针刺对干眼症患者泪液黏蛋白5AC表达的影响

目的 观察针刺治疗干眼症的疗效及对泪液黏蛋白(Mucin,MUC)5AC表达的影响.方法 50例(100只眼)干眼症患者采用针刺局部和远端相结合的方法,取穴睛明、攒竹、太阳、四白等,治疗前后观察患者干眼症状,并行泪液分泌试验(Schirmer Ⅰ test,Sit)、泪膜破裂时间(tear break-up time,BUT)检查,免疫组化方法检测泪液黏蛋白5AC的表达量.结果 泪液分泌量(mrn/5 min):治疗前5.2±2.6,治疗后7.3±2.1 (t=2.71,P=0.03).泪膜破裂时间(s):治疗前3.7±1.4,治疗后6.9±3.8(t=2.59,P=0.04).泪液黏蛋白5AC表达量(μg/ml):治疗前0.77±0.13,治疗后0.99±0.11 (t=1.98,P=0.05).临床疗效:显效43只眼,有效46只眼,无效11只眼,总有效率为89％.结论 针刺治疗可以促进泪液黏蛋白5AC的表达,提高泪膜稳定性,明显改善干眼症状.

Effect of acupuncture on expression of tear mucins5AC of dry eyes

OBJECTIVE To observe the efficacy of acupuncture treatment on tears mucin5AC expression in patients with dry eyes.METHODS Fifty patients(100 eyes) with dry eyes received acupuncture treatment on Jingming(BL1),Cuanzhu(BL2),Taiyang(EX-HN 5) and Quchi(LI 11).Before and after treatment,tear secretion volume(Schirmer I test),break up time(BUT) were observed.The expression of MUC5AC was detected by immunity histological chemistry.RESULTS The total effective rate was 89%(89/100) with acupuncture treatment.There was a significant difference in statistics in tear secretion volume(mm/5 min) 5.2±2.6 and 7.3±2.1(t=2.71,P=0.03),BUT(s)3.7±1.4 and 6.9±3.8(t=2.59,P=0.04) and MUC(μg/ml) 0.77±0.13 and 0.99±0.11(t=1.98,P=0.05) in tears before and after treatment.CONCLUSIONS Acupuncture apparently relieved the symptoms of dry eyes.Up regulation of the expression of tear Mucins5AC may be one of the underlying mechanisms.