Study On The Distribution Of Syndrome Factors And Levels Of Inflammatory Factors In Depressive Dry Ey

Objective: To explore the TCM syndrome characteristics,syndrome differentiation,syndrome element distribution and combination law of depressive dry eye,and explore the levels of inflammatory factors(IL-1β,6,17,TLR4/My D88,etc.)of the disease,so as to provide theoretical basis for TCM syndrome differentiation and clinical diagnosis and treatment of the disease.Methods :(1)Patients diagnosed with depression combined with dry eye were collected from the Depression Clinic of Hunan Brain Hospital,the Ophthalmology Clinic of the First Affiliated Hospital of Hunan University of Chinese Medicine,the Department of Neurology and the Ophthalmology Clinic of Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 2022 to October 2022.Clinical information and TCM symptom information were collected by questionnaire survey.Extraction of forensics by "simple syndrome extraction method";(2)The tears of 70 patients(149 eyes)in the outpatient department of the above hospital were collected,including 18 patients with depressive dry eye,18 patients with simple dry eye,18 patients with simple depression,and 16 healthy controls.The levels of tear IL-1β,IL-6,IL-17,TLR4 and My D88 were detected by CBAfluidic microsphere array method.(3)32 male C57 mice were randomly divided into 4 groups: The levels of IL-1β,IL-6,IL-17,TLR4 and My D88 in the hippocampus of mice in depression model group,dry eye model group,depressive dry eye model group and blank group were determined by chronic mild unpredictability stress method(CUMS method)and benzalchloramine eye drop method.Results :1.The NIBUT of depressive dry eye was shorter than that of simple dry eye group and the difference was statistically significant(P< 0.05).2.The top 10 high-frequency syndromes of depressive dry eye are: Dry eyes(79.75%)related to emotion(75.21%),emotional depression or worry withdrawal(69.42%),decreased vitality decreased activity(59.09%),insomnia(50.83%),tiredness(44.21%),red eyes(42.56%),upset(42.56%),Sadness depression(40.08%),decreased interest(35.12%).3.Tongue and pulse of depressive dry eyes: the frequency of moss deficiency was the highest accounting for 20.66%;Therewere96 cases(39.67%)with thin pulsechord.4.Liver,mind,spleen and kidney are the most common syndromes ofdepressive dryeye.5.The disease of depressive dry eye is always mixed with deficiency and excess and the most common syndromic elements are qi stagnation,Yin deficiency,Qideficiency and blood deficiency.6.The frequency of depressive dry eye syndrome from high to low is: syndrome of Qi stagnation >syndrome of Qi stagnation and blood stasis > Syndrome of phlegm and dampness > Syndrome of liver stagnation and spleen deficiency > Syndrome of liver stagnation and Yin deficiency > Syndrome of liver stagnation andheat = disorderof mind(deficiency of both heart andspleen).7.The expression of inflammatory factors IL-1β,IL-6 and IL-17 in tears in depressive dry eye group and simple dry eye group was higher than that in normal group,and the difference was statistically significant(P < 0.05).The expression of TLR4 and My D88 in tears of depressed dry eye group and simple dry eye group was higher than that of normal group,and the difference was statistically significant(P <0.05).8.The expression of inflammatory cytokines IL-1β,IL-6 and IL-17 in the hippocampus of depressed dry eyemodel micewas higher than that of normal mice,and the difference was statistically significant(P<0.05).The expression of TLR4 and My D88 in the hippocampus of depressive dry eye model mice was higher than that of normal mice and depression model mice,and the difference was statistically significant(P< 0.05).Conclusion:1.Depressive dry eye for patients with depression who have dry eyes.The common diseases are liver,heart,kidney and spleen.The nature of disease is always a mixture of deficiency and reality.Qi stagnation,yin deficiency,qi deficiency and blood deficiency are the most common.2.Core syndrome type of Dialectical classification include:Liver stagnation and qi stagnation syndrome,qi stagnation and blood stasis syndrome,phlegm dampness accumulation syndrome,liver depression and spleen deficiency syndrome,liver depression and yin deficiency syndrome,liver meridian stagnation and heat syndrome,heart and spleen deficiency syndrome,etc.3.Inflammatory factor IL-1β?Expression of IL-6 and IL-17 and TLR4/My D88 are highly expressed in the depressive dry eye group.Its pathogenesis may be related to TLR4/My D88 pathway up-regulate inflammatory factor IL-1β?IL-6?IL-17,etc.This study provides theoretical basis for clinical diagnosis and treatment of this disease.