Clinical Research On TCM Treatment On Macular Hemorrhage In Pathologic Myopia

ObjectiveTo evaluate the effect of Chinese medicine in treating macular hemorrhage of pathologic myopia and to summarize types of syndrome and TCM treatment experience.MethodsThis study was based on 29 patients (30 eyes) with macular hemorrhage in pathologic myopia of CACMS, Eye Hospital, from 1997 to 2010, which with CNV 24 eyes, without CNV 6 eyes.According to different clinical symptoms and treatments, the patients were divided into three groups:group 1,syndrome of collateral injury by deficient fire; group 2,syndrome of deficiency of the liver and kidney; group 3,syndrome of deficiency of both qi and blood.The objective was vision and absorbtion of macular hemorrhage based on TCM syndrome classification to analyze the effect and experience of TCM treating macular hemorrhage in pathologic myopia. The data was analyzed by SPSS 13.0.Results1.Vision changes:Visual acuity of 14 eyes was improved in 30 eyes.Among which 6 eyes without CNV was totally improved, while only 8 in 24 eyes with CNV was improved. The vision improvement of eyes without CNV was more significant than that of eyes with CNV.2.Changes in macular hemorrhage:The macular hemorrhage in 6 eyes without CNV was completely absorbed, while 17 in 24 eyes with CNV was absorbed, among them 9 eyes of hemorrhage was completely absorbed,6 eyes had no obvious changes, and 1 eye hemorrhage became serious. The results indicated that macular hemorrhage of eyes without CNV was more easily absorbed than those with CNV.3.Syndrome-classification:In simple macular hemorrhage group, there were 5 eyes belonging to syndrome of collateral injury by deficient fire (83.3%),1 eye to syndrome of deficiency of both qi and blood (16.7%).In CNV macular hemorrhage group,6 eyes belonged to syndrome of collateral injury by deficient fire(66.7%),7 eyes to syndrome of deficiency of the liver and kidney (29.2%), and 1 eye to syndrome of deficiency of both qi and blood (4.1%)。Among all syndromes types, syndrome of collateral injury by deficient fire was more common than others. Vision was improved more obvious in syndrome of deficiency of the liver and kidney than in others types of CNV group. The macular hemorrhage could be progressively absorbed with treatment lasting(in 3 months) in syndrome of collateral injury by deficient fire。4.Analysis of Chinese herbs:To summarize 16 herbs which was most frequently used and the top 10 herbs used in all syndrome types. Conclusion1.High myopia macular hemorrhage was caused by Deficiency of Kidney-yin which leaded to deficient fire hurts veins. So therapeutic methods of tonify liver and kidney, tonify qi and blood should be essential. Heat-clearing and blood-cooling drug could be helpful too. And Attention should be given to different treatments in different phases.2.TCM treatment based on syndrome differentiation and treatment had a good effect in improving eyesight and promoting absorption of macular hemorrhage. And the prognosis was better, shorter in period of treatment, and less changes in types of syndrome of patients without CNV than those with CNV.3.Lacquer cracks in high myopia was similar with syndrome of dryness in performance. So we could use the method of nourishing the blood to moisten dryness drug and promoting blood circulation and removing obstruction in channels drug to prevent the disease form happens.