Synergistic Effect Of Buyang Huanwu Decoction On Non-proliferative Diabetic Retinopathy

Objective:In this study,we observed the changes of visual function and the curative effect of Traditional Chinese Medicine(TCM)syndrome in patients with non-proliferative diabetic retinopathy(NPDR)of Qi-yin deficiency and blood stasis type treated by Buyang Huanwu Decoction combined with different methods,and explored the synergistic effect of Buyang Huanwu Decoction on non-proliferative diabetic retinopathy.Methods:This study collected 92 patients(92 eyes)who met the criteria of non-proliferative diabetic retinopathy and TCM syndrome differentiation(deficiency of both qi and yin and blood stasis)from January to October 2018 in the outpatient department and ward of ophthalmology and endocrinology department of the second people’s hospital affiliated to Fujian university of traditional Chinese medicine.They were randomly divided into treatment group and control group with 46 cases(46 eyes)in each group.Patients in the control group were treated with the recommended treatment plan for diabetic retinopathy issued by the American Academy of Ophthalmology in 2016.The patients in the treatment group were additionally treated with Buyang Huanwu Decoction on the basis of the control group,with 15 days as one course of treatment,and 4 courses of treatment.The patients’ best corrected visual acuity(BCVA),central macular thickness(CMT),Mean Defect(MD),intraocular pressure,fundus condition and TCM syndrome curative effect were observed before treatment,at the end of treatment and 3 months after treatment.Results:(1)The change of visual acuity in the treatment group was not obvious before treatment,at the end of treatment and 3 months after treatment,and the difference was not statistically significant(P>0.05).In the control group,the mean value of BCVA(LogMAR)at the end of 3 months after the treatment,increased from 0.36±0.31 to 0.39±0.22,and the visual acuity decreased compared with that before,with statistically significant difference(P<0.05).The value of BCVA comparison treatment group was superior to the control group at 3 months after the treatment and the difference was statistically significant(P<0.05).(2)Three months after the treatment,the mean CMT of the treatment group decreased from 271.35±97.34 μm before treatment to 235.37±39.16 μm,the difference was statistically significant(P<0.05).That of the control group decreased from 266.80±97.14 μm to 246.20±37.13 μm,but the decrease range which was less than the treatment group.The difference between the two groups was statistically significant(P<0.05).(3)The effective rate of visual field improvement in the treatment group was 71.74% three months after the treatment.And the control group was 52.17% which was lower than that of the treatment group,with statistical significance(P<0.05).(4)Three months after the treatment,the effective rate of fundus in the treatment group was 84.78%,and that in the control group was 60.87%.The effective rate in the treatment group was higher than that in the control group and the difference was statistically significant(P<0.05).(5)The effective rate of TCM syndrome improvement was 89.13% in the treatment group and 54.35% in the group at the end of the course of treatment,while 76.09% in the treatment group and 43.47% in the control group three months after the treatment.The efficacy of the treatment group on TCM symptoms was higher than that of the control group both at the end of treatment and 3 months after the end of treatment,and the difference was statistically significant(P<0.05).(6)There was no significant difference in IOP between the two groups before and after treatment(P>0.05).Conclusion:The combination of Buyang Huanwu Decoction can stabilize the vision of patients with non-proliferative diabetic retinopathy,reduce the macular fovea retinal thickness,increase the average visual field threshold,improve the fundus circulation and the syndrome of traditional Chinese medicine to a certain extent,and has a significant synergistic effect.