针刺治疗单纯性近视疗效的Meta分析

A Meta-analysis of the efficacy of acupuncture on simple myopia

目的:评估针刺治疗单纯性近视的疗效与安全性。方法:计算机检索中国知网,万方数据库,维普数据库,中国生物医学文献数据库,Web of Science,PubMed,Cochrane library等数据库库公开发表的关于针刺治疗近视的随机对照试验研究,时间截止到2021年2月1日。根据文献纳入与排除标准筛选相关文献,按照Cochrane 5.3系统评价手册对文献进行质量评价,RevMan 5.3软件对其结局指标进行Meta分析。结果:共纳入临床随机对照试验10篇,涉及患者1240例。Meta结果分析显示,与对照组相比,针刺治疗单纯性近视的有效率更高[OR=3.93,95%CI(3.0~5.14),P<0.001];在提高患者视力[MD=0.15,95%CI(0.08~0.22),P<0.001]、减慢眼轴增长速度[MD=-0.13,95%CI(-0.21~-0.04),P=0.002]、提高调节灵敏度[MD=3.51,95%CI(2.65~4.37),P<0.0001]等指标方面,均显示针刺治疗单纯性近视具有显著作用。纳入文献中有3篇提及不良反应的发生和处理,其余7篇均未描述。结论:文献证据表明,在常规治疗的基础上加用针刺治疗可有效提高视力,改善调节灵敏度,减慢眼轴增长速度。本研究分析未发现严重不良反应,但仍需要更多高质量文献佐证此分析。

Object:To evaluate the efficacy and safety of TCM acupuncture in the treatment of simple myopia.Methods:The literature in databases such as CNKI,Wanfang,VIP,CBM,Web of Science,PubMed,Cochrane library was retrieved.Search time was limited from the inception to February 2021.A comprehensive search strategy was designed to identify all randomized controlled trials comparing acupuncture therapy versus other therapies.The methodological quality of the included trials was assessed by the quality grade evaluation in Cochrane handbook.Data extraction and Meta-analysis were performed by RevMan 5.3 statistical software.Results:A total of 10 clinical randomized controlled trials involving 1240 patients were included.The Meta-analysis showed that compared with the other therapies on myopia,acupuncture therapy was better in improving the effective rate[OR=3.93,95%CI(3.0~5.14),P<0.001].It is shown that acupuncture has a significant effect on simple myopia in terms of improving patients’eyesight[MD=0.15,95%CI(0.08~0.22),P<0.001],slowing down the growth rate of eye axis[MD=-0.13,95%CI(-0.21~-0.04),P=0.002]and improving accommodation sensitivity[MD=3.51,95%CI(2.65~4.37),P<0.0001].The occurrence of adverse reactions were mentioned in 3 articles,and were not described in the other 7 articles.Conclusion:The acupuncture therapy on simple myopia is more effective compared with the other therapies.No serious adverse reactions were found in this study,but more high-quality literature is needed to support this analysis.