Clinical Research Of Liujunzi Decoction Combined With Ranibizumab For The Treatment Of Spleen-deficient And Phlegm-dampness Type ESMD Patients

Objective:To observe Liujunzi Decoction combined with intravitreal injection of Ranibizumab in the treatment of Spleen-Deficiency and Phlegm-Dampness type Shi Zhan Hun Miao(exudative senile macular degeneration(ESMD))in patients with clinical efficacy,and to further explore the mechanism of combined therapy,enrich and optimize the treatment of this disease,so as to improve the clinical therapeutic effect of the ESMD.Methods:According to the diagnostic criteria,inclusion criteria and exclusion criteria of spleen-deficiency and phlegm-dampness type ESMD,a total of 60 eyes were screened and collected from 60 patients treated in People’s hospital affiliated to FuJian University of Traditional Chinese Medicine from December 2017 to December 2018.30 eyes in the intravitreal injection of Ranibizumab group(hereinafter referred to as the control group),30 eyes in 30 cases,Liujunzi Decoction combined with intravitreal injection of Ranibizumab group(hereinafter referred to as the treatment group),30 eyes in 30 cases.Control group adopts intravitreal injection of Ranibizumab,1 time 1 month,injection 3 times in a row,treatment time for 3 months;The treatment group received Liujunzi Decoction combined with intravitreal injection of Ranibizumab once a month,three consecutive injections of Chinese medicine at the same time(Liujunzi Decoction),the treatment time was also 3 months.BCVA,FFA,OCT and fundus photography were observed before and 90 days after treatment in two groups of patients.SPSS 20.0 software was used for statistical analysis of the data.Results:1.Comparison of general conditions before treatment: there were no statistically significant differences in gender,age,BCVA and CMT between the two groups,which were comparable(P>0.05).2.Comparison of BCVA in the eyes after treatment: the BCVA of the two groups after treatment was higher than that of the pre-treatment,the difference was statistically significant(P<0.05),After treatment,the improvement of BCVA in the treatment group was better than that in the control group,the difference was statistically significant(P<0.05).3.Comparison of FFA changes in affected eyes after treatment: FFA in affected eyes of the two groups was improved after treatment,and the difference was statistically significant(P<0.05);FFA changes in affected eyes of the treatment group were better than those of the control group after treatment.4.Comparison of CMT in the eyes after treatment: the CMT of the two groups after treatment was lower than that of the eyes before treatment,the difference was statistically significant(P<0.05),After treatment,the decrease of CMT in the treatment group was better than that in the control group,the difference was statistically significant(P<0.05).5.Comparison of fundus hemorrhage and exudation area after treatment: the differences between the two groups in the fundus hemorrhage absorption and exudation area reduction after treatment were statistically significant(P<0.05),and the fundus hemorrhage absorption and exudation area reduction in the treatment group were better than those in the control group.6.Comparison of overall efficacy between the two groups after treatment: the total number of eyes with significant effect,effective and ineffective was compared between the two groups after treatment,and the difference was statistically significant(P<0.05).The overall effective rate of the treatment group was 96.7%,which was higher than 83.3% of the control group.Conclusions:1.The intracavitary injection of Ranibizumab is effective(83.3%)in the treatment of ESMD patients with Spleen Deficiency and Phlegm Dampness type,which is reflected in the improvement of BCVA,promoting the disappearance of choroidal neovascularization,reducing macular edema and reducing CMT,Promoting fundus hemorrhage,exudate absorption.2.Compared with the intracavitary injection of Ranibizumab,Liujunzi Decoction combined with the intracavitary injection of Ranibizumab is more effective(96.7%)in the treatment of ESMD patients with Spleen Deficiency and Phlegm Dampness type,and can improve BCVA better,promote the disappearance of choroidal neovascularization,reduce macular edema,reduce CMT,and promote fundus hemorrhage,exudate absorption.