中医“五位一体”综合疗法联合低浓度阿托品对青少年近视防控的效果评价

Effect of"Five-in-One"of traditional Chinese medicine combined with low concentration of atropine in prevention and control of myopia in adolescents

目的探讨中医“五位一体”综合疗法联合低浓度阿托品对青少年近视防控的安全性及有效性。方法纳入诊断为轻度近视的80例青少年为研究对象。按照受试者及监护人意愿分为对照组40例和中医干预组40例。对照组每晚睡前双眼结膜囊滴0.01%硫酸阿托品滴眼液1次。中医干预组受试者在对照组局部用药的基础上,每周进行2次中医“五位一体”综合疗法治疗。2组受试者干预疗程均为12个月。分别于干预前及治疗后3、6、12个月随访,采用国际标准视力表进行检查,测定2组受试者治疗前后裸眼远视力变化,采用散瞳验光联合电脑验光仪测定2组治疗前后等效球镜度变化,采用光学生物测量仪测量治疗前后眼轴长度变化,比较2组治疗后不良反应情况。结果对照组随着治疗时间的延长,裸眼远视力较干预前下降,中医干预组裸眼远视力较干预前逐渐增高,差异有统计学意义(P<0.05);治疗后12个月,中医干预组裸眼远视力高于对照组,差异有统计学意义(P<0.05)。随着治疗时间的延长,2组等效球镜度均逐渐增大,差异有统计学意义(P<0.05);治疗后12个月,中医干预组等效球镜度低于对照组,差异有统计学意义(P<0.05)。2组随着治疗时间的延长,眼轴长度逐渐增长,差异有统计学意义(P<0.05);治疗后6、12个月,中医干预组眼轴长度短于对照组,差异有统计学意义(P<0.05)。使用0.01%阿托品后,对照组8例患儿出现户外畏光症状;中医干预组使用中医“五位一体”综合疗法联合0.01%硫酸阿托品治疗后,4例患儿出现户外畏光症状,用药2周后症状消失。结论中医“五位一体”综合疗法联合低浓度阿托品效果显著优于单用低浓度阿托品,能有效控制近视屈光度的进展,减少其产生的不良反应。

Objective To explore the safety and effectiveness of the comprehensive therapy of"Five-in-One"of traditional Chinese medicine combined with low concentration of atropine in the prevention and control of myopia in adolescents.Methods Eighty adolescents diagnosed with mild myopia were included in the study.According to the wishes of the subjects and their guardians,they were divided into control group with 40 cases and traditional Chinese medicine intervention group with 40 cases.The control group received 0.01%atropine sulfate eye drops in both eyes once before bedtime every night,the traditional Chinese medicine intervention group underwent twice-weekly comprehensive therapy of"Five-in-One"of traditional Chinese medicine on the basis of local application of medication in the control group.Both groups received a 12-month intervention course.Follow-up visits were conducted before intervention and at 3,6,and 12 months after treatment.The international standard visual acuity chart was used to examine the changes in unaided distance visual acuity before and after treatment in both groups.The changes of distant visual acuity of naked eye before and after treatment were measured in two groups.The changes in equivalent spherical lens power before and after treatment in both groups were measured by mydriatic refraction combined with a computer optometer.The changes in axial length before and after treatment were measured using an optical biometer.The adverse reactions after treatment in both groups were compared.Results In the control group,the uncorrected distance visual acuity decreased compared with that before intervention as the treatment time prolonged,while was gradually increased in the traditional Chinese medicine intervention group compared with that before intervention(P<0.05).At 12 months after treatment,the uncorrected distance visual acuity in the traditional Chinese medicine intervention group was higher than that in the control group(P<0.05).With the prolongation of treatment time,the equivalent spherical lens power gradually increased in both groups(P<0.05).At 12 months after treatment,the equivalent spherical lens power in the traditional Chinese medicine intervention group was lower than that in the control group(P<0.05).The axial length gradually increased with the prolongation of treatment time in both groups(P<0.05).At 6 and 12 months after treatment,the axial length in the traditional Chinese medicine intervention group was shorter than that in the control group(P<0.05).After using 0.01%atropine,8 children in the control group developed outdoor photophobia symptoms;after treatment with the comprehensive therapy of"Five-in-One"of traditional Chinese medicine combined with 0.01%atropine sulfate eye drops in the traditional Chinese medicine intervention group,4 children developed outdoor photophobia symptoms,but the symptoms disappeared after 2 weeks of medication.Conclusion The comprehensive therapy of"Five-in-One"in traditional Chinese medicine combined with low-concentration atropine is significantly more effective than low-concentration atropine alone in effectively controlling the progression of refractive myopia and reducing its adverse reactions.