The Relationship Between The Wet Age-related Macular Degeneration’s Classification Of TCM Syndrome And Its Medical Treatment Sensability

ObjectiveThrough the study of TCM syndromes of wet age-related macular degeneration(wAMD), we divided the cases into three groups:syndrome of hyperactivity of fire due to yin deficiency、syndrome of pi-deficiency with damp harassment and syndrome of intermin-gled phlegm and blood stasis. Every group received the same intravitreal anti-VEGF treatment. By analyzing the effect of each group, we want to know if there were differences between wet age-related macular degeneration’s classification of TCM syndrome. Then we can develop a more scientific and reasonable treatment plan of wAMD, reduce the drug abuse, save medical expenses while improve the patient’s survival quality and reduce the burden of society at the same timeMethodsBy the method of retrospective clinical study, patients who met the standard of wAMD were included in the study. According to the general symptoms and ocular manifestations, we devided them into three groups:syndrome of hyperactivity of fire due to yin deficiency-. syndrome of pi-deficiency with damp harassment and syndrome of intermin-gled phlegm and blood stasis. Every group received the same intravitreal anti-VEGF treatment evry month twice. At the same time, we recorded the best corrected visual acuity (BCVA), central retinal thickness (CRT) and total macular volume (TMV) of each patient. Evry case was observed for 3 months. SPSS 19.0 statistical software is used for result analysis, within the detection index measuring data set matching t test is refered, while comparison between groups using multivariate analysis of variance method of repeated measurement data. P< 0.05 for statistical significance.ResultsThis study,90 patients were included which met the standard, a total of 90 eyes, which syndrome of hyperactivity of fire due to yin deficiency 22 cases with male of 14 and female 8, syndrome of pi-deficiency with damp harassment 29 cases with male of 11 and female 18, and syndrome of intermin-gled phlegm and blood stasis 39 cases with male of 23 and female 16. Each group’s average age was respectively 59.3,72.2 and 68.3 years. Syndrome of intermin-gled phlegm and blood stasis are relatively rare during the TCM syndrome of wAMD. While coming to the anti-VEGF treatment effects,we can see that the average BCVA of each group is 0.33±0.24、0.38±0.27、 0.44±0.27,0.30±0.18、0.36±0.23、0.37±0.24,0.23±0.16、0.26±0.19、0.34 ±0.30. The average CRT of each group is:239.73±43.97、246.43±61.56、250.55 ±81.01,303.53±80.00、280.48±90.28、297.99±142.97,284.49±82.30、263.54 ±69.26、262.79±54.97; The average TMV of each group is:7.19±1.18、7.20 ±0.97、7.12±0.85，8.25±1.21、7.98±1.05、8.05±1.39,7.95±1.12、7.49± 0.76、7.14±0.60. Within the set of matching t test,P< 0.05, there is significant differences between each group before and after treatment. Comparison between groups we used variance analysis method of repeated measurement data, which showed that the comparing of the three groups, BCVA, P>0.05 which mean that there is no statistical difference between treatment effect of each group while BCVA as an observation index Which means that if vision as index, the treatment has no sensitivity difference between groups. When comes to comparison of CRT between groups, we found that P<0.05 between syndrome of hyperactivity of fire due to yin deficiency, syndrome of pi-deficiency with damp harassment, which means that there was statistical difference between them while there was no significant differences between other two groups. TMV comparison results between groups suggest that the TMV changes between each two groups have significant differences, P<0.05, except syndrome of hyperactivity of fire due to yin deficiency and syndrome of intermin-gled phlegm and blood stasis.ConclusionDuring the wet age-related macular degeneration patients, that with phlegm and blood stasis is in the majority. Each TCM syndrome type has certain curative effect for the treatment of Anti-VEGF, which show that patients’visual acuity and retinal morphological features improved. Form part of the CRT and TMV comparison between has significant difference, namely the wAMD between TCM syndrome type and its anti VEGF treatment sensitivity has a diversity of insufficient evidence. Because of imperfect syndrome classification method、lack of time and small sample size, this study still need long-term, large sample, multicenter trial and prospective study to confirm its scientificity and accuracy.