| Objective This study focuses on two key stages of myopia occurrence and myopia progression,namely pre-myopia and low-grade myopia,through literature review,systematic review and two prospective,multicenter,randomized controlled clinical trials to evaluate the appropriate auricular acupuncture technique in traditional Chinese medicine.The efficacy and safety of pill pressing combined with acupuncture in the prevention and control of myopia at different stages can be obtained to obtain high-quality evidence-based evidence and provide a basis for clinical application.Chapter Ⅰ Effect of auricular point therapy on prevention and control of myopia in children and adolescents:Meta analysisMethod The databases of CNKI,Wanfang medical database,VIP medical network,PubMed,web of science,Elsevier,Springer and Cochrane library were searched by computer to screen out the clinical randomized controlled trial study of auricular acupoint pressing pill in the treatment of myopia in children and adolescents.The retrieval time limit is from the establishment of the database to June 2021.Two researchers independently screened the literature and evaluated the risk of bias included in the study.After extracting the data,Revman 5.3 software was used for meta-analysis.Result A total of 23 studies were included,including 4089 eyes of 2684 patients,including 2112 eyes in treatment group and 1977 eyes in control group.The results of meta-analysis showed that the total effective rate of auricular therapy in the intervention of low and moderate myopia in children and adolescents was higher than that of routine treatment,which was statistically significant[R=2.86,95%CI(2.41,3.41),Z=11.84,P<0.01].Compared with cycloplegic agents,auricular point pressing pill has better curative effect[OR=3.76,95%CI(2.95,4.79),Z=10.73,P<0.01];and also have a significant effect than non-cycloplegic agents[OR=2.04,95%CI(1.57,2.46),Z=5.37,P<0.01],the difference was statistically significant,and the recurrence rate of auricular therapy was lower than that of routine treatment group(8.33%vs.28.89%).In terms of improving visual acuity,the curative effect of auricular therapy was better than that of control group,and the difference was statistically significant[MD=0.13,95%CI(0.11,0.16),Z=10.32,P<0.01].In terms of improving diopter,auricular therapy was also better than routine treatment,and the difference was statistically significant[D=0.64,95%CI(0.40,0.88),Z=5.29,P<0.01].In addition,auricular therapy can reduce intraocular pressure and anterior chamber depth,and improve clinical symptoms such as blurred vision,foreign body sensation,acid swelling discomfort,dry tears,but there are different studies on delaying ocular axis.In the law of acupoint selection,the most widely used are eye,eye 1 and eye 2,followed by liver,kidney,heart,Shenmen and spleen.Conclusion 1 Ear acupoint pressing therapy can effectively prevent and control pre myopia,low and moderate myopia in children and adolescents.2 The effect of auricular therapy in preventing and controlling low and medium myopia in children and adolescents is better than that of cycloplegic agents and non-cycloplegic agents.3 Auricular therapy can improve the vision and diopter of children and adolescents with low and moderate myopia.Chapter Ⅱ A multicenter randomized controlled study of appropriate techniques of traditional Chinese medicine in preventing the progress from pseudomyopia to true myopia in childrenMethod We used a multicenter,randomized controlled trial design.The ratio of the experimental group to the control group was 1:1.The children and adolescents in pre myopia who met the inclusion criteria were assigned the treatment scheme according to the random results.The random method was random number table method and randomized hiding was carried out by the central telephone random system,and the random allocation scheme was controlled by the pharmacy.For the control group,we will tell them the knowledge of healthy eye use and for the experimental group we will give them auricular and intradermal acupuncture therapy on this basis.Six weeks was a course of treatment,a total of two courses of treatment.The best naked far vision,diopter after mydriasis optometry,eye axis,corneal curvature and adjustment range were observed before intervention,6 weeks,12 weeks,24weeks and 36 weeks,and the TCM syndromes and systemic symptoms and signs were scored.Results SPSS software was used for statistical analysis.Result A total of 266 patients were included in this study,including 4 cases of abscission.There were 132 cases in the experimental group and 130 cases in the control group,150 males and 112 females,the average age was 8.29±1.37.Before the intervention,there was no significant difference in the age,gender,nationality,past and current medical history and combined medication of all subjects(P>0.05).Visual acuity,diopter,adjustment range,symptoms and signs had no statistical significance between the two groups before intervention(P>0.05).The baseline of eye axis and corneal curvature was uneven.Therefore,covariance was used to correct the baseline before analysis.