TCM Syndromes Characteristics Of IMEM And Clincal Research Of Traditional Chinese Medicine Combined Micro-invasive Vitrectomy In The Treatment Of IMEM

Part one TCM syndromes characteristics of IMEMObjective Identificating and statisticing the TCM Syndromes in patients with Idiopathic macular membrane to study on the distribution characteristics,in order to provide the theoretical basis and clinical thinking for the treatment of this disease.Methods From March 2017 to March 2019,were collected from 120 cases of IMEM patients in the ophthalmology clinic of Chinese Academy of traditional Chinese Medicine were selected.There were 56 males and 64 females with an average age of(68.62±10.31)years.According to the four diagnostic methods,all patients were divided into six types:liver qi stagnation,deficiency of liver and kidney yin,qi and yin deficiency,phlegm dampness offense,yin deficiency and fire excess,stagnation of blood stasis.Collecting dialectical information for patients who meet the inclusion criteria and inputing the data of differentiation of symptoms and signs with a database.Results 1.There were 16 cases(13.3%)with liver qi stagnation,46 cases(38.3%)with phlegm dampness offense,6 cases(5.0%)with stagnation of blood stasis,32 cases(26.7%)with deficiency of liver and kidney yin,12 cases(10.0%)with yin deficiency and fire excess,8 cases(6.7%)with qi and yin deficiency,the composition ratio of each syndrome type had statistical difference(X2=62.00,P<0.01).2.The age of onset was mainly concentrated in the middle-aged who elderly over the age of 50,and the number of patients under the age of 50 was less,including 10(8.3%)of the 50-59-year-old,46(38.3%)of the 60-69-year-old,50(41.7%)people aged 70 to 79 and 10(8.3%)over 80 years old.The age composition ratio of patients with IMEM was significantly different(X2=81.33,P<0.01).3.There were 58 patients with hypertension(48.3%),26 patients with diabetes mellitus(21.7%),45 patients with hyperglycemia(37.5%),4 patients with renal insufficiency(3.3%).Conclusions 1.The main syndrome types of IMEM are phlegm dampness offense and deficiency of liver and kidney yin.2.The onset age of IMEM is mainly over 50 years old.Different age stages have their corresponding high incidence syndrome types.With the increase of age,each viscera and the imbalance of qi,blood,yin and yang in the whole human body will result in different pathological stages.3.Patients with IMEM often have hypertension,diabetes and hyperlipidemia at the same time.Part two Clincal research of Traditional Chinese medicine combined micro-invasive vitrectomy in the treatment of IMEMObjective To estimate the better treatment of traditional Chinese medicine combined with surgery treating IMEM contrast simple surgery group.Methods From March 2017 to March 2019.we collected the clinical data of 74 patients(82 eyes)with IMEM diagnosed in our clinic,including 34 males(38 eyes),40 females(44 eyes),58 to 89 years old.The mean age was(67.87±10.65)years old.The patients who met the inclusion criteria were randomly divided into two groups:the experimental group and the control group.The control group was treated with vitreoretinal surgery.The patients in the test group were treated with vitreoretinal surgery and treated with Chinese herbs of Lycium barbarum Fuling decoction after operation.The best corrected visual acuity,fundus color examination and OCT examination were performed at preoperation,1 week,1 month and 3 months postoperation in all patients.SPSS21.0 software was used to analyze and evaluate the results of each index of the patients.Results 1.visual acuity:There was a significant difference in visual acuity between the two groups before and after operation(P<0.05).The visual acuity of the experimental group was significantly higher than that of the control group,and there was a significant difference in the visual acuity between the two groups(P<0.05).2.OCT showed that the mean thickness of macular fovea in the experimental group were significantly lower than those in the control group(P<005),and the macular volume in the two groups was also compared with that in the control group.There was no significant difference(P>0.05).Conclusions The treatment of Lycium barbarum Fuling decoction combined with 23-g vitrectomy treating IMEM can promote absorb of edema,improve and stabilize visual acuity.It will provide a new idea and method for the treatment of macular epiretinal membrane,and it is safe and effective,and it can reduce the rate of recurrence.