| Objective:Through the observation of the clinical efficacy of oral borneol combined with traditional Chinese medicine and post goal injection of triamcinolone acetonide(triamcinolone acetonide,TA)in the treatment of retinal vein occlusion macular edema(retinal vein occlusion-macular edema,RVO-ME),to explore the clinical therapeutic effect and possible mechanism of traditional Chinese medicine borneol in the treatment of retinal vein occlusion with macular edema,It provides a basis for the research and development of compound preparations in the future and a new idea for the treatment of this disease with combined traditional Chinese and Western medicine.Methods:In this study,a prospective research method was used to screen 29 patients with retinal vein occlusion and macular edema in the Eye Hospital of the Chinese Academy of Chinese Medical Sciences,and all of them met the diagnosis,inclusion criteria and overall TCM syndrome differentiation of macular edema secondary to retinal vein occlusion.After obtaining the patient’s consent and signing the patient’s informed consent,the included patients were randomly divided into two groups(including 15 patients in the control group and 14 patients in the experimental group):the control group was the conventional treatment group,that is,retrobulbar injection of TA(Triamcinolone acetonide injection 30mg+lidocaine 0.2ml,only one injection)combined with oral Chinese medicine Xuefu Zhuyu Decoction 28 doses;the experimental group was the borneol treatment group,that is,retrobulbar injection of TA(triamcinolone acetonide injection 30mg+Lidocaine 0.2ml,only 1 injection)combined with oral Chinese medicine borneol+Xuefu Zhuyu Decoction 28 doses,when taking Chinese medicine,first melt 0.3g of borneol with 10ml of rice wine,and then add it to each decoction.The treatment period of both groups was 28 days,and the follow-up time was 3 months.During the follow-up period,both groups only took Hexuemingmu Tablets 1.5g orally,three times a day.The proposed traditional Chinese medicine prescription is based on the clinical experience of this research group in the treatment of RVO-ME,with the addition and subtraction of Fangxuefu Zhuyu Decoction as the main prescription for the treatment.,Achyranthes,Campanulaceae,Fried Citrus,Licorice,Shichangpu,Panax notoginseng powder.The method of taking is to decoct in water,one dose a day,divided into morning and evening,and taken orally for 28 consecutive days.The borneol in the experimental group(borneol treatment group)needs to be melted with 10 ml of rice wine first,0.3 g of borneol in the experimental group(borneol treatment group),and then added Take it together in each decoction;retrobulbar injection of TA is only given once on the first day after enrollment.The main observation indexes of this experiment are:(1)visual acuity:compare the best corrected visual acuity(BCVA)before and after treatment,and use LogMAR visual acuity chart for conversion.The international logarithmic visual acuity chart was used and recorded.The observation time points were:4 times before treatment,14 days after treatment,28 days after treatment and 3 months after follow-up;(2)Measurement of central macular thickness(CMT):use optical coherence tomography(OCT,Zeiss,oct-5000)instrument to observe and measure the value of CMT and record it.The observation time points were:4 times before treatment,14 days after treatment,28 days after treatment and 3 months after follow-up;(3)Recurrence rate:determine the number of recurrence according to the OCT examination after 3 months of follow-up.The recurrence rate is the number of patients with macular edema in each group(at 3 months of follow-up)/the total number of patients in each group X 100%.In addition,at each observation time node,necessary routine ophthalmic examinations need to be carried out,such as intraocular pressure measurement,mydriasis,fundus examination,etc.Results the statistical software spss25.0 was used,P<0.05 was statistically significant.Results:1.At the end of this study,a total of 29 patients were actually included.Of these,3 patients dropped out,including 1 patient in the control group and 2 patients in the experimental group.The main reason is that some patients are difficult to adhere to long-term oral traditional Chinese medicine,or some patients are unable to follow-up due to the impact of the epidemic.2.There were no statistically significant differences between the two groups in terms of age,gender,number of patients,eye type,RVO classification and other indicators before enrollment(P>0.05).Baseline data were comparable.3.Clinical efficacyAccording to the curative effect evaluation standard established by the study,after 28 days of treatment,4 cases(26.67%)in the control group were markedly effective,10 cases(66.67%)were effective,and 