Clinical Efficacy of Zhujing Pill with Modifications in the Treatment of Dry Age-related Macular Degeneration and Its Antioxidant Effects
OBJECTIVE To evaluate the clinical efficacy and antioxidant effects of Zhujing Pill with modifications in the treatment of dry age-related macular degeneration(AMD).METHODS A total of 48 patients(74 eyes)with dry AMD and liver-kidney deficiency syndrome,who visited Liyang Hospital of Chinese Medicine between March 2021 and March 2023 were enrolled in the study.The patients were randomly divided into a treatment group(24 cases,38 eyes)and a control group(24 cases,36 eyes).The treatment group received oral Zhujing Pill with modifications,while the control group received oral Lutein.Both groups underwent continuous treatment for three months.Visual acuity,fundus autofluorescence intensity,serum oxidative markers[malondialdehyde(MDA),nuclear factor erythroid 2-related factor 2(Nrf2),reactive oxygen species(ROS),glutamate-cysteine ligase(GCL),heme oxygenase-1(HO-1),NAD(P)H quinone oxidoreductase 1(NQO-1),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),catalase(CAT)],and Traditional Chinese Medicine(TCM)clinical syndrome scores were measured and recorded before and after the three-month treatment period.RESULTS(1)Visual acuity:The treatment group showed a statistically significant improvement in visual acuity after treatment(t=3.443,P=0.001),while the control group did not show a statistically significant difference(P>0.05).However,there was no significant difference between the two groups after treatment(P>0.05).(2)Fundus autofluorescence intensity:There were no statistically significant differences in fundus autofluorescence intensity within or between the groups before and after treatment(P>0.05).(3)Serum oxidative markers:Post-treatment,the levels of ROS and MDA were significantly lower,while the levels of Nrf2,GSH-Px,SOD2,GCL,CAT,HO-1,and NQO-1 were significantly higher in both groups compared to pre-treatment levels(treatment group:tROS=-3.594,P=0.002;tMDA=-3.395,P=0.002;tNrf2=3.146,P=0.005;tGSH-Px=2.081,P=0.049;tSOD2=2.335,P=0.029;tGCL=3.173,P=0.004;tCAT=3.086,P=0.005;tHO-1=3.526,P=0.002;tNQO-1=6.195,P=0.000.control group:tROS=-2.225,P=0.036;tMDA=-3.037,P=0.006;tNrf2=2.245,P=0.035;tGSH-Px=3.714,P=0.001;tSOD2=2.852,P=0.009;tGCL=2.248,P=0.034;tCAT=2.649,P=0.014;tHO-1=2.121,P=0.045;tNQO-1=2.792,P=0.010).The treatment group showed significantly higher levels of HO-1 and NQO-1 and lower levels of GSH-Px compared to the control group after treatment(tHO-1=2.242,P=0.030;tNQO-1=3.544,P=0.001;tGSH-Px=-2.127,P=0.039),while the other markers showed no significant differences between the two groups(P>0.05).(4)TCM syndrome scores:Both groups showed a significant reduction in TCM syndrome scores after treatment(tTG=7.258,tCG=4.818,both P=0.000),the treatment group was lower than the control group after treatment,with a statistically significant difference(t=2.236,P=0.030).(5)Clinical Efficacy:There were no statistically significant differences in clinical efficacy between two groups(P>0.05).CONCLUSIONS Zhujing Pill with modifications provide effective treatment for dry AMD and can enhance the body's antioxidant capacity.
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