阿托品压抑疗法与遮盖法治疗小儿弱视的Meta分析  

Meta-analysis of Atropine Penalization Therapy Versus Occlusion Therapy in the Treatment of Pediatric Amblyopia

作　　者：郭洲岐 阿力木拉提·买合木提 GUO Zhouqi;ALIMULATI·Maihemuti(Fifth Affiliated Hos-pital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第五附属医院,乌鲁木齐830011

出　　处：《中国中医眼科杂志》2024年第8期794-800,共7页China Journal of Chinese Ophthalmology

摘　　要：目的系统评价阿托品压抑疗法与遮盖法治疗小儿弱视的临床疗效。方法检索PubMed、The Cochrane Library、Web of Science、Embase、中国知网、万方、维普及中国生物医学文献数据库所有关于对比阿托品压抑疗法与遮盖法治疗小儿弱视的随机对照试验(RCT)文献,检索时间为2013年1月1日—2023年10月31日,对文献按照纳入标准与排除标准进行筛选和数据录取,采用改良Jadad评分量表评价文献质量,Cochrane手册评价文献偏倚风险,RevMan 5.4软件进行统计分析。结果共纳入12项研究,总样本量1,344例(1,654只眼),其中治疗组671例(826只眼),对照组673例(828只眼)。治疗组在总有效率[OR=3.070,95%CI(2.210,4.250),Z=6.710,P=0.000]、最佳矫正视力[OR=0.180,95%CI(0.160,0.200),Z=19.020,P=0.000]、立体视功能重建有效率[OR=2.940,95%CI(1.810,4.770),Z=4.350,P=0.000]、治疗依从性[OR=7.750,95%CI(3.880,15.470),Z=5.810,P=0.000]方面均高于对照组,在并发症发生率方面低于对照组[OR=0.370,95%CI(0.200,0.690),Z=3.120,P=0.002],差异均有统计学意义。结论阿托品压抑疗法治疗小儿弱视疗效优于遮盖法,且患儿依从性好,并发症少。OBJECTIVE To systematically evaluate the clinical efficacy of atropine penalization therapy versus occlusion therapy in the treatment of pediatric amblyopia.METHODS Literature search was conducted in PubMed,The Cochrane Library,Web of Science,Embase,CNKI,Wanfang,VIP,and CBM databases for randomized controlled trial(RCT)comparing atropine penalization therapy and occlusion therapy for treating pediatric amblyopia from January 1st 2013 to October 31st 2023.The studies were screened and data were extracted according to inclusion and exclusion criteria.The quality of the studies was assessed using the modified Jadad scale,and the risk of bias was evaluated using the Cochrane Handbook.Statistical analysis was performed using RevMan 5.4 software.RESULTS A total of 12 studies were included,with a total sample size of 1,344 cases(1,654 eyes),comprising 671 cases(826 eyes)in the treatment group and 673 cases(828 eyes)in the control group.The treatment group showed superior outcomes in terms of overall efficacy rate[OR=3.070,95%CI(2.210,4.250),Z=6.710,P=0.000],best-corrected visual acuity[OR=0.180,95%CI(0.160,0.200),Z=19.020,P=0.000],effective rate of stereopsis reconstruction[OR=2.940,95%CI(1.810,4.770),Z=4.350,P=0.000],and treatment compliance[OR=7.750,95%CI(3.880,15.470),Z=5.810,P=0.000],while the incidence of complications was lower than that in the control group[OR=0.370,95%CI(0.200,0.690),Z=3.120,P=0.002],with all differences being statistically significant.CONCLUSIONS Atropine penalization therapy is more effective than occlusion therapy in the treatment of pediatric amblyopia,with better patient compliance and fewer complications.

关 键 词：弱视 阿托品 遮盖法 小儿 

分 类 号：R777.44[医药卫生—眼科]