Clinical Study And Mechanism Of Shaoyao Gancao Decoction In Treating Accommodative Spasm

Object:To study the clinical effect of Shaoyao Gancao Decoction on the accommodative spasm,and evaluate the clinical efficacy of SYGC in the treatment of ocular accommodative spasm;and the guinea pig accommodative spasm model SYGC gavage therapy was used to explore the mechanism of action of SYGC in the treatment of accommodative spasm.Methods:The first part of clinical research:60 patients?120 eyes?with ocular accommodative spasm were randomly divided into the treatment group?conventional western medicine+SYGC?and the control group?conventional western medicine+Chinese medicine placebo?,and the changes of accommodative amplitude,accommodative response,accommodative sensitivity,positive and negative relative accommodative,anterior chamber depth and subjective symptom scores were observed before and 4 weeks after treatment.The second part of experimental research:?1?The guinea pig accommodative spasm model was established with carbachol eye drops,and was observed by Retinoscopy and light microscopy.?2?The low,medium and high concentration SYGC gavage model was used for 4 weeks,and the model refraction and He slice were observed regularly.The third part of experimental research.?1?The Ca²⁺concentration in different groups of ciliary muscle tissues was detected by Ca²⁺kit.?2?The IP₃ content in different groups of ciliary muscle tissues was detected by ELISA.?3?The expressions of IP₃R and Ryanodine R in different groups of ciliary muscles were detected by Western-blot and RT-PCR.The effects of SYGC on the receptor-G protein-PLC-IP₃-Ca²⁺and CICR calcium release pathway were studied.Results:The first part of clinical research:the study found that the conventional Western medicine treatment+SYGC treatment group was better than the control group in improving the subjective symptoms,deepening the anterior chamber depth,increasing the eye adjustment amplitude and negative relative adjustment index,but the two groups adjustment response,the adjustment sensitivity and the positive relative adjustment had no difference.The second part of experimental research:?1?By the method of carbachol eye drops,a guinea pig accommodative spasm model was successfully established and was observed by retinoscopy and light microscopy.?2?Guinea pig model SYGC gavage refraction and section observation:SYGC improved the myopia tendency of the model,the high concentration SYGC gavage model section observation,ciliary muscle myofilament arrangement loose,close to the normal group.?3?The expressions of Ca²⁺,IP₃,IP₃R and Ryanodine R in the Chinese medicine group were lower than those in the model group,and the down-regulation in the high-concentration Chinese medicine group was more obvious.Conclusion:Shaoyao Gancao decoction has a definite curative effect on ocular accommodative apasm.SYGC possibly inhibits activation of the receptor-G protein-PLC-IP₃-Ca²⁺and CICR pathway to regulate down the expression of Ca²⁺and to realize the therapeutic effect.