Clinical Observation And Mechanism Of Yiqi Tiaoxue Huayu Recipe In The Treatment Of Wet AMD

Part One Clinical Researches of YiQi TiaoXue HuaTan Decoction on wet-Age-Related Macular DegenerationObjective To investigate the clinical efficacy of YiQi TiaoXue HuaTan Decoction(YTHD)on patients of wet-AMD.Methods 48 eyes(33 cases)of wet-AMD,dividing them into TCM group and the Lucentis group.Tcm group were given YTHD.The best corrected visualacuity(BCVA),fundus pictures,fundus fluorescence angiography(FFA)and optical coherence tomography(OCT)were compared before and 12 weeks later,24 weeks later..Result Compare before and after treatment of traditional Chinese medicine,BCVA improved after treatment than before,the first 12 weeks total effective rate was 81.25%(p<0.05),the first 24 weeks of the total effective rate was 87.5%(p<0.05);retinal bleeding area reduced after the treatment,the first 12 weeks total effective rate was 81.25%(p<0.05),24 weeks of treatment of the total effective rate was 83.33%(p<0.05);CNV leakage area was reduced,the total effective rate of 12 weeks 83.78%(p<0.05),the efficiency of 24 weeks was 89.19%(p<0.05);foveal thickness decreased after treatment than before(p<0.05).Conclusion YTHD can stabilize or even improve vision in patients with wet AMD,patients,promote the absorption of retinal hemorrhage and leak,improve the retinal edema.Part Two The Mechanism of YiQi TiaoXue HuaTan Decoction for the wet-Age-Related Macular Degeneration by adjusting the IL-17RCObjective To compare the levels of IL-17RC methylation between wet-AMD patients and the healthy;To compare wet-AMD's serum IL-17RC differences in methylation levels before and after treatment of YTHDMethods Sequenom MassARRAY(?)Methylation detection method to detect the expression of IL-17RC methylation in the serum of the control group,wet AMD group and the treatment group.Results In the 35 sites were detected in comparison,no significant difference(p>0.05)between the wet AMD group and the control group;IL-17RC methylation levels had no significant difference before and after treatment(p>0.05).Conclusion 1 The relationship between IL-17RC and wet AMD in yellow race can not be determined.2 Whether YTHD could regulate IL-17RC methylation levels to intervene wet AMD is not be determined.Part Three The Related Factors Associated with Age-Related Macular DegenerationObjective To investigate the relationship between AMD and cardiovascular disease,blood pressure,obesity,blood lipid,blood glucose,cervical vertebra disease and other diseases;To explore the relationship between wet AMD and related treatment;To explore the relationship between AMD and other retinal diseases.Methods 497 cases of wet AMD visting the ophthalmology department of China-JaPan Friendship Hospital from May 2011 to May 2013.The information of their cardiovascular disease,blood pressure,obesity,blood lipid,blood glucose,cervical vertebra disease and other diseases,the related treatment,and other retinal disease were collected..Results 1 Among 497 cases of wet AMD,109 patients was dry AMD,388 Cases was wet AMD;while 282 cases were male,215 cases was female;50s accounted for19.92%,60s accounted for 29.78%,70s accounted for 32.60%,80s17.70%;2 230 cases were accompanied by cardiovascular disease,accounting for 46.28%,including 86 cases were dry AMD,144 cases were wet AMD;186 cases were accompanied by hypertension,accounted for 37.42%,of which 85 cases were dry AMD,101 cases were wet AMD;accompanied by high blood lipids in patients with 131 people,accounted for 26.36%,of which 60 cases were dry AMD,71 cases were wet AMD;there were 145 people accompanied by diabetes,accounted for 29.18%,including 87 cases were dry AMD,58 cases were wet AMD;at the same time associated with obesity have 90 cases,accounted for 18.11%,of which 48 cases were dry AMD,42 cases were wet AMD;87 cases were accompanied by cervical spondylosispatients,accounted for 17.51%,of which 40 cases were dry AMD,47 patients were wet AMD;24 cases of other diseases(13 cases of prostatic diseases,9 cases of digestive system,2 cases of depression),accounted for 4.83%;3.388 cases wet AMD,taking the vasodilator agent for the number of 209 cases,taking anti coagulant for the number of blood tubule 184;traditional Chinese medicine and blood activating agent for the number 113;Taking hypoglycemic drugs for the number is 58;taking lipid-lowering drugs for the number is 63;the use of other antihypertensive drugs for the number of 59 people;the use of other drugs for the number 30.4.497 cases of AMD,10 patients accompanied RAO,25 cases associated with RVO,47 cases associated with DR,15 cases of patients associated with AION,27 cases of patients with macular membrane,19 cases of patients with macular hole,287 cases patients accompanied no other ocular fundus.Conclusion 1 Aging is one of the important factors of AMD;2 Cardiovascular diseases have a certain degree of influence on the development of AMD;3 Using vasodilators,anti-platelet aggregation and promoting blood of Chinese patent medicines was easy to cause macular repeated bleeding,aggravate AMD disease;4.RAO\RVO\AION etc.fundus,due to differences of the nutrition system and location,the relationship is not obvious;5.DR patients with AMD may be due to their age and medication-related;6 Macular epiretinal membrane,and Macular hole.