Clinical Observation And Mechanism Of Eye-moisturizing Needling Method In The Treatment Of Dry Eye

Objective To observe the clinical therapeutic effect and safety of eye-moisturizing needling method on DE(Dry Eye)by clinical study,so as to provide safer and more effective treatment options for the clinic;to observe the effect of acupuncture on the expression of transforming growth factor-?1(TGF-?1)and interleukin-6(IL-6)in lacrimal gland of rabbits with DE and explore the mechanism of acupuncture on DE by experimental study.Methods Clinical research:A total of 60 patients with DE were randomized into control group and experimental group by random number table,30 cases in each one.In the control group,Beiran eye drops were administered,1 drop each time,3 times a day for 4 weeks;in the experimental group,Eye-moisturizing needling method was applied at Xinming I,Jingming(BL 1),Cuanzhu(BL 2),Taiyang(EX-HN 5),Sizhukong(TE 23),Tongziliao(GB 1),once every other day,3 times a week for 4 weeks,a total of 12.Then,the total scores of dry eye symptom,VAS,BUT,SIT,CFS,and the clinical efficacy differences were observed before and after the treatment and the side-effects were recorded in the 2 groups.Experimental research:Healthy purebred male New Zealand rabbits were randomized into blank group,model group,Fumilong group,acupuncture group and sham acupuncture group,6 rabbits in each one.DE model was established by subcutaneous injection of scopolamine hydrobromid.After modeling,the Fumilong group was treated with Fumilong eye drops,one drop each time,3 times a day;the acupuncture group was treated with electroacupuncture at Cuanzhu(BL 2),Tongziliao(GB 1),and acupuncture at Jingming(BL 1),Sizhukong(TE 23),Taiyang(EX-HN 5),15 min per treatment,once a day;the sham acupuncture group was treated with blunt needle on the same acupoints,and the needles were not inserted into subcutaneous area avoiding deqi,once a day.All groups were treated for 2 weeks.Before and after treatment,SIT,BUT and morphology in lacrimal gland and corneal of rabbits in each group were observed;respectively using the Western blot method and real-time fluorescence quantitative PCR method,the expression of TGF-?1,IL-6 protein and mRNA in lacrimal gland of rabbits in each group were determined.Results Clinical research:There was no significant difference in statistics in the total scores of dry eye symptom,VAS,BUT,CFS and SIT between the two groups before treatment(P>0.05);compared before treatment,the total scores of dry eye symptom,BUT and SIT in two groups were significantly improved after treatment,the differences were significant(P<0.01);after treatment,the CFS in the control group was obviously improved(P<0.05),and the CFS in the experimental group was significantly improved(P<0.01);after treatment,the VAS score in the experimental group obviously declined,the differences were significant(P<0.01),while the VAS score in the control group suggested no significant reduction(P>0.05);compared between the two groups after treatment,the improvement in the integral of dry eye symptom,VAS,BUT and SIT in the experimental group is superior to the control group,the difference was statistically significant(P<0.05);while the difference of CFS in the two groups suggested no statistically significant(P>0.05).Comparison of overall efficacy:The total effective rate in the control group was 67.9%,while 0 case cured,5 cases strikingly effective,14 cases effective,9 cases resultless.And the total effective rate of the experimental group was 82.8%,while 0 case cured,15 cases strikingly effective,9 cases effective,5 cases resultless.The difference between efficacy was statistically significant(P>0.05).Experimental study:There was no significant difference in SIT,BUT before modeling(P>0.05);after modeling,the SIT and BUT of each group,in addition to the blank group,obviously declined(P<0.01).Compared before treatment,the SIT and BUT inclined after treatment in Fumilong and acupuncture groups(P<0.05),and the SIT and BUT were of no difference after treatment in model and sham acupuncture groups(P>0.05).Compared among groups after treatment,the SIT and BUT inclined in Fumilong and acupuncture groups(P<0.05),while the SIT and BUT were of no difference in model and sham acupuncture group(P>0.05).The light microscopy showed:In blank group,the rabbits corneal tissues consisted of epithelial cells with homogeneous matrix.In model and sham acupuncture groups,many an epithelial cells were shed from the surface of corneal tissues,the numbers of focal epithelial cells layers increased,cells were disordered,lymphocytes infiltration were found on interstitium of mucosa tissues;In Fumilong and acupuncture groups,few epithelial cells were shed from the surface of corneal tissues,and lymphocytes infiltration were observed.In the blank group,lacrimal gland columnar epithelial cells were uniform in size,rich in cytoplasm,and densely arranged.In the model and the sham acupuncture groups,the lacrimal epithelial cells atrophied,and lymphocytes and plasma cells infiltrated in the interstitial of the mucosal tissue.In the Fumilong and acupuncture groups,the cell structure of lacrimal epithelium was basically normal.lymphocytes and plasma cells infiltrated in the interstitial tissue of the mucosa.compared with blank group,the levels of TGF-?1,IL-6 protein and mRNA in lacrimal gland of rabbits were significantly higher in model and sham acupuncture groups(P<0.01);compared with the model group,the expression of TGF-?1,IL-6 protein in the lacrimal gland of Fumilong and acupuncture groups down-regulated significantly(P<0.01),and the levels of TGF-?1,IL-6 mRNA obviously declined(P<0.05).while the levels of TGF-?1,IL-6 protein and mRNA in lacrimal gland of rabbits were of no difference in statistics in acupuncture group(P>0.05).Conclusion Eye-moisturizing needling method and Beiran eye drops can improve symptom of patients with DE,prolong tear break-up time,and promote secretion of tears,but eye-moisturizing needling method is better in clinical therapeutic effects;in relieving the ocular pain of patients with DE,Eye-moisturizing needling method is effective,but Beiran eye drops are non-significant effect.Meanwhile,Eye-moisturizing needling method is safe in clinical application and has no obvious side-effects.Through the observation of cornea and lacrimal gland light microscopy,it is found that acupuncture can inhibit the cells apoptosis and inflammatory reaction of cornea and lacrimal gland tissues of rabbits with DE;the mechanism of acupuncture on DE may be related to its regulation on the expression of TGF-?1 and IL-6 in lacrimal gland.