捻转补泻法与提插补泻法对青少年近视患者裸眼远视力的影响:随机对照研究

Impacts of rotating or lifting-thrusting manipulation on distant vision of naked eye in patients of juvenile myopia:a randomized controlled trial

目的:比较不同补泻方法对青少年近视患者裸眼远视力疗效差异。方法:将120例(240只患眼)青少年近视患者随机分为捻转补泻组和提插补泻组,每组60例(120只患眼),另设戴镜组60例(120只患眼)作对照。两治疗组均针刺攒竹、鱼腰、丝竹空、太阳、风池、足三里、光明、三阴交穴,分别采取捻转补泻法和提插补泻法,每周治疗3次,10次为一疗程,共治疗1个疗程;戴镜组白昼戴镜。比较3组临床疗效和治疗前后裸眼远视力变化。结果:捻转补泻组总有效率为87.5%(105/120),优于提插补泻组的69.2%(83/120,P<0.05);捻转补泻组、提插补泻组治疗后裸眼远视力均明显提高(均P<0.05);戴镜组裸眼远视力无改善(P>0.05);捻转补泻组较提插补泻组裸眼远视力提高更明显(0.75±0.23vs 0.68±0.24,P<0.05)。对96例(192只患眼)针刺治疗患者进行3个月随访,视力稳定在原水平者占87.0%(167/192),视力下降13.0%(25/192)。针刺组患者年龄越小、基础视力越好、病程越短,治疗后裸眼远视力提高越明显(均P<0.05)。结论:针刺治疗青少年近视临床效果肯定而持久,且捻转补泻法优于提插补泻法,年龄、基础视力、病程对临床疗效有影响。

Objective To compare the differences in the efficacy on distant version of naked eye in the patients of juvenile myopia between rotating manipulation and lifting-thrusting manipulation of acupuncture. Methods One hundred and twenty cases （240 eyes） were randomized into a rotating manipulation group and a lifting-thrusting manipulation group, 60 cases （120 eyes） in each group. Additionally, a corrective lenses group, 60 cases （120 eyes）, was set up as the control. In both manipulation groups, Cuanzhu （BL 2） ,Yuyao （EX-HN 4）, Sizhukong （TE 23）, Taiyang （EX-HN 5）, Fengchi （GB 20）, Zusanli （ST 36）, Guangming （GB 37） and Sanyinjiao （SP 6） were punctured, but stimulated with rotating manipulation and lifting-thrusting manipulation respectively three times per week, 10 times as a treatment session and totally one session was required. In the corrective lenses group, the glasses were applied at daytime. The clinical efficacy and the changes in distant vision of naked eye before and after treatment were compared among the three groups. Results The total effective rate was 87.5% （105/120） in the rotating manipulation group, which was better than 69. 2% （83/120） in the lifting^thrusting manipulation group （P〈0.05）. The distant vision of naked eye was improved apparently in the rotating manipulation group and the lifting-thrusting manipulation group after treatment （both P〈0.05）. But it was not improved in the corrective lenses group （P〉0.05）. The distant vision of naked eye was improved more apparently after treatment in the ro- tating manipulation group as compared with that in the lifting-thrusting manipulation group （0.75±0. 23 vs 0.68± O. 24,P〈0.05）. For 96 cases （192 eyes） with acupuncture treatment, in 3-month follow-up, 87.0% （167/192） of the cases maintained the stable vision as the original level and 13.0% （25/192） of them were reduced in the vision. In the acu- puncture groups, it was found that the improvement of distant vision of naked eye was more obvious after treatment with younger age, better basic vision and shorter duration of sickness （all P〈0.05）. Conclusion Acupuncture achieves the positive and sustainable clinical effect on juvenile myopia, and the results of rotating manipulation are superior to that oflifting-thrusting manipulation. Age, basic vision and duration of sickness impact the clinical efficacy.