Clinical Study Of Chinese Medicines (SiWuWuZiTang) Combined With Argon Laser Photo Coagulation Treatment On Diabetic Retinopathy

Objective:To observe clinical effect of Chinese Medicines(SiWuWuZi Tang) combined with Argon laser photo coagulation on theⅡ～Ⅳstages of diabetic retinopathy(DR) of GanShenBuZu type in TCM.To measure the serum levels of intercellular adhesion molecule-1(ICAM-1) before and after therapy,and discuss the mechanisms of Chinese medicine treatment during the argon laser photo coagulation of DR.Methods:Thirty-six patients(66 eyes) were randomly divided into two groups,the treatment group and the control group,twenty patients(36 eyes) in the treatment group and sixteen patients(30 eyes) in the other.20 normal subjects' serum levels of intercellular adhesion molecule-1(ICAM-1) in medical examination center were chosen to compare with the diabetes.Patients in the treatment group were treated with Chinese medicines(SiWuWuZi Tang) combined with Argon laser photo coagulation.Patients in the control group were solely treated with Argon laser photo coagulation.To evaluate the clinical therapeutic effectiveness, which included the visual acuity(best corrected visual acuity),eyeground changes were observed by direct ophthalmoscope,three-mirror contact lens,fundus photographs of the retina and FFA(fundus fluorescein angiography) in two groups,and the patients' serum levels of intercellular adhesion molecule-1(ICAM-1) were measured and compared before and after treatment.Results:1.After three months' therapy,the treatment group's visual acuity(best corrected visual acuity) was raised more significantly than control(P＜0.05);2.After three months' treatment,with regard to the retinal hemorrhages and exudates that were observed by direct ophthalmoscope and three-mirror contact lens,the results for the treatment and control group are significant different(P＜0.05);3.After three months' treatment,regarding the microangiomas,leakage and macular edema aeras which were examined by FFA,the treatment group's reflection was better than control's.The difference of retina circulation time (RCT),microangiomas,leakage and macular edema aeras for the same group before and after treatment were significant(P＜0.05),and the difference of nonperfusion areas for the same group before and after treatment had no statistical significance(P＞0.05).Regarding the abolition of retinal new vessels by FFA,the treatment group was more significant than control group after therapy(P＜0.05),the difference of the same group was insignificant before and after treatment(P＞0.05);4.After three months' treatment and one month follow-up,the overall effective ratio was 80.55%for treatment group and 50%for control group;5.The therapeutic time for retinal hemorrhages,exudates and macular edema was shorter for treatment group than one for controls(P＜0.05);6.The serum levels of intercellular adhesion molecule-1(ICAM-1) between the diabetes groups and normal group were significant different before therapy(P＜0.01).The serum levels of intercellular adhesion molecule-1 (ICAM-1) were significant different between the treatment and control group after three months' therapy(P＜0.01).The difference between the treatment and control group was insignificant before therapy(P＞0.05).The ICAM-1 levels of two groups were significant different before and after three months' therapy(P＜0.05),and the change of ICAM-1 level for treatment group was more significant than one for control group.Conclusions:1.Chinese medicines(SiWuWuZi Tang) accelerated the adsorption speed of hemorrhage,exudates and macular edema during photo coagulation in DR.Furthermore, Chinese medicine(SiWuWuZi Tang) slow the development of disease and proved to improve the microcirculation surrounding eyeground and to be anti-inflammatory;2.Measurement on the serum levels of intercellular adhesion molecule-1(ICAM-1) before and after therapy can provide some reference for discussing the mechanism of DR and supply some proof for arguments that DR was an inflammatory disease.It was important to inhabit or down-regulate the serum levels of intercellular adhesion molecule-1(ICAM-1) for prevention and treatment of DR.