The Effect Of Granules Of Xiaoshengsan To Immune, Endocrine And Tear Film In Dry Eye

Objective:By observing the subjects before and after the treatment of symptoms, tear film breakup time(BUT), tear secretion, sodium fluorescein staining and tear film interferometry and measuring the change of sex hormones and cytokines in the tear, evaluated the clinic efficacy of Granules of xiaoshengsan,explored its impact on sex hormone levels and investigated its role of immune-mediated inflammatory in molecular level combined with the animal experiments to further validate and explore.Methods:1.15cases(30eyes) were randomly divided into two groups, Group A-control group: sodium hyaluronate eye drops,every time a drop four times a day; Group B-TCM group: granules of xiaoshengsan, the mainly composed of granules is chaihu, baishai, danggui,renshen, wuweizi, maidong, ect, every time a bag twice a day. Observed the symptoms score, tear film breakup time(BUT)and fluoresceinstaining(FL) respectively before treatment, after treatment, one week, two weeks, three weeks and four weeks after treatment, and measured the amount of tear secretion, tear film interferometry, sex hormones and the content of cytokines(IL-6, TNF-a) in tear before and after treatment.2.28New Zealand male rabbits were divided into four groups, Group A:sham operation; Group B:excision of the testis and epididymis; Group C:excision of the testis and epididymis+physiological saline lavage; Group D:excision of the testis and epididymis+granules of xiaoshengsan lavage.Determined BUT respectively before surgery, after surgery, one week, two weeks, three weeks and four weeks after treatment; measured SIT and FL before surgery and after treatment.Results:1.After treatment, Group B improved significantly in symptoms, BUT, FL, SIT(after anesthesia) and tear film interferometry, and had statistically significant differences(p <0.05).Group A only had good effects on symptoms and FL and had statistically significant difference(p<0.05). After treatment, the sex hormone of group B was all normal, while Group A had no difference. The content of IL-6and TNF-a of Group B in tear decreased significantly after treatment(P<0.05), while group A was not significantly different.2.The BUT and SIT of group B, C, D was significantly shorter after surgery comparing preoperative(p<0.01), while group A(sham operation group) was not significantly different (p>0.05).The BUT and SIT of Group D was lengthened in one month observation period and had a significant difference comparing postoperative while other three groups had no significant (p>0.05). The score of Group B, C and D exceeded zero after surgery.The score of Group D was improved after treatment, but had no significant difference comparing other three groups and which was before treatment(p>0.05).Conclusion:Granules of xiaoshengsan can relieve symptoms, increase the tear secretion, elevate tear film stability and reduce ocular surface damage. It also can improve the hormone disorder and reduce the content of IL-6and TNF-a in tear. Its mechanism may be mainly related to the regulation of sex hormone levels and intervention in inflammatory cytokines, reducing proinflammatory cytokine release, and preventing apoptosis of goblet cell.