydrobromide into the roots of the hind limbs of mice. The time of lacrimal film rupture, the amount of tear secretion, corneal staining and the number of conjunctival goblet cells were measured at the first week, the second week, the third week and the fourth week after the establishment of the model. Results: 1. It was observed that the patients in the treatment group had significant improvement in conscious symptoms, tear film rupture time, tear secretion and corneal fluorescence staining, the number and grade of goblet cells (p0.05). In the control group, the symptoms, corneal fluorescence staining and the number of goblet cells were significantly improved (p0.05), while the tear secretion, tear film rupture time, and the grade of goblet cells were improved. But not statistically significant (p0.05). After treatment, the treatment group and the control group in the conscious symptoms, tear film rupture time, tear secretion, corneal fluorescence staining, the number and grade of goblet cells were improved, with statistical significance (p0.05). 2. The tear secretion, tear film rupture time and the number of goblet cells were significantly decreased, and the corneal fluorescence staining was significantly increased (p0.05). There was no significant difference between group A and model (p 0.05). After treatment, the tear secretion, tear film rupture time and the number of goblet cells were significantly improved in group D. Group D prolonged the time of tear film rupture and decreased the fluorescent staining fraction of cornea. There was statistical significance (p0.05), but there was no significant difference in tear secretion and goblet cell count (p0.05). There was no statistical significance (p0.05). Conclusion: Xiao Sheng San granule can obviously improve the conscious symptoms, increase the amount of tear secretion, prolong the time of tear film rupture, improve the stability of tear film, reduce the apoptosis of goblet cells and alleviate the injury of ocular surface. The mechanism may be through immune regulation, reduce or inhibit the intensity of inflammatory response, reduce the release of pro-inflammatory cytokines, prevent goblet cell apoptosis to play its pharmacological role, so as to achieve the purpose of treating dry eye.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R276.7
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