儿童青少年近视与中医体质类型相关性研究的Meta分析

A Meta-analysis of the Correlation Between Myopia in Children and Adolescents and Traditional Chinese Medicine Constitution Types

目的 通过Meta分析探讨儿童青少年近视与中医体质类型的相关性。方法 检索PubMed、Web of Science、Elsevier、中国知网、万方、维普、中国生物医学文献数据库中关于儿童青少年近视与中医体质类型相关性研究的文献,检索时间为建库至2023年7月1日。对文献按照纳入标准与排除标准进行筛选和数据提取,采用纽卡斯尔-渥太华量表(NOS)对文献质量进行评分,RevMan 5.4软件进行统计分析。结果 (1)一般情况:共纳入5项研究,包括20,829例受试者,其中近视患者9,050例,非近视者11,779例。近视儿童青少年的体质占比前4位的类型分别为平和质(33.50%)、阳虚质(22.02%)、气虚质(14.69%)、阴虚质(9.19%)。(2)平和质:病例组平和质体质类型人数占比低于对照组,差异有统计学意义[OR=0.480,95%CI(0.270,0.850),Z=2.530,P=0.010)]。(3)气虚质:病例组气虚质体质类型人数占比高于对照组,差异有统计学意义[OR=2.010,95%CI(1.140,3.560),Z=2.400,P=0.020)]。(4)阳虚质和阴虚质:2组阳虚质和阴虚质体质类型人数占比,差异无统计学意义(P>0.05)。(5)其他体质:其他5种体质在近视的儿童青少年中占比较少,从高到低依次为湿热质(6.80%)、气郁质(5.48%)、痰湿质(5.26%)、特禀质(2.11%)、血瘀质(1.51%)。病例组中,湿热质[OR=0.870,95%CI(0.790,0.970),Z=2.620,P=0.009)]、气郁质[OR=0.830,95%CI(0.740,0.930),Z=3.170,P=0.002)]、血瘀质[OR=0.770,95%CI(0.620,0.950),Z=2.390,P=0.020)]体质类型人数占比高于对照组,差异均有统计学意义;而2组特禀质、痰湿质体质类型人数占比,差异无统计学意义(P>0.05)。结论 气虚质、阴虚质、阳虚质是儿童青少年近视患者的主要偏颇体质类型,并且气虚质可能是其发生近视的主要体质危险因素。

OBJECTIVE This Meta-analysis aims to explore the correlation between myopia in children and adolescents and Traditional Chinese Medicine(TCM)constitution types.METHODS Databases including PubMed,Web of Science,Elsevier,CNKI,Wanfang,VIP,and SinoMed were searched for studies investigating the correlation between myopia in children and adolescents and TCM constitution types.The search covered publications from the inception of each database until July 1st,2023.The studies were screened and data extracted according to inclusion and exclusion criteria.The Newcastle-Ottawa Scale(NOS)was used to assess the quality of the included studies,and statistical analysis was performed using RevMan 5.4 software.RESULTS(1)General information:A total of five studies were included,involving 20,829 participants,of whom 9,050 were myopic,and 11,779 were non-myopic.The top four constitution types among myopic children and adolescents were Balanced Constitution(33.50%),Yang-deficiency Constitution(22.02%),Qi-deficiency Constitution(14.69%),and Yin-deficiency Constitution(9.19%).(2)Balanced constitution:The proportion of Balanced Constitution was significantly lower in the case group compared to the control group[OR=0.480,95%CI(0.270,0.850),Z=2.530,P=0.010)].(3)Qi-deficiency constitution:The proportion of Qi-deficiency Constitution was significantly higher in the case group compared to the control group[OR=2.010,95%CI(1.140,3.560),Z=2.400,P=0.020)].(4)Yang-deficiency and Yin-deficiency constitution:There were no significant differences between the case and control groups in the proportions of Yang-deficiency and Yin-deficiency Constitution types(P>0.05).(5)Other constitutions:The other five constitution types were less common among myopic children and adolescents,in descending order:Damp-heat Constitution(6.80%),Qi-Stagnation Constitution(5.48%),Phlegm-damp Constitution(5.26%),Special Constitution(2.11%),and Blood-Stasis Constitution(1.51%).The proportions of Damp-heat Constitution[OR=0.870,95%CI(0.790,0.970),Z=2.620,P=0.009)],Qi-stagnation Constitution[OR=0.830,95%CI(0.740,0.930),Z=3.170,P=0.002)],and Blood-Stasis Constitution[OR=0.770,95%CI(0.620,0.950),Z=2.390,P=0.020)]were significantly higher in the case group compared to the control group,while there were no significant differences between the two groups for Special Constitution and Phlegm-damp Constitution(P>0.05).CONCLUSIONS Qi-deficiency Constitution,Yin-Deficiency Constitution,and Yang-deficiency Constitution are the predominant TCM constitution types among children and adolescents with myopia,with Qi-deficiency Constitution potentially being a major risk factor for the development of myopia.