针刺对干眼症患者泪液黏蛋白5AC表达的影响

Effect of acupuncture on expression of tear mucins5AC of dry eyes

目的观察针刺治疗干眼症的疗效及对泪液黏蛋白(Mucin,MUC)5AC表达的影响。方法 50例(100只眼)干眼症患者采用针刺局部和远端相结合的方法,取穴睛明、攒竹、太阳、四白等,治疗前后观察患者干眼症状,并行泪液分泌试验(Schirmer I test,SIt)、泪膜破裂时间(tear break-up time,BUT)检查,免疫组化方法检测泪液黏蛋白5AC的表达量。结果泪液分泌量(mm/5 min):治疗前5.2±2.6,治疗后7.3±2.1(t=2.71,P=0.03)。泪膜破裂时间(s):治疗前3.7±1.4,治疗后6.9±3.8(t=2.59,P=0.04)。泪液黏蛋白5AC表达量(μg/ml):治疗前0.77±0.13,治疗后0.99±0.11(t=1.98,P=0.05)。临床疗效:显效43只眼,有效46只眼,无效11只眼,总有效率为89%。结论针刺治疗可以促进泪液黏蛋白5AC的表达,提高泪膜稳定性,明显改善干眼症状。

OBJECTIVE To observe the efficacy of acupuncture treatment on tears mucin5AC expression in patients with dry eyes.METHODS Fifty patients（100 eyes） with dry eyes received acupuncture treatment on Jingming（BL1）,Cuanzhu（BL2）,Taiyang（EX-HN 5） and Quchi（LI 11）.Before and after treatment,tear secretion volume（Schirmer I test）,break up time（BUT） were observed.The expression of MUC5AC was detected by immunity histological chemistry.RESULTS The total effective rate was 89%（89/100） with acupuncture treatment.There was a significant difference in statistics in tear secretion volume（mm/5 min） 5.2±2.6 and 7.3±2.1（t=2.71,P=0.03）,BUT（s）3.7±1.4 and 6.9±3.8（t=2.59,P=0.04） and MUC（μg/ml） 0.77±0.13 and 0.99±0.11（t=1.98,P=0.05） in tears before and after treatment.CONCLUSIONS Acupuncture apparently relieved the symptoms of dry eyes.Up regulation of the expression of tear Mucins5AC may be one of the underlying mechanisms.