Study On Expression Of Serum VEGF、PEDF From Qi And Yin Deficiency With Blood Stasis DR Patients By Jiawei Buyang Huanwu Decoction Combined With 532nm Laser

Background:Xiao Ke Mu Bing is equivalent to modern medicine diabetic retinopathy (DR).With the development of modern medical standards and cell biology, vascular endothelial growth factor (VEGF) and pigment epithelium derived factor (PEDF) and diabetic retinopathy are getting attention. Studies has shown that VEGF is one of the main causes of retinal neovascularization and it is also closely associated with diabetic macular edema. PEDF is the main factors which can inhibit neovascularization.Objective:To study the expression of VEGF and PEDF which are from serum of healthy controls (normal group), diabetic without DR (DM group) and Qi and Yin Deficiency with Blood Stasis DR (DR group). To observe the change of vision, fluorescein fundus angiography (FFA), optical coherence tomography (OCT), serum VEGF and PEDF of DR patients before and after treated by Jiawei Buyang Huanwu Decoction combined with 532nm laser.Method:(1) Collect 30 normal volunteers in medical center,30 cases of patients with diabetes but without DR in endocrinology,30 cases of patients with DR who is Qi and Yin Deficiency with Blood Stasis in ophthalmology outpatient and inpatient. Detect healthy controls, diabetic without DR and Qi and Yin Deficiency with Blood Stasis DR serum VEGF and PEDF levels by enzyme-linked immunosorbent assay (ELISA).(2) By comparing the change of vision, FFA and OCT before and after treated by Jiawei Buyang Huanwu Decoction combined with 532nm laser, evaluate the efficacy of combination therapy.(3) Detect the change of serum VEGF and PEDF levels before and after treatment with Jiawei Buyang Huanwu Decoction combined with 532nm laser by ELISA and evaluate the mechanism of combination therapy.Result:(1) Serum VEGF levels of normal group, DM group and DR group rose gradually, the difference was significant statistical significance among the three groups(Z=35.84, P<0.01). Serum PEDF levels of normal control group, diabetes group and DR group decreased gradually, the difference was significant statistical significance among the three groups(Z=16.29,P<0.01).(2)The treatment of Jiawei Buyang Huanwu Decoction combined with 532nm laser had a significant effect. Treatment efficiency of III-DR was up to 100%, IV-DR was up to 85.71%, V-DR was up to 33.33%, the total efficiency was up to 89.66%.(3) Serum VEGF levels in patients with DR decrease after Jiawei Buyang Huanwu Decoction combined with 532nm laser treatment, before and after treatment, the difference was statistically significant(T=2.613, P=0.14<0.05). Serum PEDF levels in patients with DR rose after Jiawei Buyang Huanwu Decoction combined with 532nm laser treatment, before and after treatment, the difference was statistically significant(Z=3.363, P=0.01<0.05).Conclusion:(1) Serum VEGF and PEDF levels may be related to the DR occurrence and development. Serum VEGF rose gradually with the DR course, but serum PEDF decreased gradually with the DR course, both can be used as indicators to assess development of DR. (2) Jiawei Buyang Huanwu Decoction combined with 532nm laser treatment for Qi and Yin Deficiency with Blood Stasis DR had a more significant effect. (3) The treatment mechanism of Jiawei Buyang Huanwu Decoction combined with 532nm laser might be due to the rise of serum VEGF and the decrease of PEDF decreased to achieve.