Literature Research On The Treatment Of Wet Age-related Macular Degeneration With Traditional Chinese Medicine And The Experience Of Professor Zuo Tao

Purpose:We collected the literature of traditional Chinese medicine(TCM)in the treatment of wet age-related macular degeneration(w AMD)over the past decade to explore the main syndrome type of TCM,the principles and methods of the treatment,and the rule of prescription and dispensation.In addition,we combined those with Professor Zuo Tao’s clinical experience of nearly 30 years and summarized the clinical routine diagnosis and treatment scheme of w AMD to a better clinical practice guide.Material and method:(1)Chinese literatures on w AMD treatment with integrated traditional Chinese and western medicine published from January 1,2008 to November 1,2020 were selected from CNKI,Wanfang and VIP.Qualified literatures in conformance with the inclusion and exclusion criteria were selected,based on which a Excel data sheet was established to perform a series of statistical analysises,including cluster analysis by means of SPSS23.0 and data mining in virtue of IBM SPSS Modeler 18.(2)We disserted and summarized Professor Zuo Tao’s clinical experience in the treatment of w AMD as well as those cases recorded in outpatient department and ward.Finally,the results of above two steps were combined to verify professor’s clinical strategy and come to a common thinking of diagnosis and treatment.Results:1.A total of 82 literatures were included in this study,and 27 syndrome types,28 therapeutic principles and methods,19 prescriptions and 141 drugs were summarized.Among27 common syndrome type in clinic,4 types,including deficiency of liver and kidney,intercombination of turbid phlegm and blood stasis,Yin deficiency with effulgent fire,and spleen Qi deficiency,are common.In terms of treatment principle,it is common to remove blood stasis,promote blood circulation,cool blood,replenish Qi and invigorate spleen and stomach.Self-designed prescriptions are relatively common in clinical practice,followed by Shenling Baizhu Powder.In terms of the drugs applied most widely,it can be found taht Poria,Rehmannia glutinosa,and Salvia miltiorrhiza top the list.2.The 141 drugs mentioned in the research literatures were statistically analyzed in terms of drug category,property and taste.There were 18 drug categories,among which the top three were drugs for tonifying deficiency(33.11%),promoting blood circulation and removing blood stasis(14.63%),and promoting urination and draining(11.66%);In terms of drug properties,cold drugs(36.96),warm drugs(28.78%)and plain drugs(25.12%)were the top three;In terms of drug taste,sweet drugs and bitter drugs accounted for 36.67% and30.02%,respectively.3.The results of clustering analysis of high-frequency drugs can be divided into four categories: The first group was Poria Cocos,Rehmannia Glutinosa,Salvia Miltiorrhiza,Angelica Sinensis and Licorice.The second group was Rhizoma Atractylodis Macrocephalae,Coix Seed,Astragalus Membranaceus and Pinellia Ternata.The third group was Lycii Fructus,Ligustrum Ligustri Fructus and Cortex Moutan.The fourth group was Ligusticum chuanxiong,Fructus Leonuri and Typhae Pollen.The results of correlation analysis showed that the most common drug combination was Rehmannia Glutinosa-Salvia Miltiorrhiza-Poria Cocos-Angelica Sinensis.4.By consulting and sorting out the clinical cases of Professor Zuo Tao in the past 30 years,a treatment of integrated Chinese and Western medicine combining Chinese herb,acupuncture,iontophoresis,and external method of traditional Chinese medicine is summarized,which has achieved good results in clinical practice.Conclusion:1.Through the literature study of wet age-related macular degeneration in the past 10 years,it was found that the incidence of wet age-related macular degeneration was mainly related to the liver,spleen and kidney,which was consistent with the clinical characteristics of my tutor’s treatment of this disease.We sorted out and summarized the treatment principle should focus on promoting blood circulation and removing blood stasis,nourishing Yin and brightening eyes,invigorating Qi and invigorating spleen,and tonifying liver and kidney.Herb selection mainly included herbs to replenish deficiency,herbs to promote blood circulation and remove blood stasis,and herbs to nourish water and moisten.Through drug cluster analysis and correlation analysis,a group of potential combinations was obtained:Poria cocos-Rehmannia glutinosa-Salvia miltiorrhiza-Angelica.2.With Professor Zuo Tao’s clinical experience more than 30 years,we summed up a treatment method of integrated traditional Chinese and western medicine,namely "Zuoshi Shenshimingmu Method",which has achieved good results in the clinical treatment of wet AMD.The unique medication thought and treatment system also provides reference for the clinical diagnosis and treatment of wet age-related macular degeneration in the future.