| Objective: To assess the clinical effect of Dendrobium nobile Lindl for treating diabetic retinopathy with dry eye,preliminarily explor it may involve an anti-inflammatory mechanism.Methods: This study was designed as a prospective study.The 38 patients with diabetic retinopathy were recruited from the Department of Ophthalmology,Affiliated Hospital of Zunyi medical university between August 2020 and December 2021.These people were divided into two groups: 20 dry eye patients(40eyes)in Group A and 18 non-dry eye patients(36eyes)in Group B.Based on whether the patients were taking Dendrobium nobile Lindl,the Dendrobium nobile Lindl intervention group was formed.The 14 patients were given Dendrobium nobile Lindl(dry powder)2g Bid PO for 8 weeks.All patients underwent an FFA examination,fundus color photography,and an OCT examination at enrollment,to clarify the stage of diabetic retinopathy,exclude macular edema and other retinal diseases.Serum IL-1β,IL-6,MMP-9,VEGF,and ICAM-1 level determined by ELISA in group A and group B,and detected the inflammatory factors in serum before and after Dendrobium nobile Lindl intervention.Comparison of serum VEGF and IL-1β concentrations before the treatment of Dendrobium nobile Lindl in group A and group B and the levels of inflammatory factors in serum were compared before and after Dendrobium nobile Lindl intervention.Differences in the symptoms of dry eyes(OSDI score),the height of the tear river,the corneal fluorescein staining scores,NIBUT and SchirmerⅠtest before and after treatment were compared using the Wilcoxon rank-sum test.Results: Baseline levels in Group A and Group B: the gender,age,and course of diabetes were not statistically different(P>0.05).The inflammatory factors in the serum from group A and B patients were detected at entry,in group A,serum IL-1β concentrations were 0.67(0.48,0.97)pg/ml,ICAM-1 concentration was 112.25±9.98 ng/ml and IL-6 concentrations was 15.96±2.58 pg/ml,in group B,serum IL-1β concentrations were 0.13(0.50,0.98)pg/ml,ICAM-1 concentration was 110.64±8.22 ng/ml and IL-6 concentrations was 14.8±1.55 pg/ml,no statistical difference(P < 0.05)was detected between group A and group B for 3 inflammatory factors.The concentrations of VEGF and MMP-9 from group A and B,in group A,serum VE GF concentrations was 76.99(47.87,190.42)pg/ml and MMP-9 concentrations were 631.05±176.28 ng/ml,in group B,serum VEGF concentrations were 30.36(9.40,40.16)pg/ml and MMP-9 concentrations were 444.22±85.99 ng/ml,a statistically significant difference was found between Group A and Group B(P< 0.05).Dendrobium nobile Lindl intervention group show that NIBUT was 9.35(6.20,13.90)S,SchirmerⅠtest was 10.00(7.00,14.50)mm,OSDI score was 13(10,21.75)points and the score of corneal fluorescein staining was 2.00(0.00,5.00)points after eight weeks post‐inter vention,all tests were showed clinical improvement after the intervention compared with before the intervention and the difference was statistically significant(all P< 0.05).The height of the tear river of the Dendrobium nobile Lindl intervention group before and after the intervention was 0.25(0.14,0.31)mm and 0.33(0.21,0.42)mm,respectively,the percentage of partial glands was 34.25(27.83,37.65)%、30.80(26.95,37.88)%,P > 0.05 was considered to be an insignificant difference.To observe the changes in serum inflammatory factors in the Dendrobium nobile Lindl intervention group before and after treatment,the VEGF level was 86.08(50.90,188.34)p g/ml,ICAM-1 level was 112.95±8.70 ng/ml,IL-6 level was 16.25±2.38 pg/ml and MMP-9 level was 646.14±191.04 ng/ml before treatment.The VEGF level was 47.64(34.71,60.26)pg/ml,ICAM-1 level was 83.87±5.26ng/ml,IL-6 level was 9.04±0.81 pg/ml and MMP-9 level was 386.19±56.01 ng/ml after treatment,the difference is statistically significant(P < 0.05).Conclusion:(1)Improvement in the signs and symptoms to some of the patients of diabetic dry eye with Dendrobium nobile Lindl.(2)Increased VEGF and MMP-9 levels in serum might be related to the occurrence of diabetic dry eye.(3)Dendrobium nobile Lindl(dry powder)was found anti-inflammatory and anti-VEGF effects could significantly decrease serum levels of MMP-9,IL-6,VEGF,and ICAM-1. |
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