专家述评
ENGLISH ABSTRACT
干眼新疗法:神经刺激促进自身泪液分泌
龚岚
王吴双
作者及单位信息
·
DOI: 10.3760/cma.j.cn115989-20231021-00147
Promoting tear production: neurostimulation for dry eye
Gong Lan
Wang Wushuang
Authors Info & Affiliations
Gong Lan
Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai 200031, China
Wang Wushuang
Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai 200031, China
·
DOI: 10.3760/cma.j.cn115989-20231021-00147
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摘要

干眼是一种常见的眼表疾病,通常由泪液分泌不足或质量不佳引起。干眼的治疗方法已有很多,但相当一部分患者治疗效果不理想,神经刺激疗法为这一难题带来了崭新的解决方案。神经刺激疗法的核心原理是通过刺激鼻部神经,借助鼻泪反射通路来促进泪液分泌。与传统干眼治疗方法相比,神经刺激疗法的独特之处在于能够促使人体自身天然泪液的分泌,而不是简单地进行成分的外源性补充。从理论上讲,这种方法有望更有效地恢复泪膜的稳定性。神经刺激促进泪液分泌是一种有前景的干眼治疗新选择,许多相关设计已成功转化,陆续完成临床试验、上市,并正在不断地改进。在实际临床应用中,神经刺激疗法能显著促进使用后即刻的泪液分泌,亦有文献报道了其长期应用能够改善干眼的症状及体征,在干眼治疗中具有很好的应用前景。建议广大眼科临床医师及研究者关注神经刺激疗法在干眼治疗中的应用和研究,未来的研究方向应更着重于探讨神经刺激疗法改善干眼症状和体征的长期作用,探索神经刺激疗法如何融入已有的干眼诊疗规范中,推广神经刺激疗法以造福更多的干眼患者。

干眼;疗法;泪液;神经刺激;泪腺功能单位;鼻泪反射
ABSTRACT

Dry eye syndrome is a common ocular surface disorder often caused by deficient or poor-quality tear production.There are numerous therapeutic approaches to address dry eye, however, there are quite a number of patients with unsatisfactory treatment results, and neurostimulation therapy has introduced an innovative solution to this challenge.This therapy involves stimulation of the nasal nerves to activate the lacrimal reflex pathway, thereby increasing tear secretion.Unlike traditional dry eye treatments, its unique capacity is to stimulate the natural production of tears, as opposed to simply supplementing tear components.Theoretically, this method may be more effective in restoring tear film stability.Neurostimulation is a promising alternative for the management of dry eye, with several designs successfully transitioning to commercialization after clinical trials.In clinical practice, neurostimulation can significantly promote immediate tear secretion after application.In addition, some studies have reported that long-term use of neurostimulation can relieve the symptoms and signs of dry eye in some research.Ophthalmologists and ophthalmic researchers are encouraged to pay attention to the application and investigation of neurostimulation therapy in dry eye management.Future research should focus on exploring the long-term effects of neurostimulation on dry eye symptoms and signs, how it can be integrated into existing dry eye treatment protocols, and promoting neurostimulation therapy to benefit more dry eye patients.

Dry eye syndromes;Therapeutics;Tears;Neurostimulation;Lacrimal functional unit;Nasolacrimal reflex
Gong Lan, Email: mocdef.9ab3138689710531
引用本文

龚岚,王吴双. 干眼新疗法:神经刺激促进自身泪液分泌[J]. 中华实验眼科杂志,2024,42(04):305-308.

DOI:10.3760/cma.j.cn115989-20231021-00147

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*以上评分为匿名评价
干眼是一种常见的慢性眼表疾病,其特征在于泪膜稳态失衡,并伴随多种眼部症状,严重影响患者的日常生活 [ 1 ]。近年来,随着屏幕终端设备的广泛应用等因素的影响,干眼的发病率逐年攀升。在此背景下,研究者们对干眼的认知不断提升,治疗方法愈加多元,但大多依然遵循着"缺水补水,缺油补油"的原则,例如基于强调补充脂质的睑板腺按摩以及强脉冲光治疗、基于强调补充水液的人工泪液点眼和泪道栓塞治疗,以及注重补充黏蛋白的地夸磷索钠滴眼液点眼治疗等 [ 2 ]。然而,鉴于干眼的多样性,相当一部分患者对于现有治疗方法的效果不满意,这使得探索全新机制的干眼治疗方法变得尤为紧迫和重要。近年来,神经刺激在干眼治疗领域引起了广泛关注,被认为是一项具有开创性意义的新疗法。这一方法以神经反射控制泪液分泌的理论为基础,经过动物实验的深入探索和验证,目前已有多款相关设计成功转化,其中一些已成功上市,另一些正在积极进行临床试验。与当前流行的干眼治疗方法相比,神经刺激的独特之处在于能够刺激自身天然泪液的分泌,不仅涵盖了水、脂质和黏蛋白等多种成分,还包括了丰富的泪液蛋白质和电解质 [ 3 ],从而最大程度地维持泪膜稳态。建议广大眼科临床医师及研究者关注神经刺激疗法在干眼治疗中的应用,积极探索干眼治疗的新方法。
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备注信息
A
龚岚,Email: mocdef.9ab3138689710531
B
所有作者均声明不存在利益冲突
C
上海市科委科技基金 (22Y11910300)
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