基于医联体模式的揿针联合小儿推拿治疗青少年儿童近视的临床研究

Clinical Study on the Treatment of Myopia in Adolescents and Children by Pressing Needle combined with Pediatric Massage Based on the Medical Alliance Model

目的:比较医联体模式下揿针、小儿推拿、揿针联合小儿推拿3种不同方法治疗青少年儿童近视的临床疗效及安全性。方法:将105例青少年近视患儿随机分为揿针组(35例)、小儿推拿组(35例)及联合组(35例),揿针组予穴位埋植揿针,小儿推拿组采用小儿推拿揉法、指推法、擦法治疗,联合组予小儿推拿治疗后予揿针穴位埋植。观察各组患儿治疗前后裸眼视力、近视屈光度等指标,并评价有效性及安全性。结果:揿针组脱落1例,其余两组无脱落。揿针组总有效率为70.59%(24/34),小儿推拿组总有效率为74.29%(26/35),联合组总有效率为88.57%(31/35),联合组总体疗效优于揿针组、小儿推拿组(P<0.05);揿针组与小儿推拿组疗效比较,差异无统计学意义(P>0.05)。3组患儿治疗后双侧裸眼视力、双侧近视屈光度较治疗前均改善(P<0.05);联合组双侧裸眼视力、双侧近视屈光度改善较揿针组、小儿推拿组更佳(P<0.05);揿针组、小儿推拿组治疗后双侧裸眼视力、双侧近视、屈光度比较,差异无统计学意义(P>0.05)。治疗期间3组无不良事件发生。结论:3种治疗方法均能改善青少年近视患儿裸眼视力、近视屈光度,揿针联合小儿推拿治疗方法相较于单一揿针或小儿推拿疗法疗效更优。

Objective:To compare the clinical efficacy and safety of three different methods for treating myopia in adolescents and children based on the medical consortium model:press needle,infantile massage,and press needle combined with infantile massage.Methods:A total of 105 adolescent myopia patients who met the inclusion criteria were randomly divided into a pressing needle group,a infantile massage group,and a combination group.The pressing needle group was treated with acupoint embedding pressing needle,the infantile massage group was treated with kneading method,finger pushing method and rubbing method,and the combined group was treated with acupoint embedding pressing needle after infantile massage treatment.The unaided visual acuity,myopia diopter and other indicators of children in each group before and after treatment were observed,and the efficacy and safety were evaluated.Results:One case fell off in the pressing needle group,while the other two groups did not fall off.The total effective rate of the pressing needle group was 70.59%(24/34),the total effective rate of the infantile massage group was 74.29%(26/35),and the total effective rate of the combination group was 88.57%(31/35).The overall efficacy of the combination group was better than that of the pressing needle group and the pediatric massage group(P<0.05).The therapeutic effect of the pressing needle group is equivalent to that of the infantile massage group(P>0.05).After treatment,the unaided visual acuity and bilateral myopia refractive power of the three groups of children improved compared to before treatment(P<0.05).The combined group showed better improvement in unaided visual acuity and myopia refractive power compared to the pressing needle group and infantile massage group(P<0.05),while the pressing needle group and infantile massage group had similar therapeutic effects(P>0.05).During the treatment period,there were no adverse events in the three groups.Conclusion:All three treatment methods can improve naked eye vision and myopia diopter in adolescent and child myopia patients.The combination of pressing needle and infantile massage therapy is more effective than single pressing needle or infantile massage therapy.