Intravitreous Injection With Ranibizumab?zi Shen Jian Pi Hua Yu Pian Combined Laser For The Treatment Of Diabetic Macular Edema

ObjectiveThrough the analysis of the curative effect of different treatment of diabetic macular edema,we explore the economic,effective,low risk treatment of DME,which can provide reference for clinical rational drug use and to choose the best treatment.MethodIn a total of 62 cases(62 eyes)from the first affiliated hospital of guangzhou university of TCM system in 2012-2016 has been diagnosed as diabetic macular edema,and has the complete data which we need.Grouping:according to the previous treatment those cases were divided into experimental group of 3lcases(31 eyes)and control group of 31 cases(31eyes),experimental group:Intravitreous Injection with Ranibizumab,oral zi shen jian pi hua yu pian combined laser photocoagulation;Control group:oral zi shen jian pi hua yu pian joint retinal laser photocoagulation.The experimental group:intraocular injection of bevacizumab,1 to 2 months at a time,regular 3+x scheme(note:regular intraocular injection of bevacizumab 3 times in a row,the specific in fundus decided to note the increase or decrease in the number of drugs),after a week,according to the fundus circumstances to take the Panretinal photocoagulation or Subtotal laserphotocoagulation treatment which divided into 2 or 3 times.And supplement laser photocoagulation treatment when necessary after laser treatment,during oral zi shen jian pi hua yu pian;The Control group:patients received laser photocoagulation treatment which the same as experimental group,during oral zi shen jian pi hua yu pian.Three months after treatment,the datas of BCVA,OCT and adverse reaction condition changes were compared with and observed in the two groups.Around the group t-test was used,the comparison between the two groups was using two independent sample t-test,heterogeneity of variance and ranked data using the wilcoxon rank sum test,the classification data were analyzed by the x2 test,to analyze the curative effect of two groups,and make the appropriate conclusions.ResultsVision:After treatment,visual acuity improved in both groups.The experimental group before treatment(0.28±0.17),after treatment(0.57 ±0.22),visual acuity increased about 0.29 on average,the difference was statistically significant(p<0.05);The control group before treatment(0.32±0.12),after treatment(0.45±0.18),visual acuity increased about 0.13 on average,the difference was statistically significant(p<0.05);The total effective rate:the experimental group 87.10%,the control group 54.84%,the visual acuity of experimental group better than the control group,the difference was statistically significant(P<0.05).OCT:After treatment,the pit of the center of the macular retinal thickness acuity improved in both groups.The pit of the center of the macular retinal thickness average:the experimental group before the treatment(417.65±180.48)um,after treatment(281.58 ± 84.21)um;the control group before treatment(381.23 ±118.28)um,after treatment(289.68 ± 90.35)um,the difference was statistically significant(p<0.05).The value of improvement of the center pit:the experimental group(136.06±136.47)um,the control group(91.55±78.38)um,the difference was not statistically significant(P>0.05);the average retinal thickness of 1 mm diameter of the fovea:the experimental group before treatment(390.81 ±121.19)um,after treatment(294.35±96.36)um,the difference was statistically significant(p<0.05);The control group before treatment(384.26±98.64)um,after treatment(310.03±101.66)um,the difference was statistically significant(p<0.05);The value of improvement of the fovea 1 mm diameter of retinal:the experimental group(96.45 ±91.02)um,the control group(74.23 ± 85.76)um,the difference was not statistically significant(P>0.05).Conclusion1.After treatment,visual acuity improved in both groups,the visual acuity of experimental group improve more significantly than the control group.2.After treatment,the pit of the center of the macular retinal thickness average and the average retinal thickness of 1 mm diameter of the fovea acuity improved in both groups,and the experimental group improved more significantly than the control group.3.After treatment,the difference of the value of improvement of the center pit and the fovea 1 mm diameter of retinal was not statistically significant.Both intravitreous injection with Ranibizumab?oral zi shen jian pi hua yu pian combined laser photocoagulation and oral zi shen jian pi hua yu pian joint retinal laser photocoagulation are all the effective methods for the treatment of DME,all can significantly improve the visual acuity and macular edema,and the former was better than the latter.But after treatment,the difference of the value of improvement of the center pit and the fovea lmm diameter of retinal was not statistically significant.Therefore,in clinical we should comprehensive analysis of the patient's specific situation and the various risks in the process of treatment,and choice for the best treatment of patients.