| Objective:To evaluate the clinical efficacy of the traditional Chinese medicine "Huoxue Lishui Recipe" combined with dexamethasone intravitreal implants in the treatment of uveitis macular edema(UME),and reveal the superiority of combined Chinese and Western medicine in the treatment of UME.Methods:This study is a prospective,randomized controlled trial.A total of 50patients(58 eyes)who were clinically diagnosed with UME in the Department of Ophthalmology,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from October 2018 to October2020 were selected,and a random number table was adopted.The method is divided into control group and treatment group.Among them,25 cases in the control group(28 eyes)were treated with dexamethasone intravitreal implant(Ozurdex(?))0.7 mg alone;25 cases in the treatment group(30 eyes)were treated with the traditional Chinese medicine "Huoxue Lishui Recipe" has 6courses of treatment,each course of 15 days.According to the analysis of syndrome differentiation and treatment,the addition and subtraction of Chinese medicine prescriptions can be made appropriately.Observed for 3months from the start of treatment,and recorded the best corrected visual acuity(BCVA),central macular thickness(CMT)and intraocular pressure(IOP)of each study subject before treatment,1 week after treatment,1 month after and 3 months after.At the same time,it is necessary to record the changes in the degree of vitreous haze(VH)of each study subject before treatment and after 3 months of treatment,adverse reactions that occurred during the test,and Complications and other conditions,and finally comprehensively evaluate and compare the overall efficacy of the two groups based on various indicators and results.The data results are all statistically analyzed by SPSS26.0 statistical software.Results:Before treatment,the general clinical data between the two groups including age,gender,course of disease,initial BCVA,initial CMT and initial IOP were not statistically significant(P>0.05),and they were comparable.1 BCVA comparison:The average BCVA(log MAR)of the treatment group before treatment,1 week after treatment,1 month after treatment and 3months after treatment were 0.81±0.50,0.53±0.40,0.43±0.33,0.39±0.30;the control group before treatment,1 week after treatment,1 month after treatment and 3 months after treatment were 0.82±0.45,0.64±0.40,0.66±0.42,0.62±0.40,respectively.The average value of BCVA(log MAR)in the treatment group after 1 week,1 month and 3 months of treatment compared with before treatment,the difference was statistically significant(P<0.05),and each stage was compared with the previous stage,The difference is still statistically significant(P<0.05);the average value of BCVA(log MAR)in the control group after 1 week,1 month,and 3 months of treatment compared with before treatment,the difference is statistically significant(P<0.05),but there is no significant difference between the treatment group and the control group after treatment for 1 month and 1 week,3 months after treatment and 1week after treatment,3 months after treatment and 1 month after treatment(P>0.05);There was no statistically significant difference between the groups after 1 week of treatment(P>0.05),but the difference between the groups after 1 month and 3 months of treatment was statistically significant(P<0.05).2 CMT comparison:The average CMT values of the treatment group before treatment,1 week after treatment,1 month after treatment and 3months after treatment were 530.67±126.64μm,386.97±108.34μm,350.17±90.53μm,308.40±83.07μm;the control group before treatment,1week after treatment,1 month after treatment and 3 months after treatment were 523.54±123.25μm,437.54±86.96μm,406.18±85.61μm,356.96±87.48μm,respectively.The average value of CMT in the treatment group after 1 week,1 month and 3 months of treatment compared with before treatment,the difference was statistically significant(P<0.05),after 3 months of treatment,after 1 week of treatment,and after 3 months of treatment Compared with after 1 month of treatment,the difference is still statistically significant(P<0.05),but after 1 month of treatment,compared with 1 week after treatment,the difference is not statistically significant(P=0.05);the average CMT in the control group The values After 1 week,1 month,and3 months of treatment compared with before treatment,the difference was statistically significant(P<0.05),and each stage compared with the previous stage,the difference was still statistically significant(P<0.05);there was no statistically significant difference between the treatment group and the control group after 1 week of treatment(P>0.05),but there was a statistically significant difference between the groups after 1 month of treatment and 3months of treatment(P<0.05).3 IOP comparison:The average intraocular pressure before treatment,1week after treatment,1 month after treatment and 3 months after treatment in the treatment group were respectively 17.23±5.15 mm Hg,17.73±6.13 mm Hg,14.80±2.94 mm Hg,14.50±3.81 mm Hg;the control group before treatment,1week after treatment,1 month after treatment and 3 months after treatment in the treatment group were respectively 16.29±5.84 mm Hg,20.57±6.57 mm Hg,16.57±4.27 mm Hg,15.32±4.37 mm Hg.The average intraocular pressure in the treatment group was compared with before treatment after 1 month and 3months,and the difference was statistically significant(P<0.05)after 1 month and 3 months after treatment.After 1 week compared with before treatment,after 3 months of treatment and after 1 month of treatment,the difference was not statistically significant(P>0.05);in the control group after 1 week of treatment compared with before treatment,after 1 month of treatment Compared with after 1 week of treatment,after 3 months of treatment and after 1 week of treatment,the difference was statistically significant(P<0.05),but after 1 month and 3 months of treatment,compared with before treatment,after 3 months of treatment,compared with After 1 month of treatment,the difference was not statistically significant(P>0.05);there was no significant difference between the treatment group and the control group after 1 week,1month,and 3 months of treatment(P>0.05).4 Comparison of the degree of vitreous opacity:The changes in the degree of vitreous opacity in the treatment group and the control group were statistically significant before and after treatment(P<0.05).5 Overall curative effect comparison: There were 30 eyes in the treatment group,of which 4 eyes were cured,20 eyes were markedly effective,4 eyes were effective,and 2 eyes were ineffective.The overall effective rate was 93.34%;28 eyes in the control group,of which 2 eyes were cured,13 eyes were effective,8 eyes were effective,and 5 eyes were ineffective.,The overall effective rate was 82.14%.After 3 months of treatment,the overall efficacy of the two groups was compared,and the difference was statistically significant(P<0.05).Conclusion:1.Simple Ozurdex(?) vitreous implantation and the traditional Chinese medicine "Huoxue Lishui Recipe" combined with Ozurdex(?) are effective in the treatment of UME,but the overall effect of the latter is better.2.The combination of traditional Chinese medicine "Huoxue Lishui Recipe" combined with Ozurdex(?) vitreous implantation can not only better improve the patient’s visual function,improve the anatomical structure and function of the macula,but also have advantages in safety and efficacy stability.3.Pure Ozurdex(?) vitreous implantation may cause a transient increase in intraocular pressure,but the duration is not long;and Ozurdex(?)implantation can significantly improve the degree of vitreous opacity. |
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