The Clinical Investigation Of The Union Of Laser Therapy And Chinese Traditional Medicine (Xiaomengling Tablets) To Treat Diabetic Macular Edema

Objective:To observe the clinical efect of the union of laser therapy and Chinese TraditionaI Medicine(xiao meng ling tables)to treat diabetic macuIar edema.Methods:According to the fundus fluorescein angiography and optical coherence tomography,we chose 30 patients,46 eyes with diabetic(Ⅲ～Ⅴ)macular edema(Qi-yin deficiency and stasis blocking eye collaterals ),and randomly divided them into the observation group and control group.Both of these two groups received the treatment of panretinal photocoagulation(PRP).After that,the observation group was given the Chinese Traditional Medicine treatment,taking orally xiaomengling tables.Twelve weeks for a course.The effectiveness indexes were the vision,the thicness of the macular central fovea and the symptom of TCM.Meanwhile we record the vision of one-week and four-weeks during the follow up pariod.Results:The total effectiveness of the vision enhancement of the observation group for one-week and four-weeks was respectively 91.3%and 86.95%,while the control group was respectively 88.89%and 72.22%.The difference of the two group was not statistically significant.Twelve weeks later,the total effectiveness of the vision enhancement and macular edema improvement of the observation group were 86.95%and 96.65%,while the control group were 66.67%and 38.89%.The difference of them was statistically significant.The total effect of TCM symptom and diabetic microangiopathy of the observation group was respectively 86.67%and 91.3%,while the control group was respectively 26.67%and 55.56%.The difference of them was statistically significant.The results of therapy effect of pre and post treatment for every groups:(1)control group:The average visual acuity pre treatment was 0.38±0.06.One-week,four-weeks and twelve-weeks later it was respectively 0.46±0.07(P＜0.05),0.37±0.06(P＞0.05)and 0.36±0.06(P＞0.05).The results suggest that the difference of average visual acuity was statistically significant in a week,but was not statistically significant in four-weeks and twelve-weeks. The mean thicness of macular fovea detected by OCT pre and post treatment were 250.55±18.16(um)and 260.83±16.41(um),P＞0.05,so the difference was not statistically significant.(2)observation group:The average visual acuity pre treatment was 0.29±0.05.One-week,four-weeks and twelve-weeks later it was respectively 0.39±0.06(P＜0.05),0.36±0.05(P＜0.05)and 0.35±0.05(P＜0.05).The results suggest that the difference of average visual acuity was statistically significant in one-week,four-weeks and twelve-weeks.The mean thicness of macular fovea detected by OCT pre and post treatment were 330.70±45.20(um)and 275.13±30.75(um)(P＜0.05),so the difference was statistically significant.(3)The therapy effect for different classification macular edama:The total effectiveness of the vision enhancement for mild,moderate and severe macular edama was respectively 83.33%,78.95%and 60%(P＞0.05). The total effective rate on the improvement of macular edema for that three different classification macular edama was respectively 66.67%,57.89%,50%(P＞0.05).Conclusions:The effect of the union of panretinal photocoagulation(PRP) and Chinese Traditional Medicine(Xiaomengling tablets)to treat diabetic macular edema is better than the treatment of panretinal photocoagulation,the difference was statistically significant.The union of PRP and Xiaomengling tablets can improve the vision,the diabetic microangiopathy,the degree of the macular edema and the symptom of TCM,can shorten the time of vision enhancement and macular edema retrogression.The effect of different degree of macular edema is decreasing whith increasing of the severity of the macular edema,It suggest that early treatment can improve the curative effect of DME.