Clinical Observation Of Shengmai Powder Combined With Vitreous Injection Of Leizumab In The Treatment Of Diabetic Macular Edema

Objective: To observe the curative effect of oral Shengmai powder combined with leizumab in the treatment of diabetic macular edema,and compare it with western medicine alone,so as to explore the clinical value of integrated Chinese and western medicine in the treatment of diabetic macular edema.Methods: In this study,40 patients(67 eyes)with diabetic macular edema who were hospitalized in the ophthalmology department of the First Affiliated Hospital of Guangxi University of Chinese Medicine from October 2018 to October 2020 were selected.The patients were randomly divided into control group(20 cases,32 eyes)treated with Western medicine and observation group(20 cases,35 eyes)treated with Western medicine.The Western medicine group was treated with intravitreal injection of thunderzumab,once a month,3times in total.Traditional Chinese and western medicine group on the basis of western medicine treatment with oral birth pulse dispersion flavored(specific formula is: radix pseudostellariae 20 g 15 g,schisandra fruit l0 g,astragalus root,dwarf lilyturf,20 g,20 g kudzuvine root,prunella 20 g,densely covered flower l0 g,peach kernel 15 g 12 g,12 g cassia twig,aconite,safflower(Fried),15 g atractylodes,alisma 15 g,12 g scorpion 6 g)treatment,and according to the specific syndrome types of patients with card to add and subtract,If the five irritability is hot,the tongue is red and less jin,and the deficiency of Qi and Yin is obvious,add 15 g of Sheng Di and 10 g of Xuan Shen;If patients with fundus hemorrhage,blood stasis can be added Pu Huang 15 g,Panax notoginseng 10g;If the body of the patient is obese,the head and body are heavy,and the phlegm is wet,add Pinellia pinellia 10 g and Poria Coing15 g.Take 15 consecutive days as a course of treatment,a total of three courses.Then,the best corrected visual acuity,macular retinal thickness and TCM syndrome score were observed before treatment and 1,2 and 3 months after treatment to evaluate the efficacy of DME patients.The therapeutic effect of the two groups was observed and counted.Results:(1)Comparison of BCVA(LOG MAR)values in the two groups: 1 month,2months and 3 months after treatment,the LOG MAR values in the two groups were all decreased compared with before treatment,indicating that the BCVA of the patients was increased compared with before treatment.One month after treatment,the LOG MAR value of control group and observation group decreased from 0.750±0.224 and 0.746±0.269 to 0.653±0.193 and 0.589±0.198,respectively,with no statistical significance(P=0.183>0.05).Two months after treatment,the LOG MAR value decreased to 0.569±0.171 and 0.474±0.172,respectively,and the difference was statistically significant(P=0.028 < 0.05).3 months after treatment,the LOG MAR value decreased to 0.497±0.175 and0.406±0.188,respectively,and the difference was statistically significant(P=0.044 < 0.05).(2)Comparison of macular fovea retinal thickness(CMT): after 1 month of treatment,the CMT values in the control group and the observation group decreased from 472.59±12.30μm and 469.86±13.40μm at baseline to408.44±10.86μm and 403.23±11.82μm,respectively,without statistical significance(P= 0.066> 0.05).After 2 months of treatment,the CMT values of the control group and the observation group decreased to 349.13±9.88μm and338.11±10.63μm,respectively,and after 3 months of treatment,the CMT values of the control group and the observation group decreased to313.34±9.84μm and 288.34±11.47μm,respectively,with statistical significance(P=0.000 < 0.05).(3)the TCM syndrome score: the control group of TCM syndrome score before the treatment of 16.20±1.32 to 17.25±1.52,the observation group of TCM syndrome score before the treatment of 17.05±1.76 to 14.85±1.81,on two groups of patients before and after treatment of traditional Chinese medicine symptom integral compare within the group,always by paired sample t test,the difference was statistically significant(P < 0.05),shows that after the treatment,observation group of patients was to improve the symptoms of;In terms of comparison between groups,independent sample t test showed that there was no statistical difference between the two groups before treatment(P<0.05),which was comparable,while the difference after treatment was statistically significant(P < 0.05).(4)in the two groups after treatment the overall efficient comparison: after treatment,the control efficacy of 11 eye had marked effect,14 effective eye,and there are 7 eye,invalid and observation group of 22 eyes were markedly improved,effective nine eye,invalid four eyes,control group total effective rate was 78.1%,the experimental group total effective rate 88.6%,two groups of efficient compared with rank and inspection P = 0.03 < 0.05,the difference was statistically significant,suggesting licensed anti-japan union calls hopson pulse dispersion flavored observation group is relatively simple to use licensed resistance to treatment,control group total effective rate is higher.Conclusion(s):(1)The results showed that both the observation group treated with Shengmai San plus vitreous intravitreal injection of leizumab and the control group treated with leizumab could improve visual acuity and reduce macular edema in DME patients;(2)Compared with the western medicine treatment group,the combined Chinese and western medicine treatment group has a more significant effect on improving patients’ visual acuity and reducing macular edema,and can significantly improve patients’ systemic symptoms,which is safe and reliable.