梅花针防治青少年近视有效性和安全性的Meta分析

The Efficacy and Safety of Plum-Blossom Needle for the Prevention and Treatment of Myopia in Adolescents:A Meta-Analysis

目的系统评价梅花针用于防治青少年近视的疗效和安全性。方法计算机检索Cochrane Library、Embase、PubMed、中国知网、万方、维普、中国生物医学文献数据库,搜集以梅花针为主防治青少年近视的随机对照试验(RCT)和半随机对照试验,检索时限均从建库至2021年7月31日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入7篇RCT文献,2,583例患者,其中采用梅花针治疗的试验组1,216例,采用其他治疗方法的对照组1,367例。与对照组相比,梅花针可提高青少年近视的治疗总有效率[RR=1.200,95%CI(1.140,1.270),Z=6.590,P=0.000]。剔除异质性较高的研究后发现,试验组患者的裸眼视力提高幅度、散瞳后屈光度值、眼轴的提高幅度与对照组比较,差异均无统计学意义(均P>0.05)。所有纳入研究均未发现梅花针治疗的不良反应。结论梅花针用于防治青少年假性近视或低度近视具有一定疗效,但在改善患者裸眼视力、降低散瞳后屈光度、延缓眼轴进展方面尚缺乏高级别证据,尚未发现其有明显的安全风险。

OBJCTIVE To systematically evaluate the efficacy and safety of using plumblossom needle for the prevention and treatment of myopia in adolescents.METHODS Cochrane Library,Embase,PubMed,China National Knowledge Infrastructure(CNKI),Wanfang,VIP,and Chinese Biomedical Literature Database were searched from their inception until July 31st,2021 for randomized controlled trial(RCT)and quasi-RCT that used plum blossom needle therapy as the main intervention for the prevention and treatment of myopia in adolescents.There were two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was performed using RevMan 5.3 software.RESULTS A total of seven RCTs with 2,583 participants were included,of which 1,216 participants were in the plum blossom needle therapy group and 1,367 were in the control group using other treatments.Compared with the control group,plum blossom needle therapy can improve the overall treatment effectiveness of myopia in adolescents[RR=1.200,95%CI(1.140,1.270),Z=6.590,P=0.000].After excluding studies with high heterogeneity,there were no statistically significant differences in the improvement of uncorrected visual acuity,cycloplegic refraction,and axial length between the treatment and control groups(all P>0.05).No adverse reactions were reported in any of the included studies.CONCLUSIONS Plum blossom needle therapy has a certain therapeutic effect in preventing and treating pseudo-myopia or mild myopia in adolescents,but there is still a lack of high-level evidence to support its efficacy in improving uncorrected visual acuity,reducing cycloplegic refraction,and delaying the progression of axial length.No significant safety risks have been found.