中医综合疗法对假性近视患者黄斑处脉络膜厚度及微血流密度的影响

Effect of comprehensive therapy of traditional Chinese medicine on patients with pseudomyopia effects of choroidal thickness and micro blood flow density in macula

关键词:  青少年假性近视  中医综合疗法  黄斑中心凹下脉络膜厚度  黄斑区浅层血流密度  疗效观察

Key words:  juvenile pseudomyopia  comprehensive traditional Chinese medicine therapy  subfoveal choroidal thickness  superficial macular blood flow density  observation of curative effect

摘要:

[目的] 研究中医综合疗法对青少年假性近视患者黄斑处脉络膜厚度及微血流密度的影响，为中医疗法在青少年假性近视的治疗方面提供依据。[方法] 使用SPSS 21.0软件产生随机数字，将51例（102只眼）假性近视青少年患者随机分成对照组和治疗组。对照组患者27例（54只眼），单纯使用复方托吡卡胺滴眼液点眼治疗；治疗组患者24例（48只眼），在对照组治疗的基础上配合中药雾化、中药眼贴和耳穴埋籽等中医综合治疗。两组患者疗程均为8周，治疗前后检测两组患者裸眼远视力、电脑验光屈光度数、黄斑中心凹下脉络膜厚度及黄斑区浅层血流密度，并评价两组患者疗效。[结果] 1）治疗组1例因中药雾化过敏导致脱落，最终纳入23例（46只眼）。2）治疗8周后，治疗组总有效率为92.3%，对照组总有效率为75.0%，治疗组疗效优于对照组，差异有统计学意义（P＜0.05）。3）治疗后，治疗组患者平均视力较治疗前提高，差异具有统计学意义（P＜0.05）；对照组患者平均视力较治疗前无明显改善，差异无统计学意义（P＞0.05）。组间比较方面，治疗组治疗后平均视力较对照组有一定提高，差异有统计学意义（P＜0.05）。4）经治疗，治疗组患者平均假性近视度数较治疗前下降，差异有统计学意义（P＜0.05）；对照组患者平均假性近视度数较治疗前略有下降，差异无统计学意义（P＞0.05）。组间比较方面，治疗组治疗后平均假性近视度数较对照组有一定下降，差异有统计学意义（P＜0.05）。5）治疗组患者黄斑中心凹下脉络膜厚度较治疗前增厚，差异有统计学意义（P＜0.05）；对照组黄斑中心凹下脉络膜厚度较治疗前无明显改变，差异无统计学意义（P＞0.05）；组间比较方面，治疗组治疗后黄斑中心凹下脉络膜厚度较对照组增厚，两组比较差异有统计学意义（P＜0.05）。6）治疗后，治疗组黄斑区浅层血流密度较治疗前增加，差异有统计学意义（P＜0.05）；对照组黄斑区浅层血流密度较治疗前增加，但差异无统计学意义（P＞0.05）；组间比较方面，治疗组治疗后黄斑区浅层血流密度较对照组明显增加，两组比较差异有统计学意义（P＜0.05）。[结论] 采用中医综合疗法对青少年假性近视治疗效果较好，并且可以增加黄斑中心凹下脉络膜厚度及黄斑区浅层血流密度，短期观察无不良反应，值得临床推广运用。

Abstract:

[Objective] To study the effect of comprehensive therapy of traditional Chinese medicine(TCM) on choroidal thickness and micro blood flow density in juvenile pseudomyopia,and to provide basis for the treatment of juvenile pseudomyopia with TCM. [Methods] The 51 adolescent patients with pseudomyopia(102 eyes) were randomly divided into a control group and a treatment group. 27 patients in the control group(54 eyes) were treated with compound tropicamide eye drops alone;24 patients in the treatment group(48 eyes) were treated with TCM atomization and TCM eye patch on the basis of the treatment of the control group and the comprehensive treatment of TCM such as ear acupoint embedding seeds. The treatment course of the two groups of patients was 8 weeks. Before and after treatment,the far visual acuity of naked eyes,the diopter of computer refraction,the thickness of choroid under macular fovea and the superficial blood flow density in macular area were measured,the curative effects of the two groups were evaluated. [Results] 1)In the treatment group,1 case was shedding due to allergy to Chinese medicine atomization,and 23 cases(46 eyes) were eventually included. 2)After 8 weeks of treatment,the total effective rate of the treatment group was 92.3%,and the total effective rate of the control group was 75.0%. The treatment group was better than the control group in comparison between the groups,and the difference was statistically significant(P<0.05). 3)Treatment After that,the average visual acuity of patients in the treatment group improved compared with that before treatment,and the difference was statistically significant(P<0.05);the average visual acuity of patients in the control group did not improve significantly compared with before treatment,and the difference was not statistically significant(P>0.05). In terms of comparison between groups,the average visual acuity after treatment in the treatment group was improved to a certain extent compared with the control group,and the difference was statistically significant(P<0.05). 4)After treatment,the average degree of pseudomyopia in the treatment group decreased compared with that before treatment,and the difference was statistically significant(P<0.05). The average degree of pseudomyopia in the control group decreased slightly compared with that before treatment,and the difference was not statistically significant(P>0.05). In terms of comparison between groups,the average degree of pseudomyopia in the treatment group decreased compared with the control group,and the difference was statistically significant(P<0.05). 5)The thickness of macular foveal choroid in the treatment group was significantly higher than that before treatment(P<0.05). There was no significant change in the thickness of choroid under fovea in the control group compared with that before treatment(P>0.05). In terms of comparison between groups,the thickness of macular foveal choroid in the treatment group was thicker than that in the control group after treatment. The difference between the two groups was statistically significant(P<0.05). 6)After treatment,the superficial blood flow density of macular area in the treatment group was significantly higher than that before treatment(P<0.05). The superficial blood flow density of macular area in the control group was slightly higher than that before treatment,but the difference was not statistically significant(P>0.05). In terms of comparison between groups,the superficial blood flow density in macular area in the treatment group was significantly higher than that in the control group after treatment,and the difference between the two groups was statistically significant(P<0.05).[Conclusion] The comprehensive treatment of TCM is effective in the treatment of juvenile pseudomyopia,and can increase the thickness of the subfoveal choroid. Short-term observation has no side effects,and it is worthy of clinical application.