Clinical Research Of Qing Jie Huo Xue Tang On Retinal Vasculitis In Early And Medium Period

Objective:1 To assess the methodlogical quality of clinical studies on traditional chinese medicine,integrated troditional chinese medicine and western medicion, western medicion in treating retinal vasculitis.2 Through the retrospective analysis of inpatients with retinal vasculitis in eye hospital of China academy of Chiniese medical sciences,investigate the clinical characteristics,the syndrome differentiation and treatment of retinal vasculitis.3 To detect the expression of anti-endotheial cell antibodies in patients with retinal vasculitis and Explore the observation index for diagnosing and reflecting clinical activity of retinal vasculitis.4 Through observating the therapetic effect of using qing jie huo xue tang compared to western medicine to treat retinal vasculitis,investigate the effects of qing jie huo xue tang to clinical expressions of patients with retinal vasculitis,and provide a new way of treating the disease.Method:1 Search the main domestic databases(1994-2007) and pubmad(1997-2007),and evaluate the quality of literatures on their study object,diagnostic criteria,randomization and blind method,intervention method and follow-up.2 The synptomes and signs,the syndrome differentiation and treatment were retrospectively analyzed on the basis of 59 inpatients of our hospital from 1997 to 2007.3 Sera AECA level in 12 patients with retinal vasculitis and 13 healthy individuals were detected by ELISA method.4 Separated the 30 RV patients consistent with our diagnostic criteria into two groups:The 15 patients of the test group take the qing jie huo xue tang,while the 15 patients of the control group take western medicine,The period of clinical trial was 3 months.Before and after the clinical trial we tested and compared the visual acuity,fundus hemorrhage and fluorescein Leakage,as well as the Chinese medicine general symptom of the two groups.Result:1 There are 51 literatures bringing into the evaluation,Among the total,10 literatures are controlled trials,2 literatures are randomized controlled trials,no literatures mentioned their randomization method and blind method,1 literature mentioned balance between the two groups,3 literatures mentioned diagnostic criteria,and their criteria to evaluate effect are different.2 Most of the ocular fundus signs are abnormal diameters of the vessels,fundus hemorrhage,exudation,edema and vascular sheathing.There are 4 syndromes of the patients,After the therapy,vission in 14 eyes(16.9%) obtained significant improvement,14 eyes(16.9%) were effective,49eyes(59%) were stabilized and 6 eyes had no improvement,ocular fundus in 44 eyes(53%) were effective,9eyes (47%) had no improvement.3 Sera AECA in 3 patients with retinal vasculitis were positive,the positive rate was 25%,while sera AECA were negative in healthy individuals.4 Before the clinical trial,the two groups had no significant difference in age,course of disease,visual acuity,Chinese medicine general symptom score. After the clinical trial,the two groups had no significant difference in visual acuity(p=0.485＞0.05) and fluorescein Leakage(p=0.057＞0.05).Both of the two treatment can improve the symptomsbut and signs of the patents.The test group had better effects on the improvement of the fundus hemorrhage(p=0.028＜0.05) and Chinese medicine general symptom(p=0.000＜0.05).Conclusion:1 literatures on retinal vasculitis now at home and abroad are mainly narrative trails,while there are few randomized controlled trials,so the research quality of the disease should be improved.2 From the experience of treating RV patients,we think that following the syndrome differentiation of TCM,the method of Zhong Yao Tang Ji and intravenous drip TCM preparation for heat-clearing,detoxicating and activating blood circulation to treat retinal vasculitis was effective.3 The immunity damage relevant to AECA was exist in the development of retinal vasculitis,and the patients whose sera AECA were positive are all in an active period of vasculitis,so we can Speculate that AECA have a close correlation with the disease activity of retinal vasculitis.4 Both of the two methods had some effects in the improvement of the visual acuity,fundus hemorrhage and fluorescein Leakage.Qing jie huo xue tang had better effects in the improvement of the fundus hemorrhage and Chinese medicine general symptom.