Clinical Efficacy and Mechanism of Modified Yihuo Qinggan Tuiyi Tang in Treating Herpes Simplex Keratitis with Liver Meridian and Wind-heat / 中国实验方剂学杂志

ABSTRACT

Objective:To observe the clinical efficacy of modified Yihuo Qnggan Tuiyi Tang on herpes simplex keratitis with liver meridian and wind-heat，so as to explore its mechanism of action. Method:Totally 130 patients with herpes simplex keratitis with liver meridian and wind-heat were randomly divided into control group and observation group，with 65 cases in each group. The control group was treated with conventional western medicine，while the observation group was treated with modified Yihuo Qinggan Tuiyi Tang in addition to the therapy of the control group for 4 weeks. The clinical efficacy，traditional Chinese medicine（TCM） syndrome score，symptoms and signs，adverse reactions and recurrence rate of the two groups were compared. The levels of serum interferon gamma（IFN-γ），interleukin-6（IL-6），interleukin-8（IL-8） inflammatory factors，malondialdehyde (MDA)，antioxidant activity (TAC)，glutathione peroxidase（GSH-PX）of oxidative stress indexes were detected by enzyme linked immunosorbent assay （ELISA）. The levels of CD4+ and CD8+ were measured by flow cytometry. The recurrence rate was observed during 1-year follow-up visit. Result:The total effective rate of observation group was better than that of control group (Z=2.161，P<0.05). After treatment，the scores of eye pain，shame，photophobia，tears，vision loss，redness and total eyelid swelling were significantly lower than those of control group (P<0.05). The total effective rate of TCM syndrome in the observation group was better than that of control group (Z=2.540，P<0.05). After treatment，the scores of pain，eyelid redness，conjunctival congestion，corneal punctate pannus，corneal pannus and corneal pannus depth of symptoms and signs in observation group were better than those of control group (P<0.05). The level of serum IFN-γ in observation group was higher than that of control group，and the levels of IL-6 and IL-8 were lower than those of control group (P<0.05). Levels of MDA in the observation group was higher than that of control group (P<0.05). The levels of CD4+and CD4+/CD8+ in observation group were higher than those of control group，and the levels of CD8+ were lower than that of control group (P<0.05). The recurrence rate in observation group was significantly lower than that in control group after withdrawal for 6 months and 12 months (P<0.05). Conclusion:In addition to the therapy of routine western medicine， modified Yihuo Qinggan Tuiyi Tang has a good clinical efficacy in treating herpes simplex keratitis with liver meridian and wind-heat，and can reduce the scores of TCM syndromes，alleviate symptoms and signs，and reduce the recurrence rate. Its mechanism may be related to reducing inflammation reaction，and improving oxidative stress index and immune function.