Professor Wu Lie Summarized The Clinical Experience Of Treating AMD Based On The Theory Of "six Qi"

Objective:To assess the effectiveness and safety of TCM in the treatment of age-related macular degeneration,and to summarize the clinical experience of the supervisor in the treatment of age-related macular degeneration based on the theory of "six qi".Methods:1.We searched CENTRAL,EMBASE,PubMed,CNKI,VIP,WANFANG DATA.,which between January 1990 to December 2018 to identify randomised clinical trials.Two researchers independently screened literature,extracted data and checked the results.We used risk of bias to evaluate methodological quality and used RevMan5.3 for Meta analysis.2.After three years of theoretical study and clinical work,I summarized my tutor’s clinical experience about the treatment of AMD.And I would try to elaborate my tutor’s academic ideas of "six qi" from eight aspects with theoretical origin,pathogenesis,zang-fu theory,core of syndrome differentiation,microscopic syndrome differentiation,syndrome differentiation thoughts,medication rules and clinical application.Finally I would list typical cases for clinical reference.Results:1.We included 25 trials with 1885 participants.Low-quality evidence suggested:little difference in the effect of the TCM group or the western medicine group on change in visual acuity(MD 0.03,95%CI 0.01 to 0.04),the TCM and western medicine group combination could improve visual acuity compared to the western medicine group(MD 0.12,95%CI 0.08 to 0.16).In terms of counting by number of eye,the TCM group and the combination of the TCM and western medicine group were superior to the western medicine group in clinical efficiency(RR 1.52,95%CI 0.93 to 2.49 and RR 1.37,95%CI 1.11 to 1.69).In terms of counting by number of people,the TCM group and the combination of the TCM and western medicine group were superior to the western medicine group in clinical efficiency(RR 1.69,95%CI 1.35 to 2.12 and RR 2.17,95%CI 1.41 to 3.33).The TCM and western medicine group combination could decrease the CMT more than the western medicine group(MD-28.98,95%CI-44.00 to-13.96).TCM could improve the quality of life of AMD patients,but due to the lack of literature reports,credibility is not satisfied.The recurrence rate is difficult to estimate because of lacking of reported literature.There were no significant adverse effects noted,so TCM is relatively safe in the treatment of AMD.2.The tutor treated AMD’s academic thought based mainly on the theory of "six qi" and targeted syndrome differentiation for treatment.We made use of the advanced techniques and methods of modern medicine to accurately determine the AMD’s Subtle pathological changes at all stages.Drawing on the academic theories and medication ideas of ancient books,this paper puts forward the thinking of treating AMD based on syndrome differentiation and corresponding drugs in early stage,advanced stage edema,advanced stage bleeding and late stage,which improves the clinical efficacy.Conclusion:1.We found it had positive effect in improving visual acuity,ameliorating clinical efficiency and reducing the CMT of the TCM treatment for AMD.And the combination of the TCM and western medicine group was the optimal choice of AMD treating.In terms of quality of life and recurrence rate,it is difficult to evaluate the results effectively due to the lack of reported literature.The above conclusions need to be further verified by high-quality prospective research results.2.The theory of "six qi" established by my tutor provides a new dialectical thinking and method for the treatment of AMD and clinical promotion and application of the value.