1 case(6.66%)was ineffective;10 cases(71.42%)in the experimental group)was significantly effective,4 cases(28.57%)were effective,and the difference between the two groups was statistically significant(P<0.05),so the final clinical treatment effect of the experimental group was better than that of the control group.4.Best corrected visual acuity(BCVA)The BCVA(LogMAR)of the control group before treatment was(0.97±0.20),and the BCVA(LogMAR)of the experimental group before treatment was(0.99±0.31),and there was no significant difference between the two groups(P>0.05),the BCVA(LogMAR)of the control group was(0.71 ±0.14),and the BCVA(LogMAR)of the experimental group was(0.57±0.10),and the difference between the two groups was statistically significant(P<0.05).The BCVA(LogMAR)of the experimental group was(0.38±0.10),and the BCVA(LogMAR)of the experimental group was(0.21±0.06).The difference between the two groups was statistically significant(P<0.05),indicating that after 14 days of treatment and 28 days after treatment The two observation time points in the experimental group were better than those in the control group in improving visual acuity.The BCVA(LogMAR)of the control group was(0.27±0.12),(0.54±0.14),(0.28±0.10)from 14 days of treatment to before treatment,from 28 days of treatment to before treatment,and from 28 days of treatment to 14 days of treatment,respectively.The BCVA(LogMAR)of the group was(0.41 ±0.22),(0.77±0.27),(0.36±0.09)from 14 days of treatment to before treatment,from 28 days of treatment to before treatment,and from 28 days of treatment to 14 days of treatment,respectively.The difference before and after treatment was statistically significant(P<0.05),indicating that during the 28-day treatment observation period,the treatment of both groups was effective,but the difference in visual acuity improvement between the different observation time points between the two groups was compared.,the difference of visual acuity improvement in the experimental group was greater than that in the control group,indicating that the therapeutic effect of the experimental group was better than that of the control group.5.Central Macular Thickness(CMT)The foveal thickness of the control group and the experimental group during the treatment were(528.33±64.80)μm and(565.79±56.91)μm,respectively,and the difference was not statistically significant(P>0.05);58.70)μm,(357.14±36.06)μm,the difference was statistically significant(P<0.05);after 28 days of treatment,they were(346.00±46.29)μm,(254.21±40.64)μm,the difference was statistically significant Significant(P<0.05),indicating that the efficacy of the drug in reducing macular edema in the experimental group is much higher than that in the control group at different observation time points;the difference in CMT reduction in the control group from 14 days of treatment to before treatment was(109.87 ±50.89)μm,(182.13 ± 72.48)μm from 28 days of treatment to before treatment,and(72.27±46.78)μm from 28 days of treatment to 14 days of treatment,the difference in CMT reduction in the experimental group from 14 days of treatment to before treatment was(208.64±51.17)μm,(311.79±61.99)μm from 28 days of treatment to before treatment,and(103.14±28.60)μm from 28 days of treatment to 14 days of treatment,so the difference between the two groups before and after treatment was statistically significant Significant difference(P<0.05),and the difference of CMT reduction in the experimental group at these different observation time points was greater than that in the control group,indicating that during the 28-day observation period,both groups were effective in reducing the degree of macular edema,And the treatment effect of the experimental group was better than that of the control group.6.Recurrence rateAccording to the recurrence calculation formulated in this clinic,after 3 months of follow-up,there were 4 cases of recurrence in the control group with a recurrence rate(26.67%),and 2 cases in the experimental group with a recurrence rate of(14.29%).The difference is not statistically significant(P>0.05),and it cannot be shown that the effect of the experimental group is better than that of the control group in reducing the recurrence rate.Conclusions:1.Borneol can promote the absorption speed and absorption efficiency of retrobulbar injection of TA,improve its clinical efficacy,and provide a basis for the research and development of compound preparations in the future.2.Borneol+Chinese medicine combined with retrobulbar injection of TA in the treatment of retinal vein occlusion and macular edema proved to be safe and effective.It can be widely used in clinical practice,and can reduce the economic pressure and pain of patients and improve the quality of life. |
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