| Objective:To evaluate the clinical efficacy of the triple therapy of the traditional Chinese medicine on the primary retinitis pigmentosa by observing the changes of morphology and visual function and to explore its mechanism of action.Methods:A prospective,randomized,non-blind,controlled study way was conducted to select 30 patients(60 eyes)with binocular PRP as subjects,who met the criteria in the diagnosis of traditional Chinese and Western medicine.They were randomly divided into three groups and in each group have 10 patients(20 eyes).Control group 1(Yi Shi Yin);Control group 2(Yi Shi Yin with acupuncture therapy);Treatment group(Yi Shi Yin with Sanqi Panax Notoginseng for Injection iontophoresis and acupuncture therapy).In each group,10 patients(20 eyes)were observed and recorded the changes of the best central visual acuity and visual field examination,visual electrophysiological examination(PVEP 、 FVEP 、 FERG)before and after 4weeks treatment and according these data to have statistical analysis software SPSS20.0 was used for sstatistical analysis and evaluation.Results:1.Compared with before the visual acuity of the three groups was improved after 4 weeks treatment,indicating that all three ways have the effect of improving the visual acuity of PRP patients,and the difference have statistical significance(P<0.05),meanwhile the effective rate of the treatment group was higher than that of control group 2 and control group 1,with the total effective rate of 85%,75% and 35% respectively.Compared the visual acuity of the three groups after treatment,control group 1 was significantly different from that of control group 2 and treatment group,and there was no statistically significant difference between control group 2 and treatment group.The results shows that the therapeutic effect of Yi Shi Yin combined with acupuncture therapy was better than that of traditional Chinese herbal medicine alone.Traditional Chinese medicine triple method couldsignificantly improve PRP vision,and its curative effect is higher than that of Yi Shi Yin alone.2.After 4 weeks treatment the absolute values of MD and PSD of visual field in the three groups is reduced than before,indicating that the three ways all have the effect of improving the visual field of PRP patients,and the difference have statistical significance(P<0.05).Compared with the visual field of the three groups after treatment,the difference of MD absolute value between the control group 1 and the treatment group was statistically significant and there was no statistically significant difference with the other two groups.About absolute PSD of visual field there is no statistical significance between each other.This study indicated that traditional Chinese medicine triple method can significantly improve the whole retinal function of PRP,but the effect on local visual field defect function need further study.3.After 4 weeks treatment,PVEP(60’P100,15’P100 latency)and FVEP(P2 latency)in three groups were lower than those before,indicating that the three ways all have the effect of improving VEP in PRP patients,and the difference have statistical significance(P<0.05).After treatment,there was no significant difference in PVEP(60’P100 latency)between treatment group and the two control groups.In PVEP(15’P100 latency),control group 1 and the treatment group has statistical significance and the difference between the other two groups was not statistically significant.FVEP(P2 latency)between the control group 1 and the treatment group was statistically significant.There was no significant difference between the other two groups.This study shows that traditional Chinese medicine triple method can significantly improve the macular retinal function of PRP,but for the change of optic nerve conduction function still need further study.4.After 4 weeks treatment,the amplitudes of b-wave of dark adaptation0.01,dark adaptation 3.0,dark adaptation 3.0 OPS,light adaptation 3.0 and light adaptation 3.0 flashing in three groups were higher than before,indicating that the three ways all have the effect of improving the amplitudeof b-wave of PRP patients,the difference have statistical significance(P<0.05),and the effective rate of the treatment group was higher than that of the control group 2 and 1,the total effective rate was 90%,70%and 40% respectively.After treatment,there was significant difference in FERG between control group 1 and treatment group,and there was no significant difference between the other two groups.This study shows that traditional Chinese medicine triple method can significantly improve the b-wave amplitude of PRP full field electroretinography,and its curative effect is higher than that of Yi Shi Yin alone.5.The effective rates of total efficacy in the control group 1,the control group 2 and the treatment group were 35%,75%,and 85%,respectively.The total efficacy of the three groups was statistically significant(P<0.05).And the effective rate of the treatment group was higher than that of the control group 2 and the control group 1.After treatment compared the curative effect of three ways,there was significant difference between control group 1 and the other two groups,Meanwhile there was no significant difference between control group 2 and treatment group.It shows that the effect of Yi Shi Yin combined with acupuncture treatment is higher than that of traditional Chinese herbal medicine alone,The effect of triple therapy of traditional Chinese medicine is better than that of Yi Shi Yin alone.There exist difference between Yi Shi Yin combined with acupuncture treatment and triple therapy of traditional Chinese medicine but no statistical significance.Conclusion:Yi Shi Yin combined with Sanqi Panax Notoginseng for Injection iontophoresis and acupuncture has good clinical effect on PRP.It can improve thevisual acuity,visual field average defect,fundus retinal microcirculation,optic nerve conduction and retinal metabolism.Besides its treatment effect of the PRP is better than Yi Shi Yin group.Although there have difference between triple therapy of the traditional Chinese medicine and Yi Shi Yin combined with acupuncture treatment,and the observation also need enlarge sample size to have further study. |
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