耳穴贴压联合眼周揿针技术预防假性近视向真性近视进展:多中心随机对照试验  

Pseudomyopia treated with auricular point sticking combined with periocular needle-embedding therapy and prevention of true myopia:a multicenter randomized controlled trial

作　　者：侯昕玥 王健全 亢泽峰[1] 杨迎新[3] 姚小萍[4] 张风梅[5] 姚靖 喻京生 刘新泉[8] 梁凤鸣[9] 俞晓艺[10] 宋曼 HOU Xinyue;WANG Jianquan;KANG Zefeng;YANG Yingxin;YAO Xiaoping;ZHANG Fengmei;YAO Jing;YU Jingsheng;LIU Xinquan;LIANG Fengming;YU Xiaoyi;SONG Man(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China;China Academy of Chinese Medical Sciences,Bejing 100040;Beijing Hospital of TCM,Capital Medical University;Shenzhen Hospital of TCM;Henan Provincial Hospital of TCM;First Affiliated Hospital of Heilongjiang University of CM;First Affiliated Hospital of Hunan University of CM;Longhua Hospital Affiliated to Shanghai University of TCM;First Teaching Hospital of Tianjin University of TCM;First Affiliated Hospital of Guangzhou University of CM;Fuzhou TCM Hospital Affiliated to Fujian University of TCM)

机构地区：[1]中国中医科学院眼科医院,北京100040 [2]中国中医科学院,北京100040 [3]首都医科大学附属北京中医医院 [4]深圳市中医院 [5]河南省中医院 [6]黑龙江中医药大学附属第一医院 [7]湖南中医药大学第一附属医院 [8]上海中医药大学附属龙华医院 [9]天津中医药大学第一附属医院 [10]广州中医药大学第一附属医院 [11]福建中医药大学附属福州中医院

出　　处：《中国针灸》2024年第4期405-410,共6页Chinese Acupuncture & Moxibustion

基　　金：国家中医药管理局中医眼科专病(儿童青少年近视防控)循证能力提升建设项目;国家重点研发计划资助项目:2022YFC3502500;中医药传承与创新“百千万”人才工程(岐黄学者)项目;福建省第三批柔性引进医疗卫生高层次人才团队项目。

摘　　要：目的:观察耳穴贴压联合眼周揿针技术预防假性近视发展成为真性近视的临床疗效及安全性。方法:将269例假性近视患儿随机分为观察组(134例,脱落2例)与对照组(135例,脱落5例)。对照组予健康宣教;观察组在对照组基础上予耳穴贴压(肝、脾、心、眼,每次取单侧耳穴)联合眼周揿针(双侧攒竹、鱼腰、四白)干预,治疗4周后休息2周,6周为一疗程,共治疗2个疗程。分别于治疗前、治疗6周、治疗12周及治疗结束后12周(第1次随访)、24周(第2次随访)观察两组患儿等效球镜(SE)及SE进展量、眼轴(AL)进展量、调节幅度(AMP)、中医症状和全身症状评分,并评价安全性及依从性。结果:治疗6、12周及第1、2次随访,两组患儿SE较治疗前增长(P<0.05),观察组患儿AMP较治疗前升高(P<0.05)。治疗12周及第1、2次随访,观察组患儿SE进展量低于对照组(P<0.01,P<0.001);治疗6、12周及第1、2次随访,观察组患儿AL进展量低于对照组(P<0.05,P<0.01,P<0.001);第1、2次随访,观察组患儿AMP高于对照组(P<0.05,P<0.001)。治疗6、12周及第1、2次随访,观察组患儿中医症状和全身症状总分较治疗前降低(P<0.05);治疗6、12周,对照组患儿中医症状和全身症状总分较治疗前降低(P<0.05)。观察组患儿第1、2次随访中医症状和全身症状总分差值大于对照组(P<0.05);第1、2次随访面色淡白/晦暗评分及第2次随访神疲乏力评分低于对照组(P<0.05);治疗12周注意力下降评分及第2次随访睡眠不佳、记忆力下降评分低于对照组(P<0.05)。两组均无不良反应发生,观察组依从性为98.5%,对照组为96.3%,两组依从性比较差异无统计学意义(P>0.05)。结论:在健康宣教基础上,耳穴贴压联合眼周揿针技术可有效预防假性近视向真性近视进展,控制SE增加、延缓AL增长、增加AMP,且能改善全身症状,从多途径综合预防近视,安全性高,依从性好。Objective To observe the clinical effect and safety of auricular point sticking combined with periocular needle-embedding therapy for pseudomyopia and prevention of true myopia.Methods A total of 269 children with pseudomyopia were randomized into an observation group(134 cases,2 cases dropped out)and a control group(135 cases,5cases dropped out).In the control group,the healthy education was provided.In the observation group,besides the intervention as the control group,the auricular point sticking was delivered at gan(CO12),pi(CO13),xin(CO15)and yan(LO5)on one ear in each treatment,combined with periocular needle-embedding technique at bilateral Cuanzhu(BL 2),Yuyao(EXHN 4)and Sibai(ST 2).There were 2 weeks of interval after 4 weeks of treatment.One course of treatment was composed of 6 weeks and 2 courses were required.Separately,before treatment,after 6 and 12 weeks of treatment,and after 12 weeks(the 1st follow-up visit)and 24 weeks(the 2nd follow-up visit)of treatment completion,the spherical equivalent(SE),SE progression,axial length(AL)progression,accommodative amplitude(AMP),the score of the TCM symptom and the general symptom were observed in the two groups.The safety and compliance were evaluated in the two groups.Results After 6 and 12 weeks of treatment,and in the 1st and 2nd follow-up visits,SE increased when compared with that before treatment in the two groups(P<0.05),and AMP was larger than that before treatment in the observation group(P<0.05).After 12 weeks of treatment,and in the 1st and 2nd follow-up visits,the progression of SE was slower in the observation group compared with that in the control group(P<0.01,P<0.001).After 6 and 12 weeks of treatment,and in the 1st and 2nd follow-up visits,the progression of AL in the observation group was lower than that of the control group(P<0.05,P<0.01,P<0.001);and in the 1st and 2nd follow-up visits,AMP of the observation group was larger when compared with that in the control group(P<0.05,P<0.001).After 6 and 12 weeks of treatment,and in the 1st and 2n

关 键 词：近视 中医适宜技术 耳穴贴压 揿针 预防 公共卫生疾病 

分 类 号：R246.82[医药卫生—针灸推拿学]