| Purpose:By collecting ancient and modern literature and monograph of ophthalmology,it can concise Anterior Uveitis etiology and pathogenesis.The clinical treatments prove the clinical effect of the treatment of Qingreziyin and the animal experiments reveal its action mechanism.They provide the effective compound Chinese medicine to reduce or stop using glucocorticoid,in the clinical treatment of Anterior Uveitis.Material & Method:By collecting 64 chinese and foreign literature about Anterior Uveitis and 14 monograph of ophthalmology,it can concise Anterior Uveitis etiology and pathogenesis.Through the typical cases can verify the clinical effectiveness of the medicine of professor Li Zhengyu's years clinical summarize.The treatment is baesd on the principle of clearing heat?nourishing yin and activing blood and clinical treatment of Anterior Uveitis stage of differentiation of personalized principle.Twenty SPF female Lewis rats were randomly divided into the four groups:Group 1(Comparison Group): 5 rats by injection of complete Freund's adjuvant(CFA)Group2(Model Group): 5 rats by injection of complete Freund's adjuvant(CFA)& Interphotoreceptor Retinoid-Binding Protein(IRBP)Group3(TCM Group A): 5 rats by injection of complete Freund's adjuvant(CFA)& Interphotoreceptor Retinoid-Binding Protein(IRBP),feeding normal concentration of extract of traditional Chinese medicine after inflammationGroup4(TCM Group B): 5 rats by injection of complete Freund's adjuvant(CFA)& Interphotoreceptor Retinoid-Binding Protein(IRBP),feeding double concentration of extract of traditional Chinese medicine after inflammation.According to Experimental Autoimmune Anterior Uveitis modeling,grading inflammatory phases by way of iris photography estimation in the eyes of Lewis Rats.In addition,collecting peripheral blood respectively after different inflammation situations and feeding TCM,and then using ELISA kit to measure IL-17 in serum,in order to carry out treatment effect of traditional Chinese medicine through statistical data analysis.The major aim of using Lewis mouse to be animal models to induce Anterior Uveitis by the injection of Interphotoreceptor retinoid-binding protein(IRBP)is to induce the kind of uveitis which is idiopathic and produced by CD4+ T,it only attacks the choroid and iris,not to retina,similarly the same situation in human beings.What the difference is that the acute-phase inflammation will disappear within one month,but recur many times in human beings.Considering this important point,designing two models,Group 3 feeding normal concentration of extract of traditional Chinese medicine after inflammation and Group 4 feeding double concentration of extract of traditional Chinese medicine after inflammation based on Dr.Chen-yu Lee's prescription,in order to observe if it would reduce the inflammatory process due to higher concentration.This experimental TCM is composed of Mianyiguokangfang and Siwutang,based on Dr.Chen-yu Lee's prescription to cure the acute-phase of Anterior Uveitis that is diagnosed as Yurezheng,considering the iris belongs to Gan of Wulun.By way of making pictures record,through iris photography estimation and blood biochemical index to observe partial inflammation and whole-body inflammation respectively of test rats,since it doesn't attack retina and recur often to cause synechiae of iris,therefore it is not necessary to have the tissue section inspection.Results: 1.Literature Results:1.Literature ResearchFrom ancient Chinese medicine books and literature research,an eye disease name usually defined by its key feature,syndrome or description from patients,it's quite different from modern definition,especially key feature or syndrome in different durations.From traditional Chinese medicine books,regarding the anterior uveitis,you may get some terms including ‘Tongshenjinsiao',‘Tongzenganzuei',‘Huangyishangchon',‘Leitoufong',similar clinical symptoms with ‘Yunwuyijin',‘Shizhanhunmiao' and ‘Huhuo' disease.In addition,the same disease name could have different prescription in different dynasty,carefully Chinese medical diagnoses is needed,to prescribe specific personal Chinese medicine to meet one's own needs according to different duration and syndrome.Most autoimmune uveitis is clearly known that occur due to HLA gene involvement,such as spondylitis ankylosans,Behcet's disease,VKH syndrome,Juvenile rheumatoid arthritis,Fuchs heterochronic uveitis and Birdshot choroidopathy.Currently,Glucocorticoid,Immunomodulatory Therapy and Biological Agents are the three main treatments for anterior uveitis,as to Taiwan individuals' habit,patients usually take western medicines first,in the long run they may trigger severe side effects.On the basis of careful consideration with these side effects,traditional Chinse medicine can be composed with good flexibility,and increasing or decreasing in various Chinese medicines as needed to meet proper treatment to reduce patients' part western medicines or in a low dose and unwanted side effects caused by that.And thus,to be diagnosed properly and precisely to get the most benefit of TCM therapy,having the careful consultation is very important.2.From Dr.Chen-yu Lee's experienced research:In Dr.Chen-yu Lee's clinical cases,anterior uveitis can present with acute,chronic or recurrent attacks.Within duration of acute phase,using Ru-mo siwutang or Mienyiguokangfang,to lower inflammatoory situation and prevent from any damage to the eye structure.Within duration of recurrent phase,ESR,CRP and C-Cell are normal,using Digupiruan or Zhibuodihuangtang to improve blood system and kidney function.As to the duration of chronic phase,lasting to take TCM for 3~6 months to prevent from complication of Cataract or Glaucoma.3.Experimental Research:Experimental rats all can be induced Autoimmune Anterior Uveitis in Group 2(Model Group),Group 3(TCM Group A)& Group 4(TCM Group B)with little difference between groups(p>0.5).After feeding TCM,situations of both iris inflammation and IL-17 level in serum blood gettng better in Group 3(TCM Group A)& Group 4(TCM Group B)with specific difference than rats in Group 2(Model Group),(p>0.5).That is,feeding double concentration of extract of traditional Chinese medicine,apparently makes the treatment effect manifest,as to the inflammation level,serum levels of IL-17 increased sharply to the peak value a week earlier to the anterior eye segment.Conclusion: 1.In recent studies and literatures,traditional Chinese medicines show obvious therapy effects,but need to be diagnosed based on syndrome differentiation,to bring out personalized medicine and treatment.2.The Mianyiguokangfang treatment has a significant anti-inflammatory effect of Autoimmune Anterior Uveitis(AAU),the higher inflammatory marker the more efficacious treatment,aim to reduce dose of Glucocorticoids or stopping using any it.3.It's clear to see the theoretical basis and innovative ideas on Dr.Chen-yu Lee's experienced prescriptions,in his clinical cases,anterior uveitis can present with acute,chronic or recurrent attacks which is diagnosed by the patient's symptoms and blood inspection.It's very crucial for doctors to make precise diagnose to judge which duration it is and carry out proper treatment prescriptions.4.Referring to this animal test results,it shows the Mianyiguokangfang treatment stops the inflammatory development of IRIS is one of the treatment mechanisms to cure Autoimmune Anterior Uveitis.5.Referring to this animal test results,it also shows that the Mianyiguokangfang treatment reduces the IL-17 in serum,is another treatment mechanism to cure Autoimmune Anterior Uveitis.6.Referring to this animal test results,controlled and certain prescription drug dosage has a positive correlation with therapy effects.7.Referring to this animal test results,it shows that inflammatory factors in blood appear first than the iris,and thus it is highly necessary to make blood inspections in advance.For clinical recurrence in EAU patients,should regularly have blood inspection and properly start using medicine remedy before any Uveitis symptom appear. |
PDF Full Text Request