Clinical Observation Of Modified Liuwei Dihuang Decoction In The Treatment Of Diabetic Macular Edema Due To Deficiency Of Spleen And Kidney And Liver Depression

Objective: To evaluate the therapeutic effect of Modified Liuwei Dihuang Decoction on diabetic macular edema(DME)with deficiency of both spleen and kidney and stagnation of liver.Methods: 64 DME patients with deficiency of both spleen and kidney and stagnation of liver were selected from Henan Hospital of Traditional Chinese Medicine,which were divided into observation group and control group according to random number table method,32 subjects(32 eyes)in every group.Control group:According to the condition of macular edema,The patients were treated by Frequency doubled Nd:YAG laser with grid-like photocoagulation or local photocoagulation.The spot diameter was limited to 50-100μm,and the distance was about one spot diameter.The exposure time was 0.1 s.The laser energy parameters were set according to the condition of macular edema.After photocoagulation,the grade I-II spot reaction was achieved.Patients in control group were followed up every 4 weeks for 12 weeks.Observation group:On the base of laser photocoagulation treatment,patients in observation group were given Modified Liuwei Dihuang Decoction orally.Four weeks was a course of treatment and the trial consisted of 4 courses.After treat three courses,the changes of best corrected visual acuity(BCVA),central macular thickness(CMT)and TCM syndrome scores were compared between the two groups before and after treatment.Results:(1)The total effective percentage of the observation team was 87.5%,and that of the control group was 62.7%.The observation team was significantly better than the control team(P<0.05).(2)The curative effect of TCM symptoms in the observation group was 93.75%,while that in the control group was 12.5%.The curative effect of TCM symptoms in the observation group was significantly better than that in the control group with significant statistical difference(P<0.05).(3)After treatment,vision of the two groups increased,CMT decreased significantlyand TCM symptom score decreased,P < 0.05,The difference was statistically significant.(4)After treatment,the improvement of vision,CMT and TCM symptom score in the observation group were better than those in the control group with significant difference in statistics(P<0.05).(5)During the treatment,the general vital signs,routine hematuria,liver and kidney functions and electrolytes were all within normal range during treatment,and there was no allergic reaction.Conclusion: Modified Liuwei Dihuang Decoction can effectively promote macular edema subsidence and improve best corrected visual acuityment and accompanying symptoms in DME patients with both spleen and kidney deficiency and liver depression,in addition,which has no obvious side effects.It is a safe and effective treatment for DME patients with both spleen and kidney deficiency and liver depression.