调和肝脾法在抑郁型干眼治疗中的研究进展OA

Dry eye is a chronic disease,with a high incidence in today's society,usually accompanied by symptoms such as dry eyes,foreign body sensation,visual fatigue and other discomforts.Prolonged onset can significantly affect the mood and quality of life of patients.Studies show that there is an obvious bidirectional relationship between dry eye and depression,and the severity of the two is often positively correlated.Western medicine usually treats dry eye with local symptomatic treatments,such as artificial tears,anti-inflammatory eye drops,and other medications.Although it can temporarily relieve symptoms,it is difficult to fundamentally regulate systemic pathological links,and some antidepressants may aggravate dry eye symptoms due to anticholinergic effects.From the overall concept,traditional Chinese medicine(TCM)believes that dry eye can be attributed to the categories of"Baise Zheng"(白涩症)and"Shenshui Jiangku"(神水将枯),and its pathology is closely related to the dysfunction of the five organs and the abnormal distribution of body fluid.A large number of studies have pointed out that the common pathological basis of dry eye and depression is highly related to liver and spleen dysfunction.On this basis,this paper analyzes previous studies and concludes that the comorbidity basis of dry eye and depression lies in a complex physiological and pathological network,while the TCM theory of liver-spleen disharmony provides a highly concise interpretation of its core pathogenesis.The liver-spleen harmonizing therapy represented by classical formulas such as Sini San(四逆散),Xiaoyao San(逍遥散)and Chaihu Shugan San(柴胡疏肝散)exerts its effects through multiple targets and pathways.The bioactive components contained in these formulas(e.g.,saikosaponins,paeoniflorin,total flavonoids of licorice,etc.)can perform functions including anti-inflammation,antioxidation,neurotransmitter regulation,stabilization of the hypothalamic-pituitary-adrenal(HPA)axis,and neurotrophic promotion,thereby achieving simultaneous intervention in the comorbidity mechanisms of dry eye and depression.Its effect of soothing the liver,invigorating the spleen,and regulating Qi(气)activity is not only reflected in symptom improvement,but also serves as evidence for the modern scientific connotation of"treating different diseases with the same therapy".This paper demonstrates the scientificity and effectiveness of the liver-spleen harmonizing therapy in the treatment of depression-induced dry eye.However,it lacks high-quality clinical trial evidence with large sample sizes,multicenter participation,and long-term follow-up.Therefore,subsequent research should conduct more extensive clinical trials and further explore the mechanism of action of the eye-brain axis.