The Clinical Effect Of Laser Acupuncture In The Treatment Of Dry Eye By Regulating TLR4 Pathway

Objective:To observe the clinical effect of laser acupuncture in the treatment of dry eye,and to explore the modulation effect of laser acupuncture on TLR4 signaling pathway in dry eye.Methods:A total of 60 patients(120 eyes)with dry eyes were selected from the TCM ophthalmology clinic of Shanxi Eye Hospital from June 2019 to December 2019.They were randomly divided into laser acupuncture group and sodium hyaluronate eye drop group(control group),with 30 cases(60 eyes)in each group.Laser acupuncture group:laser acupuncture treatment(laser wavelength: 650 nm,output power: 5m W),20 min each time,once a day,one course of treatment for 10 days;Control group: Sodium hyaluronate eye drops on eyes,3 times a day,1-2 drops each time,10 days a course of treatment,both groups were treated for 3 courses.Subjective symptom score,lacrimal river height,tear film rupture time,corneal fluorencein staining,serum TLR4,My D88,NF-κB,NLRP3,NLRP6 expression levels were observed before and after treatment.Results:1.Subjective symptoms: Both treatment methods could improve the subjective symptoms of patients with dry eye,and the differences before and after treatment were statistically significant(all P < 0.05).There was no statistical significance in subjective symptom improvement between the laser acupuncture group and the control group(P>0.05).2.Height of lacrimal river: there was statistically significant difference in the height of lacrimal river between the two groups before and after treatment(P < 0.05).There was no statistical significance in the control group(P > 0.05).After treatment,the laser acupuncture group and the control group had statistical significance(P < 0.05).3.Tear film rupture time: The tear film rupture time of the two groups before and after treatment showed statistically significant difference in the laser acupuncture group(P <0.05);There was no statistical significance in the control group(P > 0.05).There was statistically significant difference between the two groups after treatment(P < 0.05).4.Corneal luciferin staining: The corneal luciferin staining scores in both groups were lower after treatment than before treatment,with statistical significance(P < 0.05).There was no significant difference in the improvement of corneal fluorescein staining between the laser acupuncture group and the control group after treatment(P > 0.05).5.Comparison of serum TLR4,My D88,NF-κB,NLRP3 and NLRP6 expression levels: There was no statistical significance in serum TLR4,My D88 and NF-κB expression levels of laser acupuncture group before and after treatment(P > 0.05).NLRP3 and NLRP6 were statistically significant(P < 0.05).The expression levels of TLR4,My D88,NF-κB,NLRP3 and NLRP6 in serum of control group were not significantly different before and after treatment(P > 0.05).After treatment,the expression levels of NLRP3 and NLRP6 in 2 groups were significantly different(P < 0.05).6.Clinical efficacy: In the laser acupuncture group,after treatment,the apparent efficiency was 16.67%,the effective rate was 61.67%,and the total effective rate was78.33%.In the sodium hyaluronate eye drops group,the effective rate was 13.33%,45.00% and 58.33%.The difference between the two groups was statistically significant(P< 0.05),and the clinical effect of laser acupuncture on dry eye was better than that of the control group.Conclusion:Laser acupuncture can improve the subjective symptoms of patients with dry eyes,increase the height of lacrimal river,prolong the mean tear film rupture time,repair the damage of corneal epithelium,and improve the expression levels of serum NLRP3 and NLRP6.Laser acupuncture of dry eye clinical efficacy is better than the control group,but laser acupuncture in the treatment of parameters and instrument design still need a lot of optimization and adjustment,its mechanism also needs to be further explored.It is believed that through continuous optimization,laser acupuncture will have broad application prospects.