| Objective:In order to observe Jiawei Danggui Shaoyao Powder combined with acupuncture effectiveness of treating phlegm-stasis interjunction AMD,and the variation of serum apolipoprotein level and Pittsburgh Sleep quality Index score(PSQI),and to explore the associated risk factors for the disease as well as the correlation with the circadian rhythm and the mechanism of Jiawei Danggui Shaoyao Powder combined with acupuncture.Methods:Using a table of random numbers,40 patients with phlegm-stasis interjunction AMD were divided into control(n=20)and treatment(n=20)groups.Control group:Jiawei Danggui Shaoyao Powder;treatment group:Jiawei Danggui Shaoyao San with acupuncture.Recording the TCM symptom score,BCVA,macular OCT(cube volume average thickness,central sub-area thickness),serum apolipoprotein(ApoA,ApoB)levels and PSQI scale evaluation before and after 4 weeks of treatment and used the statistical software SPSS25.0 for statistical analyses.Results:1.Eyesight:The visual acuity of the two groups before treatment was comparable(P>0.05).The BCVA of control group enhanced from 0.2(0.21,0.19)to 0.3(0.2,0.5)after treatment,while that in the treatment group increased from 0.25(0.2,0.4)to 0.4(0.288,0.6).The effective rate of treatment 90.00%was higher than that in control 65.00%(P=0.022<0.05).During the 4-week follow-up,the control group BCVA was 0.25(0.2,0.425),and the treatment group was 0.4(0.288,0.525).The effcacy of treatment was superior to that in control(P=0.42<0.05).2.OCT:The two groups average thickness of ILM-RPE cube before treatment was comparable,however that in the control group changed from 314.95±33.99μm to 284.40±31.51 μm after 4 weeks treatment.It was lower than that before treatment(P=0.001<0.05).In the treatment group,it was 306.30±36.26μm before treatment and 258.80±31.49μm after 4 weeks treatment(P<0.001).The effcacy of treatment was superior to that in control(P=0.014<0.05).The thickness of central sub-area of ILM-RPE was comparable between the two groups before treatment.In the control group,it was 298.45±35.84 μm before treatment and 275.65±30.50μm after 4 weeks treatment.It become thin than that before treatment(P=0.040<0.05).In the treatment group,it trandformed 306.90±37.69μm to 254.40±31.19μm after 4 weeks treatment,that was lower than before treatment(P<0.001).The effcacy of treatment was superior to that in control(P=0.036<0.05).3.Apo:The levels of Apo-A and Apo-B were comparable before treatment.In the control group,Apo-A was 1.35±0.16 g/L to 1.46±0.14 g/L,which was enhanced than that post-treatment(P=0.003<0.05).The Apo-A of the treatment group before treatment was 1.33±0.13 g/L to 1.55±0.15 g/L after 4 weeks treatment,which was significantly higher than that before treatment(P=0.117<0.05).The treatment group showed a better curative effect than the control group(P<0.05).In the control group,the Apo-B before treatment was 1.02±0.17 g/L to 0.87±0.15 g/L after 4 weeks treatment,which was lower than that before treatment.(P=0.005<0.01)In the treatment group,the Apo-B before treatment was 1.08±0.18 g/L to 0.77±0.12 g/L after 4 weeks treatment,which was lower than that before treatment(P<0.001).The treatment group curative effect was better than that of the control(P<0.05).4.TCM symptom score:There was no significant difference in the before treatment total score of TCM symptoms between the two groups(P>0.05).The control group decreased from 19.40±4.26 to 11.90±3.92,and the treatment group decreased from 19.50±3.43 to 8.70±3.69,both of them were lower than those before treatment(P<0.05).The treatment group effective rate of TCM symptoms 85.00%was higher than that in the control 60%.5.PSQI scale score:Two groups PSQI scale scores before treatment was no significant difference.(P>0.05)The control group decreased from 14.60±2.41 to 11.45±2.11 after treatment,and the treatment group decreased from 14.40±2.01 points to 9.85±2.32 points after treatment,and there were differences between two groups(P<0.05).Conclusion:1.Modified Danggui Shaoyao Powder can improve vision of patients with phlegm-stasis interjunction AMD,improve macular morphology,TCM syndrome score,PSQI scale score,regulate the daily rhythm and the level of apolipoprotein A and B.The curative effect of supplemented Danggui Shaoyao powder combined with acupuncture(acupuncture combined with medicine)was better than that of simple TCM group.2.Acupuncture combined with medicine can effectively regulate the daily rhythm and Apo-A and Apo-B level expression in patients with phlegm-stasis interjunction AMD,suggesting that there is a certain correlation between AMD and the recent rhythm and apolipoprotein level,which may be a related factor affecting the outcome of AMD disease.3.The mechanism of treating AMD with combination of acupuncture and medicine may be related to inhibiting peroxidation,promoting microcirculation,increasing lipid metabolism and transport,improving nutrient metabolism of RPE,and regulating circadian rhythm. |
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