Yiqi Jianpi Xiaoshui Decoction Combined With Compaq In The Treatment Of Diabetic Macular Edema

Objective:To observe the curative effect of modified Yiqi Jianpi Xiaoshui Decoction combined with Compaq intraocular injection in the treatment of diabetic macular edema patients based on syndrome differentiation of spleen failing to invigorate health and transportation and water-damp stagnation,so as to provide some ideas and methods for clinical diagnosis and treatment.Methods:Thirty-seven patients(59 eyes)with macular edema who met the diagnostic criteria for diabetic retinopathy in western medicine and the syndrome of spleen failing to maintain good health and transport and water-damp stagnation in traditional Chinese medicine were selected from the ophthalmology outpatient department and ward of guangxi university of chinese medicine Affiliated Ruikang Hospital.According to the visiting sequence and random number table,they were randomly divided into a control group and a treatment group,with 18 cases(30 eyes)in the control group and 19 cases(29 eyes)in the treatment group.Patients in the control group were only treated with Compatriot and received intravitreal injection regularly every month for three consecutive months.On the basis of this,the treatment group was given Yiqi Jianpi Xiaoshui Decoction,with oral administration of Chinese medicine for 20 days and 10 days’ rest in each course,totally 3 courses.The best corrected visual acuity(BCVA),the central macular thickness(CMT)shown by optical coherence tomography(OCT),Fundus fluorescein angiography(FFA)observed in the fundus retinal neovascularization,retinal fluorescence leakage and/or shielding,collateral circulation and TCM syndrome score.Results:1.Before treatment,compared the two groups in age,gender,DR stage,BCVA,CMT,TCM syndrome score,the P values were greater than 0.05,and the difference was not statistically significant.In the two groups,there were 11 males(19 eyes)and 7 females(11 eyes)in the control group.Age ranged from 47 to 83(60.50±10.14)years old;In the control group,10 eyes were in stage Ⅲ,13 eyes in stage Ⅳ,4 eyes in stage Ⅴ,and 3 eyes in stage VI.The BCVA and CMT values before treatment were(0.86±0.47)and(461.73± 178.38)μm,respectively.The TCM syndrome score before treatment was(26.10± 1.81).In the experimental group,there were 8 males(13 eyes)and 11 females(16 eyes).Age ranged from 45 to 79(62.26±8.59)years old;In the experimental group,12 eyes were in stage III,15 eyes were in stage IV,1 eye was in stage V,and 2 eyes were in stage VI.The BCVA before treatment was(0.85±0.53).The CMT before treatment was(443.07±166.64)μm;The TCM syndrome score before treatment was(26.81±2.19).2.(1)Thirty eyes in the control group after treatment:The BCVAwas(0.58±0.28)one month after treatment,the BCVA was(0.53±0.23)two months after treatment,and the BCVA was(0.49±0.20)three months after treatment,all of which were higher than those before treatment(4.14±0.48).The CMT was(377.17± 135.62)μm one month after treatment,(367.07± 128.15)μm two months after treatment and(310.47±93.90)μm three months after treatment,all of which were lower than those before treatment(461.73±178.38)μm.The P of the control group before and after BCVA was greater than 0.05,without statistical significance.The P of the control group before and after CMT was less than 0.05,and the difference was statistically significant.(2)In the treatment group(29 eyes),the BCVA was(0.54±0.33)one month after treatment,the BCVA was(0.5±0.25)two months after treatment and(0.46±0.22)three months after treatment,all of which were higher than those before treatment(0.85±0.53).The CMT was(357.24±154.90)μm one month after treatment,(323.86± 115.40)μm two months after treatment and(289.00±92.691)μm three months after treatment,all of which were lower than those before treatment(443.07± 166.64)μm.The difference of values before and after BCVA in treatment group was P>0.05,without statistical significance.The difference of CMT pre-treatment and post-treatment in treatment group was statistically significant 05),with comparability.(3)The P values of BCVA and CMT in the three-cycle inter-group comparison after treatment were less than 0.05,and the difference was statistically significant.3.The fundus fluorescein angiography of the two groups three months after treatment was compared with that before treatment.The effective rate of that control group was 86.67%;The effective rate of the experimental group was 93.10%.The effective rate of the experimental group was significantly higher than that of the control group,indicating that the neovascularization,retinal fluorescence leakageand/or shielding,and collateral circulation were improved in the experimental group as compared with those in the control group.4.Comparison between the two groups of CME patients three months after treatment and before treatment shows that the TCM syndrome score of the control group after treatment is(18.83±2.61),t=12.524,P=0.000,n=30;After treatment,the TCM syndrome score of the experimental group was(16.66±1.74),t=15.867,P=0.000,n=29.The TCM syndrome scores of the two groups were higher than those before treatment.The TCM syndrome scores of the experimental group after treatment were superior to those of the control group,with t=3.756,P=0.000.Conclusion:Traditional Chinese medicine combined with Compaq can more accurately improve the patient’s vision,alleviate the patient’s macular retinal edema,and slow the formation of retinal neovascularization.Therefore,Yiqi Jianpi Xiaoshui Decoction combined with Compatriot in the treatment of diabetic macular edema provides a new way for clinical treatment,and is more reasonable and effective than the conventional simple western medicine treatment.