Clinical Efficacy Observation On Diabetic Macular Edema With Spleenkidney Yang Deficiency Treated By Pricking-cupping Bloodletting Ther Apy Combined With Traditional Chine Se Medicine As Adjuvant Therapy

Objective: The purpose of this article is to explore a new clinical scheme for diabetic macular edema.I approached this by observing the clinical effect of pricking-cupping bloodletting therapy combined with traditional Chinese medicine assisted intravitreal injection of Conbercept in the treatment of diabetic macular edema with spleen-kidney yang deficiency.Methods: Sixty patients(60 pairs of eyes)meeting the inclusion criteria were selected and randomly divided into experimental group(30cases,30 eyes)and control group(30 cases,30 eyes).The control group was given intravitreal injection of Conbercept once.The experimental group was treated with pricking-cupping bloodletting therapy(The patients were treated twice a week and rested for 2 weeks after 2 weeks of treatment.Four weeks was a course of treatment,a total of 3 courses of treatment.)combined with traditional Chinese medicine(The patients took the selfmade Wenyang Huoxue Decoction for 2 weeks and then rested for 2 weeks.Four weeks was a course of treatment,a total of 3 courses of treatment.)and intravitreal injection of Conbercept once(Injection at the beginning of the course of treatment).During the study,both groups were treated routinely to control blood glucose.I recorded the results of the 4 stages of the expertment(before treatment,1 course,2 courses and 3 courses after treatment): the best corrected visual acuity(BCVA),central macular thickness(CMT),vascular density of superficial retinal capillary plexus in macular area,vascular density of deep retinal capillary plexus in macular area,TCM syndrome score and adverse reactions of the two groups.The above results were statistically analyzed to compare the efficacy differences between the two groups.Results:(1)Comparison on relevant indicators: Within the two groups,after each set of treatment,BCVA,CMT,vascular density of superficial retinal capillary plexus in macular area,vascular density of deep retinal capillary plexus in macular area and TCM syndrome score of the two groups were different from those before treatment,with statistical significance(P < 0.05).Compared between the two groups,after each set of treatment,the BCVA,CMT and TCM symptom scores of the experimental group were significantly different from those of the control group(P < 0.05).After the first set of treatment,there were no significant differences in vascular density of superficial retinal capillary plexus and deep retinal capillary plexus in macular area between experimental group and control group(P > 0.05);and at the end of the second and third sets of treatment,there were significant differences in vascular density of superficial retinal capillary plexus and deep retinal capillary plexus in macular area between the experimental group and the control group(P < 0.05).(2)Comparison on curative effect: After the first set of treatment,the total effective rates of the experimental group and the control group were 96.67% and 60.00% respectively.After the second set of treatment,the total effective rates of the experimental group and the control group were 83.33% and 50.00% respectively.After the third set of treatment,the total effective rates of the experimental group and the control group were76.67% and 40.00% respectively.There were statistically significant differences between the two groups(P < 0.05).(3)Safety comparison: During the treatment,no serious adverse reactions occurred in the experimental group and the control group,and the treatment methods in the two groups were safe and effective.Conclusion: Pricking-cupping bloodletting therapy combined with traditional Chinese medicine assisted intravitreal injection of Conbercept has a significant therapeutic effect on DME with spleen-kidney yang deficiency,and the therapeutic effect is better than pure intravitreal injection of Conbercept.The experimental group can better improve vision,reduce macular edema,increase the vascular density of Inner retinal in the macular area,improve TCM symptoms,delay the progression of macular edema,and achieve better clinical and economic benefits.It can be an effective treatment for diabetic macular edema.