METHODS: From January 2016 to October 2018, 60 eyes of 60 patients with diabetic macular edema were included in the prospective clinical control study. They were divided into control group and Chinese and Western medicine group according to the random number table method. The patients in control group were injected with anti-vascular drug into the vitreous cavity. After the injection, the patients were treated with photocoagulation. The patients in Chinese and Western medicine group were treated with the Yiqi Yinshui Xiaozhong decoction on the basis of the treatment of the control group. The best corrected visual acuity(BCVA), and macular foveal thickness(CMT)were observed before treatment and at 1, 3, and 6mo after treatment. The macular fluorescence leakage in fluorescein fundus angiography(FFA)and the recurrence rate of macular edema were observed at 6mo after treatment.

RESULTS: BCVA was 0.92±0.26 before treatment, 0.58±0.18, 0.60±0.27 and 0.62±0.28 at 1, 3 and 6mo after treatment, BCVA in the Chinese and Western medicine group BCVA was 0.94±0.31 before treatment, 0.56±0.20, 0.50±0.25, 0.51±0.21 after treatment; CMT in the control group was 461.62±84.26 before treatment, 299.92±43.18, 290.60±39.36, 311.10±42.78 at 1, 3 and 6mo after treatment, CMT in the Chinese and Western medicine group was 455.74±83.89 before treatment, 288.96±40.20, 265.86±32.55, 270.38±31.60 at 1, 3 and 6mo after treatment. Both groups had improved BCVA and CMT after treatment(P<0.05). There was no significant difference between BCVA and CMT in the Chinese and Western medicine group and the control group at 1mo after treatment(t=0.539, 0.739, P>0.05), BCVA and CMT after 3 and 6mo of treatment in the Chinese and Western medicine group improved significantly, and the difference was statistically significant compared with the control group(3mo after treatment t=2.891, 2.992, P=0.004, 0.021; 6mo after treatment t=3.733, 3.643, P<0.01, 0.005). The recurrence rate of macular edema at 6mo after treatment in the Chinese and Western medicine group was lower(χSymbolr@@=4.344, P<0.05).

CONCLUSION: Combined application of the Yiqi Yinshui Xiaozhong decoction, anti-VEGF drugs and laser to treat diabetic macular edema can improve vision, reduce macular edema, reduce the recurrence rate of edema, and bring better prognosis for patients.