Diabetic Retinopathy and Integrating Chinese and Western Medicine

  With the improvement of socio-economic conditions and the increase of average life expectancy, diabetes mellites has become a common disease affecting people’s health and life in China, second only to cardiovascular and cerebrovascular diseases and cancer. 1997, the prevalence rate was 5.89% in a survey of 29,558 residents aged 40 to 99. Diabetes mellites are divided into type 1 and type 2, with type 2 accounting for 90% of the total and the age of onset The age of onset is above 40 years.  Diabetic retinopathy (DR) is one of the most serious complications and has become the leading cause of blindness in economically developed countries. In China, RD accounts for 46.8% of diabetic patients and is increasingly becoming an important eye disease that harms the vision of middle-aged and elderly patients. 75% of patients with type 2 diabetes of 15 years or more have reduced vision to the point of inability to work, and half of them are legally blind (visual acuity of 0.1 or less).  The main symptom of diabetes is vision loss, and the signs are hemangioma, hemorrhagic spots, cotton wool spots, retinopathy, macular degeneration, vitreous and optic neuropathy. Diabetes is divided into six stages, the first three of which are non-proliferative, with microangiomas, hemorrhages, exudates and cotton wool spots in the fundus, and the last three are proliferative, including neovascularization, retinal and vitreous fibrous tissue proliferation and retinal detachment. Diabetic retinal pathogenesis Due to long-term high blood glucose levels, impaired glucose metabolism causes capillary basement membrane thickening, endothelial cell proliferation, pericyte degeneration, and finally capillary rupture and ablation. According to Chinese medicine, this disease belongs to the category of thirsty eye disease. According to the course and performance of the disease, it is divided into Yin deficiency and dry heat, Qi and Yin deficiency, Spleen and kidney deficiency, blood stagnation and phlegm stagnation.  Treatment: The main drugs in Western medicine are Dobes and Voltaren. Used to protect blood vessels, reduce exudation, stop bleeding and help absorption. Laser treatment is used to treat macular degeneration and retinal proliferative lesions. Vitrectomy for vitreous hemorrhage and retinal proliferative membrane and fibrous striae.  After long-term clinical observation, a combination of Chinese and Western medicine quadruple therapy is proposed to treat retinopathy (1) intravenous injection of vasodilating, nerve-nourishing and vascular-softening drugs. To promote retinal blood circulation, increase nutrition, improve metabolism, and help absorption.  (2) Chinese tonics, according to the specific lesion of the individual, targeted with nourishing Yin and moistening dryness, warming Yang and benefiting Qi, resolving blood stasis and removing phlegm and stasis, etc., to improve and regulate the systemic state.  (3) According to the theory of Chinese medicine meridians, acupoint injection is used to stimulate the acupuncture points so that the meridians through the eyes can be smooth and play a therapeutic role. Also combined with the application of ear acupuncture points, easy to operate, the patient can massage at any time to assist in treatment.  (4) Local ultrasonic therapy, with the role of promoting local blood circulation, to achieve a high concentration of local drugs.  Through the above treatment more than 90% of patients have improved visual acuity, improved fundus lesions, absorption of fundus and vitreous hemorrhage, absorption of macular edema and reduction of exudation. Especially the effect is better in patients with first three stages of lesions.  Clinical experience and suggestions: (1) The above treatment is based on the premise of normal blood glucose control. (2) Diabetes is a lifelong disease, and the severity of comorbidities is proportional to the duration of the disease, so the above treatment should be carried out regularly, we recommend at least once a year.  (3) Diabetes mellitus with hypertension, hyperlipidemia and atherosclerosis will aggravate retinal fundopathy, so it is recommended to stabilize blood pressure and lower lipids. Prevent atherosclerosis.  (4) Fundus changes are one of the primary lesions in diabetes, so it is recommended that patients have their fundus checked once a year, or once every three months in severe cases. Immediate detection, immediate treatment.  If you are a diabetic patient for more than 6 years, it is recommended to contact us, we will give you a serious examination, reasonable assessment, excellent treatment, to ensure the good state of your vision.