高度近视后巩膜葡萄肿患者中医证型分布及相关因素分析  

Distribution of TCM Syndrome Types in Patients with Posterior Staphyloma in High Myopia and Analysis of the Related Factors

作　　者：夏宇婕 廉丽华[2] 郑香悦 罗英子 俞晓艺[2] XIA Yu-Jie;LIAN Li-Hua;ZHENG Xiang-Yue;LUO Ying-Zi;YU Xiao-Yi(Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Dept.of Ophthalmology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广州中医药大学第一附属医院眼科,广东广州510405

出　　处：《广州中医药大学学报》2023年第12期2984-2990,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20201106)。

摘　　要：【目的】分析高度近视后巩膜葡萄肿患者中医证型分布特点,探究高度近视后巩膜葡萄肿发生的影响因素。【方法】选取2020年2月至2022年1月在广州中医药大学第一附属医院眼科门诊就诊的137例(137眼)高度近视患者为研究对象,根据是否合并后巩膜葡萄肿分为观察组(合并)60例和对照组(未合并)77例。分析2组高度近视患者的中医证型分布特点;并通过单因素分析,比较2组患者视力、眼压、眼轴长度、前房深度及角膜中央厚度、视网膜形态、黄斑区血流密度等眼部参数差异,通过多因素Logistic回归分析探讨影响高度近视发生后巩膜葡萄肿的危险因素。【结果】(1)中医证型分布方面,观察组以肝肾亏虚证的占比最高,为51.67%(31/60),其他从高到低依次为肝血不足证、脾虚气弱证、心阳不足证、气滞血瘀证;对照组以气滞血瘀证和肝肾亏虚证占比最高,均为27.27%(21/77),其他从高到低依次为肝血不足证、心阳不足证、脾虚气弱证;组间比较,观察组的肝肾亏虚证占比明显高于对照组(P<0.01),气滞血瘀证占比明显低于对照组(P<0.01)。(2)视力方面,观察组气滞血瘀证患者的视力较对照组明显下降(P<0.05),而2组其他证型患者的视力比较,差异均无统计学意义(P>0.05);观察组中,与气滞血瘀证相比,肝肾亏虚证患者的视力较好(P<0.05),而其他证型两两比较,差异均无统计学意义(P>0.05)。(3)单因素分析结果显示:观察组患者的眼轴长度、角膜中央厚度、血流密度、血流灌注密度及视网膜劈裂、周围性视网膜病变占比与对照组比较,差异均有统计学意义(P<0.05或P<0.01)。(4)多因素Logistic回归分析结果显示:眼轴长度、角膜中央厚度及视网膜劈裂是高度近视发生后巩膜葡萄肿的独立危险因素(P<0.05或P<0.01)。【结论】高度近视后巩膜葡萄肿患者中医证型多表现为肝肾亏虚证,其中以气滞血瘀证患者视力Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in patients with posterior staphyloma in high myopia,and to analyze the influencing factors for the occurrence of posterior staphyloma in high myopia.Methods A total of 137 cases(involving 137 eyes)of high myopia who admitted to the ophthalmology outpatient clinic of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from February 2020 to January 2022 were included in the study.The patients with high myopia were divided into the observation group(60 cases,complicated with posterior staphyloma)and the control group(77 cases,without the complications of posterior staphyloma).The distribution of TCM syndrome types in the two groups of patients with high myopia was analyzed,and the differences of visual acuity,intraocular pressure,the length of ocular axis,depth of anterior chamber,central corneal thickness,retinal morphology and macular blood flow density between the two groups were compared by univariate analysis.Multivariate logistic regression analysis was used to explore the risk factors of posterior staphyloma in high myopia.Results(1)The distribution of TCM syndrome types showed that liver-kidney deficiency syndrome occupied the highest proportion[51.67%(31/60)]in the observation group,and then came the liver-blood insufficiency syndrome,spleen deficiency and qi weakness syndrome,heart-yang insufficiency syndrome,and qi stagnation and blood stasis syndrome in descending order;in the control group,qi stagnation and blood stasis syndrome and liver-kidney deficiency syndrome accounted for the highest proportion[both being 27.27%(21/77)],and then came liver-blood insufficiency syndrome,heart-yang insufficiency syndrome,and spleen deficiency and qi weakness syndrome in descending order.The intergroup comparison showed that the proportion of liver-kidney deficiency syndrome in the observation group was significantly higher(P<0.01),and the proportion of qi stagnation and blood stasis syndrome was signif

关 键 词：高度近视 后巩膜葡萄肿 中医证型 肝肾亏虚 气滞血瘀 危险因素 

分 类 号：R276.7[医药卫生—中医五官科学]