Clinical Observation Of Guben Mingmu Recipe In The Treatment Of Nonproliferative Diabetic Retinopathy Patients With Deficiency Of Liver And Kidney Syndrome

Objective:To observe the clinical efficacy of Guben Mingmu Fang combined with calcium dobesilate capsule in the treatment of non-proliferative diabetic retinopathy(NPDR)of deficiency of liver and kidney syndrome,and to explore its therapeutic mechanism and its effect on retinal nerve fiber layer(RNFL),providing new ideas and methods for clinical treatment of NPDR.Methods:Fifty-seven patients with NPDR of deficiency of liver and kidney syndrome who met the diagnostic criteria and inclusion criteria from February 2019 to February 2021 were included in this clinical study and randomly divided into the test group(n=29)and the control group(n=28).Calcium dobesilate capsules was given to the control group,0.5 g each time,three times a day.The test group was given calcium dobesilate capsule and Guben Mingmu Fang,oralling once a day,decocted 200ml,The two groups were treated for 4 weeks as a course of treatment,and each was observed for 3 courses.The clinical TCM symptom score,TCM symptom efficacy,best corrected visual acuity,fundus changes and RNFL thickness changes before and after treatment were observed,recorded and evaluated in the two groups of NPDR patients.Result:1.Before and after treatment,the TCM symptom scores of the test control group were improved,P<0.05,the degree of improvement of the test group was better than that of the control group;the efficacy of TCM symptoms of the test group was 86.21%,the efficacy of the control group was 39.29%,P<0.05,the difference between the two groups was statistically significant,and the improvement of the test group was better than that of the control group.2.The best corrected visual acuity of the test group was improved before and after treatment,P<0.05,and the difference was statistically significant;the BCVA of the control group was improved after treatment,but the difference was not statistically significant,suggesting that it was not significantly improved;the difference was statistically significant after treatment,P<0.05,suggesting that the improvement of visual acuity of the test group was significantly better than that of the control group.3.After treatment,the total effective rate of fundus efficacy was 65.52%in the test group and 32.14%in the control group,P<0.05,the difference was statistically significant,indicating that the test group was superior to the control group in improving the degree of lesions.4.After treatment,the thickness of retinal nerve fiber layer in the inferior parapapillary quadrant and total retinal nerve fiber layer in the test group decreased compared with before(P<0.05),and the RNFL thickness in the other quadrants did not change significantly(P>0.05);the thickness of retinal nerve fiber layer in the superior parapillary quadrant in the control group decreased compared with before(P<0.05),the thickness of retinal nerve fiber layer in the inferior quadrant and total retinal nerve fiber layer decreased significantly compared with before(P<0.01),and the RNFL thickness in the other quadrants did not change significantly(P>0.05);there was no significant difference between the two groups before and after treatment(P>0.05),It is suggested that Guben Mingmu Recipe can protect retinal neurons to some extent,but the degree of improvement is small.5.No adverse events occurred before and after treatment in both groups.Conclusion:Guben Mingmu Recipe combined with Calcium Dobesilate Capsule can improve the visual acuity and clinical symptoms of patients with non-proliferative diabetic retinopathy of liver-kidney yin deficiency type.The efficacy is better than that of Calcium Dobesilate Capsule alone.It has a certain protective effect on retinal neurons,delays the loss of retinal neurons,delays the progression of diabetic retinopathy(DR),and without clinical safety problems.