干眼症的发病机制及中医药治疗研究进展

Pathogenesis of Dry Eye and Research Progress of Traditional Chinese Medicine Treatment

近些年来,干眼症的发病率呈逐年上升的趋势,已经成为最普遍的眼科疾病之一。干眼症的症状主要为眼部的干涩感、异物感、灼热感、经常会伴随眼部有黏稠分泌物,由于睡眠质量差,用眼过度而加重,严重者甚至会影响视力和正常生活。干眼症的发病机制较为复杂,包括泪膜的不稳定性以及泪膜渗透压的增高,性激素水平的异常,眼部神经调节的异常,但是最近国内外将干眼症的发病机制研究热点放在了眼表炎症及眼表细胞的凋亡等方面,并且发现多种干眼症相关的炎症因子如白细胞介素、表皮细胞因子、肿瘤坏死因子、细胞间黏附分子等,还研究了多种干眼症相关的细胞凋亡因子如凋亡因子Bax、Fas和Fas L等。研究干眼症的发病机制可以更加明确干眼症的发病原因,对于临床上干眼症的检查,分类及治疗方法的选择都有很大的益处,且效果会更加明显,能更大程度地减轻干眼症患者的痛苦。现阶段干眼症的治疗方法多为人工泪液替代疗法和免疫抑制剂如0. 01%环孢素A,都只能改善眼表的症状,且刺激性很强,不易长时间使用。我国利用中医药治疗干眼症具有悠久的历史,而且效果比较明显,对于干眼症的全身症状也能有改善作用。其中包括单位中药的提取物治疗干眼症,古方加减治疗干眼症,辅助针灸、熏蒸、艾灸、雷火灸的方法治疗干眼症。因此,用中医的治疗方法来辅助治疗,实现中西医结合治疗干眼症,往往可以取得更好的疗效。本文就近些年来对干眼症的发病机制研究,以及中医药治疗干眼症的研究进展进行综述。

In recent years,the incidence of dry eye disease is increasing year by year,and it has become one of the most common ophthalmic diseases. The main symptoms of dry eye disease are dry,foreign body sensation,burning in eyes,and often accompanied by viscous secretion. Because of poor sleep quality and excessive use of eyes,it will aggravate and even affect the vision and normal life. The pathogenesisis complex,including the instability of tear film,the increase of tear film osmolality,the abnormality of sex hormone level and the abnormality of ocular nerve regulation. But recently,the research focus of the pathogenesis has been focused on the inflammation of ocular surface and the apoptosis of ocular surface cells,and many kinds of inflammation factors and intercellular adhesion molecules were also studied. Apoptosis factors such as Bax,Fas and Fas L were also studied. The study of the pathogenesis can make the cause of dry eye more clear. It is of great benefit to the examination,classification and treatment of dry eye in clinic,and the effect will be more obvious,which can reduce the pain of patients with dry eye to a greater extent. At present,most of the treatment methods of dry eye disease are artificial tear replacement therapy and immunosuppressant,such as 0. 01% cyclosporine A,which can only improve the symptoms of the ocular surface,and 0.01% cyclosporine A is highly irritant to the ocular surface. Dry eye patients are not easy to accept it for a long time. There is a long history of using traditional Chinese medicine to treat dry eye in China,and the effect is quite obvious,which also can improve the systemic symptoms of dry eye. It includes the extract of traditional Chinese medicine,the treatment with modified ancient prescriptionsand acupuncture,fumigation,moxibustion and thunder fire moxibustion. Therefore,the use of traditional Chinese medicine to assist the treatment of dry eye as well as the combination of Chinese and Western medicineoften can achieve better results. In this paper,the pathogenesis of dry eye in recent yearsas well as the research progress of traditional Chinese medicine treatment was reviewed.