| Objective:To analyze the clinical efficacy and characteristic advant ages of Liqi Huatan Tongluo method combined with anti-Vascular Endoth elial Growth Factor(VEGF)in the treatment of polypoid choroidal vas culopathy(PCV)by retrospective research,providing certain clinical ideas and practical basis for the treatment of PCV with traditional Chinese and western medicine.Methods:The information of 44 patients with polypoid choroidal vascu lar disease who were newly diagnosed as outpatients or inpatients in Sichuan Provincial Hospital of Traditional Chinese Medicine from Janu ary 2016 to December 2018 was collected.According to whether combine d with traditional Chinese medicine treatment,those patients who met the inclusion and exclusion criteria were devided into groups A and B.Group A is those who accept an anti-VEGF therapy combined with tiq i Huatan Tongluo treatment with a total of 22 cases(22 eyes);Group B is those who accept a pure anti-VEGF treatment with a total of 22 ca ses(22 eyes).Compare and analyze the best corrected visual acuity(B CVA),central retinal thickness(CRT),subfoveal choroidal thickness(SFCT),data such as the number of anti-VEGF treatments.TCM symptom s,adverse reactions and ocular complications,treatment costs,and f ollow-up data by SPSS 23.0 statistical software,and study the therap eutic effects and differences of various observation indicators betwe en the two groups.Results:1.Best corrected visual acuity(1)The BCVA of group A and group B was improved at 3rd,6th,and 12th month than before treatment.In terms of improvement,at 3rd and 6th month after treatment,there was no significant difference between t he two groups(P>0.05).At 12th month,the difference between the tw o groups was statistically significant(P=0.009<0.01),the increase in BCVA in group A was significantly better than that in group B.(2)There was no significant difference in BCVA between group A a nd group B at 3rd and 6th months after treatment(P>0.05).At 12th mont h,there was a statistically significant difference between the two g roups(P=0.021<0.05).(3)The result suggested that 14 cases showed significant effect s,5 cases were effective,1 case was ineffective in group A,and the total effective rate was 95%;There was 10 cases showed significant effects,6 cases were effective,4 cases were ineffective in group B,and the total effective rate was 80%.Comparing the two groups by Ri dit test,P<0.05,the effect of group A was better than that of grou p B.2.central retinal thickness:(1)The CRT of group A and group B was decreased at 3rd,6th,and 12th month than before treatment,and the difference was statistically significant(P<0.01).(2)There was no significant difference in CRT between the two gr oups at 3rd and 6th months after treatment(P>0.05).At 12th,there wa s a statistically significant difference between the two groups(P=0.001<0.01).3.Subfoveal choroidal thickness(1)The average SFCT in group A and group B was statistically sig nificant at 3rd,6th,and 12th month after treatment compared with that before treatment(P<0.01).(2)There was no significant difference in SFCT between the two g roups at 3rd and 6th months after treatment(P>0.05).At 12th month,t he difference between the two groups was statistically significant(P=0.047<0.05).In terms of reduction,there was no significant differe nce between the two groups in 3rd month compared with that before trea tment,and there were statistically significant differences between t he two groups in 6th and 12th month(P=0.030,0.021<0.05).4.Comprehensive effects of traditional Chinese medicine(1)There was no significant difference in the total symptom scor e between the two groups before treatment(P>0.05),and the differen ce was significant after 12 months of treatment(P=0.047<0.05).Afte r treatment,the total scores of the two groups were significantly lo wer than before(P<0.05),but the A group was better than the B grou p,and the difference was statistically significant(P=0.001<0.01).(2)After treatment,4 cases were cured,3 cases were markedly ef fective,12 cases were effective,and 1 case was ineffective in group A;2 cases were cured,1 case was markedly effective,14 cases were effective,and 3 cases were ineffective in group B.Comparing the two groups by Ridit test,P<0.05,the effect of group A was better than that of group B.5.Analysis of health economic indicators(per capita anti-VEGF times and treatment costs in 1 year)(1)Analysis by Mann-Whitney test.There was a significant differ ence in the number of injections between group A and group B(P=0.014<0.05).This shows that there is a significant difference in the num ber of injections between the Chinese medicine group and the control group.During the follow-up period,the number of injections of the C hinese medicine group is less than that of the control group.(2)The independent sample t test showed that the difference in p er capita treatment costs between the two groups within 12 months was statistically significant(P=0.009<0.01).This shows that the medic al cost of the Chinese medicine combined with the anti-VEGF treatment group is lower than that of the pure anti-VEGF group,which has high er economic benefits.6.Analysis of safety indicators(adverse reactions,ocular complicat ions):(1)Incidence of systemic adverse reactions:No significant syste mic adverse reactions occurred in both groups after treatment;(2)Occurrence rate of ocular complications:No ocular complicati ons occurred in group A,and 3 cases of subconjunctival hemorrhage oc curred in group B,all of which were absorbed by themselves within 1 week after surgery.There were no other complications such as high in traocular pressure,corneal epithelial defects,endophthalmitis,and vitreous hemorrhage in both groups.Conclusion:Compared with anti-VEGF therapy alone,Liqi Huatan Tonglu o method combined with anti-VEGF therapy can improve patients' visual acuity and OCT morphological indicators better,reduce patient's disc omfort and improve patients'quality of life.Meanwhile,Liqi Huatan Tongluo method can reduce the number of re-injection of anti-VEGF and medical costs,reduce the incidence of complications and adverse rea ctions,and improve the safety of anti-VEGF therapy. |
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