Study On The Relationship Between The Pathological Changes Of Macular Morphology And The Syndrome Differentiation Of TCM In Diabetic Retinopathy

ObjectiveTo investigate the relationship between diabetic retinopathy(DR)and the pathological changes of macular morphology of diabetic retinopathy(DR),and to clarify the characteristics of TCM syndromes of retinal morphological changes in different stages of DR macular area,and to explore the changes of diabetic retinopathy macular pathology Changes in the etiology and pathogenesis of traditional Chinese medicine and syndromes,for the dialectical treatment of DR to provide an objective basis.Methods60 patients(96 eyes)with DR were enrolled in the Department of Ophthalmology,Second Affiliated Hospital of Guangdong Province.OCT was examined and collected.The symptoms and signs of TCM were recorded.Blood glucose was collected and the best corrected visual acuity,OCT indicators(macular area center concave thickness,macular volume,the average volume thickness),TCM syndromes according to Yin deficiency heat,hot and humid in the resistance,liver and kidney,Qi and Yin Deficiency,blood stasis,Blood stasis in the stop,liver qi stagnation syndrome type 7 dialectical classification.The correlation analysis was performed with SPSS 17.0 statistical software.Results1.60 cases of DR patients with 96 cases of macular OCT mainly manifested:macular exudation in 34 eyes;macular retinal hemorrhage in 27 eyes;macular edema(DME)65 eyes,according to the shape is divided into:cystic edema,diffuse edema,serous neuroepithelium(ERM)11 eyes;combined with the front membrane,edema,10 eyes,macular lamellar hole,false hole in a total of 5 eyes;macular morphology Normal 10 eyes;combined with more than two morphological changes in 40 eyes;local retinal thickness thinner 22 eyes.2.DR staging and disease-related,r= 0.418,P=0.000<0.05.In the course of diabetes mellitus<5 years,DR mainly manifested as ? and ?;5 to 10 years DR mainly manifested as ?,?,?,10-20 years,DR mainly for ?,?,?,20 years,DR mainly for the ?,?,? period.3.TCM syndromes are associated with the course of the disease,the correlation coefficient r=0.257,P=0.026<0.05.4.DR syndromes were associated with visual acuity,r=-0.221,P =0.014<0.05.According to the order of visual acuity from low to high,R value from low to high,the corresponding is the blood stasis card,wet turbidity in the card,Qi and Yin Deficiency,indicating blood stasis patients were lower than the wet In the resistance to those who see vision;wet turbidity in the resistance of those who are less than Qi and Yin deficiency.(Mann-Whitney U=4.500,P?0.032);Yin deficiency heat syndrome and blood stasis syndrome(the number of visual acuity between the two groups,the difference was statistically significant:(Mann-Whitney U = 0.000,P=0.024);the control of wet turbidity and blood stasis syndrome(Mann-Whitney U = 3.000,P= 0.007)(Mann-Whitney U = 1.500,P =0.023);liver and kidney yin deficiency syndrome and blood stasis syndrome(Mann-Whitney U =(Mann-Whitney U = 411.000,P?0.005);blood stasis syndrome and liver qi stagnation syndrome(Mann-Whitney U = 5.000,P=0.041).5.There was significant correlation between macular morphological changes and DR TCM syndromes,X2 = 81.337,P=0.000<0.05.Differences between the two groups were statistically significant:(1)retinal hemorrhage:blood stasis and dampness in the dampness syndrome,Qi and Yin Deficiency;(2)macular edema:blood stasis card and qi and yin two Deficiency;(3)local retinal thinning:Qi and Yin Deficiency and blood stasis syndrome.6.The change of macular shape was related to the DR stage of Western medicine,X2=199.281,P-0.000<0.05,the difference was significant.Differences between the two groups were statistically significant:?:the local thinning of the retina and retinal hemorrhage;V:epiretinal membrane and macular exudate,retinal hemorrhage,macular edema,retinal thinning,lamellar macular hole and retinal holes or pseudo thinning;?:retinal hemorrhage and macular exudation and macular edema.7.There was significant correlation between the best corrected visual acuity and the thickness of the central fovea,the macular volume and the average thickness of the 1 mm diameter.The correlation coefficient r is-0.591,-0.466,-0.361,p value is<0.05.Indicating that the best corrected visual acuity was negatively correlated with the thickness of the center fovea,the macular volume,and the average thickness of the center of the 1 mm diameter.Conclusion1.DR patients with macular morphological changes are mainly seven types:hard exudation,retinal hemorrhage,edema,anterior membrane,macular lamellar hole or pseudo-hole,local retinal thickness thinning.Which is hard to seepage,edema,retinal hemorrhage is the most common.2.DR staging and course of the disease,with the course of the extension,DR staging gradually increased.3.DR TCM syndromes are associated with the duration of diabetes mellitus.4.DR TCM syndromes associated with vision,blood stasis syndrome were lower than those in the wet turbidity in the resistance,wet turbidity in those who were lower than those of Qi and Yin deficiency.5.Morphological changes of macular morphology were associated with DR TCM syndromes6.The distribution of macular morphology was related to the DR stage of western medicine.7.The best corrected visual acuity is related to the thickness of the center fovea,the macular volume,and the average thickness of the center concave 1 mm.With the center of the concave thickness,volume,center concave 1 mm diameter average thickness increases,the best corrected visual acuity.