Research Advances of Traditional Chinese Medicine in the Treatment of Primary Open Angle Glaucoma

TCM takes clinical symptoms and signs as the treatment target. Under the guidance of the "overall concept" and "syndrome differentiation and treatment," the patient's condition was analyzed, and the appropriate treatment method was selected. TCM believes that the leading cause of POAG is stagnation of liver qi and retention of water. Therefore, the treatment of dispersing stagnated liver qi for relieving qi stagnation and eliminating water should be adopted. 

Chinese herbal medicine has complex bioactive components, which can trigger many signal pathways and have a wide range of effects on essential organs. Many studies have reported that Chinese herbal medicine can improve the optic nerve injury of POAG patients and protect their eyesight [1]. The primary mechanism of its action is to safeguard RGC cells by regulating various ways [2]. However, the diversity and multiple combinations of natural Chinese medicines and the complexity of their preparation methods have become one of the bottlenecks restricting further research development. Network pharmacology aims at biological networks, analyzes the relationship between drugs, targets, and diseases in the network, and understands the interaction mechanism of Chinese herbal medicine compounds from a systematic point of view [3]. Therefore, network pharmacology is essential for analyzing Chinese herbal medicine compounds. 

The meridian theory of TCM shows that the eye is closely related to the whole body. As one of the treatment methods in the world, acupuncture can prevent or treat diseases by stimulating body surface meridians. Chinese scholars have successfully treated POAG optic nerve atrophy with acupuncture. Clinical studies have also shown that acupuncture can significantly reduce intraocular pressure in patients with POAG [4]. Modern imaging technology enables the fine structure of the optic nerve to be seen [5]. With the help of this technology, the real-world research of TCM can confirm the prospect of acupuncture in the field of POAG research. 

TCM believes that the constitution is innate, and acquired factors constantly influence it. Once the constitution is formed, it has the characteristics of relative stability. The constitution includes this characteristic under the influence of morphological structure, physiological function, and psychological factors. The emergence, development, treatment, and prevention of diseases need the guidance of TCM constitution theory. Studies have shown that people with different constitution types have other tendencies and susceptibility to POAG. Under the guidance of the theory of "physique adjustable" and "balance of traditional Chinese medicine," it is expected to bring dawn for the treatment of POAG.

This work was supported by the National Key Research and Development Project of China (No. 2019YFC1711605), the National Natural Science Foundation of China (No. 81904257 and No. 81804147), and the Medical innovation research project of Science and Technology Commission of Shanghai Municipality (No. 21Y11923100).

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