基于“柔肝”理论探讨清火柔肝方对实验性自身免疫性葡萄膜炎作用机制研究

Uveitis is a kind of common recurrent blinding eye disease. As a leader of uveitis collaboration group approved by the state administration of traditional Chinese medicine, we have carried out the uveitis diagnosis and treatment plan with a TCM approach. "Qinghuo Rougan” therapy was applied in the course of treating uveitis, and curative effect and obvious advantages have been confirmed by clinical practice. Our previous study has also showed that Th1, Th17 and NKT cells play an important role in experimental autoimmune uveitis (EAU). Based on the predecessors' therapy and "Qinggan Xiehuo" practice as well as the theory of "liver being unyielding organ, Yin nature and Yang function, which should be treated softly” and “liver opening at eye",the present study will carry out the investigations on the mechanism of "Qinghuo Rougan formula" acting on EAU. This project proposes to set up an EAU model and a tEAU model, performs multi-levels intervention study on uveitis followed by theory of "Qinggan Xiehuo, Qinghuo Rougan and Rougan". Using molecular biology and immunological techniques, we detect the proliferation and differentiation of Th1, Th17 and NKT, explore the changes of content and expression of IL-17, IL-4, IFN-γ, NKT in peripheral blood, lymph nodes, retina, aqueous humor, liver and spleen. Taken together, the present project will investigate the incidence and the curative effect of "Qinghuo Rougan formula" on uveitis, laying a theoretical foundation for the clinical application of this formula, initiating a new therapeutic method with TCM for treatment of uveitis.

葡萄膜炎是一类常见反复发作的致盲眼病。我院作为国家中管局葡萄膜炎协作组组长单位，主持制定了全国中医葡萄膜炎的诊疗方案，“清火柔肝”治法贯穿始终，实践证明疗效确切、优势明显，成为国家中管局第一批中医优势病种。我们前期研究表明：Th1、Th17、NKT在实验性自身免疫性葡萄膜炎（EAU）发病中作用明确。本研究在继承前人“清肝泻火”治法及研究基础上，基于“肝为刚脏，体阴而用阳，必柔以济之及肝开窍于目”的理论，探讨我院“清火柔肝方”对EAU作用机制。本课题拟建立EAU模型及tEAU模型，进行“清肝泻火、清火柔肝、柔肝”多层次干预研究，采用分子生物学、免疫学等技术检测Th1、Th17、NKT的增殖、分化，大鼠外周血、淋巴节、视网膜组织、房水、肝脏、脾脏中IL-17、IL-4、IFN-γ、NKT含量及表达变化，观察发病情况及疗效，为该方的临床应用奠定理论基础，为中医药治疗葡萄膜炎开创新治法。