Meta-analysis Of Clinical Studies On Age-related Macular Degeneration Treated By Integrated Traditional Chinese And Western Medicine

Objective: To systematically evaluate the clinical efficacy and safety of integrated traditional Chinese and Western medicine in the treatment of age-related macular degeneration by using meta-analysis method,to provide evidence-based basis for exploring the effective means of clinical treatment of age-related macular degeneration.Methods: Relevant databases(CNKI,Wanfang,CBM,VIP,Cochrane trials,Pub Med,EMBASE)were searched to obtain the literatures.The process of literatures selection were based on inclusion and exclusion rules.The quality of the studies was evaluated by cocharane bias risk assessment tool.Relevant data were extracted,including basic information of literature,outcome indicators of response treatment effectiveness(visual acuity,macular thickness,fundus angiography fluorescence leakage,clinical efficiency,TCM syndrome,recurrence rate),and safety outcome indicators(adverse reactions).After the data is extracted,use Review Manager 5.4 for meta analysis.Results: 25 articles were included,including 1646 people and 1916 eyes.1.In terms of visual acuity,the included visual outcome indicators were divided into 1-point recording mode BCVA group and Log MAR recording mode BCVA group.In 1-point recording mode BCVA group,MD=0.10,95%CI= [0.07,0.13],Z=7.45,P<0.00001.Log MAR recording mode BCVA group: MD=-0.07,95%CI=[-0.12,-0.02],Z=2.94,P=0.003,the difference was statistically significant.The results show that the combination of traditional Chinese medicine and Western medicine is better than western medicine alone in improving vision.2.Macular thickness: MD=-26.15,95%CI=[-32.09,-20.21],Z=8.62,P<0.00001,the difference was statistically significant.The results show that the combination of traditional Chinese and Western medicine is better than western medicine alone in reducing the thickness of macular area.3.The effective rate of fundus fluorescence leakage: RR=1.21,95%CI=[1.13,1.30],Z=5.32,P<0.00001,the difference was statistically significant.The results showed that the combination of traditional Chinese medicine and Western medicine was better than western medicine alone in reducing the leakage of fundus.4.In the evaluation of the overall efficacy,the clinical effective rate:RR=1.25,95%CI=[1.15,1.35],Z=5.28,P<0.00001,the difference was statistically significant.The results show that in improving the clinical efficiency,the combination of traditional Chinese and Western medicine treatment is better than the simple western medicine treatment.5.The effective rate of TCM syndrome: RR=2.55,95%CI=[1.82,3.56],Z=5.44,P<0.00001,the difference was statistically significant.The results showed that the Chinese and Western medicine was better than the simple western medicine in improving the systemic syndrome.6.Recurrence rate: RR=0.34,95%CI=[0.20,0.56],Z=4.21,P<0.0001,the difference was statistically significant.The results showed that in terms of recurrence rate,the treatment of integrated traditional Chinese and Western medicine was better than that of Western medicine alone.7.The incidence of adverse reactions: RR=0.40,95%CI=[0.16,0.99],the Effect Test Z=1.98,P=0.05,the statistical difference was not significant.Through the study,we found that the safety of integrated traditional Chinese and Western medicine in the treatment of ARMD is guaranteed,but whether it has more advantages than simple western medicine remains to be further studied.Conclusions: Compared with western medicine intervention,the treatment of integrated traditional Chinese and Western medicine has more advantages in saving vision,reducing retinal macular thickness,reducing fundus leakage,improving clinical efficiency,improving systemic syndrome and reducing recurrence rate.In terms of safety,there is not enough evidence in this study to prove which approach is more advantageous,which needs to be further evaluated after expanding the sample size.