Discussion On The Curative Effect And Mechanism Of Simiao Yong’an Decoction Combined With Dahuang Zhechong Capsules In The Treatment Of NPDR

Objective:Diabetic retinopathy(DR)is one of the complications of diabetes.A large number of studies show that timely diagnosis and treatment of diabetic retinopathy is of great significance for its prognosis.Western medicine lacked effective treatment methods in the early stage,while traditional Chinese medicine showed its own advantages in the early prevention and treatment of DR with its unique idea of "preventing the disease".Through literature search,this paper summarizes and analyzes the progress of traditional Chinese and Western medicine in the pathogenesis and treatment of DR.On this basis,research idea of Miaoyong’an Decoction combined with Dahuangzhe Capsule in the treatment of NPDR was established.The clinical efficacy was observed,and the effectiveness and feasibility of the treatment idea were evaluated.Methods:The first part is a literature review.Search related literature on diabetic retinopathy on CNKI.Summarized and analyzed the mechanism and prevention of non-proliferative diabetic retinopathy,and provided guidance for the clinical and scientific research of NPDR.The second part is the clinical study,68 patients(68 eyes)who met the standard were selected.The patients were divided into two groups by random parallel controlled trial.In the control group,33 cases(33 eyes)were treated with calcium dobesilate capsules orally.The experimental group of 35 cases(35 eyes),on the basis of the control group,were treated with Simiao Yong’an Decoction and Dahuang Zhechong capsules.Every 4weeks is a course of treatment,and the treatment is 2 courses.The BCVA,CMT,systemic and ocular symptom scores of the two groups were observed,and statistical analysis was performed to evaluate the clinical efficacy.Results:Results of retrospective analysis: Traditional Chinese medicine for Diabetic retinopathy mostly treats it from the perspective of "deficiency,heat and blood stasis".It often uses blood activating drugs together with tonic drugs such as supplementing qi and nourishing Yin,and treats it according to the syndrome differentiation of patients’ physique.Early treatment of diabetic retinopathy is limited in western medicine.Most of them focus on the treatment of basic diseases.Most patients rely on surgery for later treatment.Clinical study results:(1)BCVA after treatment: Before and after treatment,there were statistical differences between the experimental group and the control group(P<0.01).There was no significant difference between the two groups after treatment(P>0.05).(2)CMT after treatment: The intra-group comparison of the experimental group before and after treatment was statistically significant(P<0.05).There was no statistical difference between the control group before and after treatment(P>0.05).After treatment,there was no statistical difference between the experimental group and the control group(P>0.05).(3)Fundus score after treatment: The intra-group analysis before and after treatment in the experimental group showed a statistically significant difference(P<0.01);there was no statistical difference in the control group(P>0.05).There was significant statistical difference between the experimental group and the control group(P<0.01).(4)TCM syndrome score after treatment: There was significant statistical difference between the two groups after treatment(P<0.01).Comparison within groups: There were statistical differences between the experimental group and the control group before and after treatment(P<0.01).The treatment effect of the experimental group was better than that of the control group.The total effective rate of the experimental group was 88.6%;the total effective rate of the control group was 33.4%.(5)Analysis of curative effect after treatment: Statistical analysis of curative effects(visual curative effect and fundus score curative effect)of the two groups showed that there was a statistical difference between the two groups(P<0.01),and the curative effect of the experimental group was better than that of the control group.Conclusion:Aiming at the pathogenesis of diabetic retinopathy "deficiency,heat,blood stasis" in TCM,under the guidance of TCM’s concept of "preventive treatment" and the combination of disease differentiation and dialectics,aiming at the dual mechanisms of inflammation,microvascular damage and the mechanism of blood stasis blocking collaterals,Simiao Yong’an Decoction combined with Dahuang Zhechong capsules has achieved good curative effect in the treatment of non-proliferative diabetic retinopathy,which provides new ideas and methods for the prevention and treatment of NPDR.