Combined Chinese and Western medicine treatment for retinitis pigmentosa

  Retinitis pigmentosa is a group of progressive hereditary dystrophic degenerative lesions. The clinical features are mainly progressive visual field defects, night blindness, retinitis pigmentosa and electroretinogram abnormalities. The disease is a blinding eye disease. The prevalence of the disease is about 1 in 4,000, and it usually develops in children or early adolescents (10-20 years old), with symptoms worsening in adolescence and gradual contraction of the visual field; in middle age or old age, macular involvement leads to loss of central vision, or even severe impairment and blindness. The earlier the onset of the disease, the worse the outcome. It is often accompanied by myopia, cataract and glaucoma. Funduscopic examination is a triad of retinitis pigmentosa with waxy yellow optic papillae, retinal vascular narrowing and osteochrome-like cells.  The main instrumental examinations are optic electrophysiology and visual field. The manifestation of optic electrophysiology is the decrease and disappearance of EOG and ERG amplitude, and the visual field changes as the first central dark spot, the dark spot is connected to an island, the island is connected to an arc, and the arc is fused to a typical ring-shaped dark spot, and as the disease progresses the dark spot proceeds to the posterior pole and the central sulcus, forming a tubular visual field and finally blindness.  The disease is hereditary, and all four forms of inheritance are possible (autosomal dominant, autosomal recessive, sex-linked and isolated), with sex-linked patients having the fastest development of heavy disease and autosomal dominant patients having the slowest development of light disease. In Chinese medicine, this disease belongs to the category of high phoenix cataract, which is divided into deficiency of endowment (liver and kidney deficiency) and loss of warmth in the eyes. Liver and kidney yin deficiency, yin deficiency can not help yang, yang can not be used. Weakness of the spleen and stomach, lack of sources of nourishing the eyes, and the eyes cannot see things.  Treatment: Western medicine considers it to be a genetic disease and there is no treatment for lack of cutting. Oral vitamin A, avoidance of vitamin E and symptomatic treatment.  We believe that although this disease belongs to heredity, endowment deficiency, we cannot change it. However, from the fundus examination, the retinal blood vessels shrink and become thin, and the retinal choroid gradually atrophies, making the nerve atrophy, presenting poor blood circulation and malnutrition in the fundus. Accordingly, we propose the following combined Chinese and Western medicine treatment: (1) Intravenous injection of vasodilator drugs and nutritional drugs to improve retinal blood circulation and nutrition to counteract the damage of this disease.  (2) According to the patient’s condition and disease type, Chinese tonics are used to nourish the liver and kidney, strengthen the spleen and benefit the qi, and warm the kidney yang.  (3) According to the Chinese medicine meridian theory, acupuncture point injection is used to achieve unblocking the meridians, so that the eye meridians are smooth and nutrition is increased. Post-ball injection and ear acupuncture are also used.  (4) Local ultrasonic ion introduction treatment to increase local blood circulation and resistance to disease. According to our clinical observation, the early stage of the lesion is very effective, with varying degrees of improvement in visual acuity and visual field, and the late stage of the lesion can also maintain the original state, making the condition stable.  Typical case: The patient, Gaoxin Feng, female, 33 years old, from Jiang Village, Wangmang Township, Chang’an District, Xi’an City, was admitted to the hospital on October 20, 2010 with the complaint of night blindness in both eyes with vision loss for 5 years, and her visual acuity was 0.25 in the left eye and 0.25 in the right eye, and her visual field was tubular. 5-10 degrees. We analyzed that the patient’s visual field could be improved mainly because of the early consultation and the above treatment suddenly improved the retinal blood circulation, increased the nutrition, improved the retinal choroidal resistance to disease, and prevented the further development of the disease.