Real-World Study on the Treatment of Macular Edema in Central Retinal Vein Occlusion Using Traditional Chinese Medicine (TCM) and Its Medication Guidelines

Abstract

Object: The aim is to evaluate how effective Traditional Chinese Medicine (TCM) is in treating patients who have central retinal vein occlusion with macular edema (CRVO-ME) in a real-world study. Furthermore, the objective of the research was to examine the TCM prescription trends in the management of CRVO-ME. Method: A single-center real-world study (RWS) was carried out over a span of 19 years, following the established design. The study encompassed 113 patients diagnosed with CRVO-ME. Out of these, 74 patients received TCM treatment, while the remaining individuals underwent a combined therapy involving TCM and anti-VEGF drugs through intravitreal injection. The patients were matched using propensity score matching (PSM). The result measured in the RWS was BCVA. The oral prescriptions for CRVO-ME that led to observable and effective outcomes were collected. Excel and the TCM Inheritance Auxiliary Platform V2.5 were utilized to optimize mutual information, hierarchical clustering based on entropy, and other techniques to extract medication regulations and features. Result: After applying PSM, each group comprised 29 cases. Both groups exhibited improved BCVA following treatment; however, there was no statistically significant distinction in BCVA or effectiveness between the two groups (all P > 0.05). Apart from the analysis of oral prescriptions for CRVO-ME, the investigation pinpointed the most frequently used TCMs, namely Flos Carthami, Semen Persicae, Radix Angelica sinensis, Radix Rehmanniae, and Radix et Rhizoma Notoginseng. Frequently utilized medications tended to possess cold, warm, or mild attributes and exhibited a taste profile that was either bitter or sweet. The primary meridians associated with the medicines employed in treating CRVO-ME were liver, spleen, stomach, heart, and lung. Through the application of association rule analysis, it was discerned that there were 195 commonly employed combinations of medicines. Additionally, a complex system entropy cluster analysis unveiled 13 key combinations of medicines. By employing an unsupervised entropy hierarchical clustering analysis, a novel prescription was formulated. Conclusion: Within a real-world population of CRVO-ME patients, TCM exhibited its effectiveness. The treatment approach for CRVO-ME predominantly involved the regulation of qi (Qi is an exceedingly subtle substance within the human body, brimming with vitality and ceaseless motion. It constitutes the fundamental element that shapes and sustains the various processes of human life.) and blood as well as the resolution of dampness. The oral prescriptions frequently targeted the meridians of liver, spleen, stomach, heart, and lungs.