①The control rate of myopia progression between the two groups at 12 weeks,24 weeks and 36 weeks was different(P<0.05).After the intervention,the control rate of myopia progression in the experimental group was higher than that in the control group(83.33%vs.64.62%),and after the follow-up,the control rate of myopia progression in the experimental group was also higher than that in the control group(46.21%vs.32.31%).② SE-Diopter:in terms of controlling the growth of diopter,there were significant differences between the two groups and within the group at each observation node before and after the intervention(P<0.05),indicating that both groups can control the growth of myopia,and the control effect of auricular point pressing pill combined with pressing needle group is better.③Eye axis length:Taking the pre intervention as the baseline index,the AL of each node were compared respectively.The results showed that there were significant differences between and within the two groups(P<0.05).The comparison of axial growth rate between groups was also statistically significant(P<0.05),indicating that both groups can control axial growth,and the effect of delaying axial growth in the experimental group is better.④The result of naked eye visual acuity comparison was negative.⑤Corneal curvature:The results showed that the differences between and within the two groups were negative(P>0.05).⑥ Adjustment range:at the 12 week and 24 week follow-up nodes,the difference between the two groups on the improvement of adjustment range was statistically significant(P<0.05),and the difference between the two groups at all observation nodes was statistically significant(P<0.05).The test group was positive(P<0.05)and the control group was negative(P>0.05),indicating that auricular point pressing pill combined with pressing needle can improve the adjustment range and enhance the adjustment ability of patients.⑦Syndrome and score:Although the total score between the experimental group and the control group was not statistically significant(P>0.05),and the score of the experimental group showed a downward trend as a whole.Auricular point pressing pill combined with pressing needle therapy was statistically significant in improving pale/dark complexion and mental fatigue compared with the control group(P<0.05).⑧ Systemic symptoms and signs:the experimental group was better than the control group in improving attention,memory and sleep(P<0.05).Finally,we also evaluated the compliance.The results showed that the treatment group was higher than that of the control group(98.48%vs.96.15%),and there was no obvious adverse reaction event in the study,indicating that the treatment was safe.Conclusion1 Auricular and intradermal acupuncture therapy is effective in preventing the occurrence of myopia,effectively preventing 46.21%of patients from developing myopia.2 Auricular and intradermal acupuncture therapy can effectively delay the growth of refraction in children and adolescents with pre-myopia.3 Auricular and intradermal acupuncture therapy can delay the growth of the eye axis of children and adolescents with myopia and control the progress of myopia.4 Auricular and intradermal acupuncture therapy can improve the accommodation range and enhance the accommodation ability of children and adolescents with pre-myopia,and the long-term curative effect is better than the short-term curative effect.Chapter Ⅲ A multicenter randomized controlled study of appropriate techniques of traditional Chinese medicine in controlling the progress of myopia in children and adolescentsMethod We used a multicenter,randomized controlled trial design.The ratio of the experimental group to the control group was 1:1.The children and adolescents in pre myopia who met the inclusion criteria were assigned the treatment scheme according to the random results.The random method was random number table method and randomized hiding was carried out by the central telephone random system,and the random allocation scheme was controlled by the pharmacy.For the control group,we will tell them the knowledge of healthy eye use and get them to wear glasses,for the experimental group we will give them auricular and intradermal acupuncture therapy on this basis.Six weeks was a course of treatment,a total of two courses of treatment.The best naked far vision,diopter after mydriasis optometry,eye axis,corneal curvature and adjustment range were observed before intervention,6 weeks,12 weeks and 24weeks,and the TCM syndromes and systemic symptoms and signs were scored.Results SPSS software was used for statistical analysis.Result A total of 210 patients were included in this study,including 12 cases of abscission.There were 108 cases in the experimental group and 102 cases in the control group,105 males and 101 females,the average age was 9.48±2.11.Before the intervention,there was no significant difference in the age,gender,nationality,past and current medical history and all observed indicators between two groups(P>0.05).①Control rate of myopia progression:there was significant difference in the control rate of myopia progression between the two groups at 12 weeks of intervention and 24 weeks(P<0.05).After the intervention,the control rate of myopia progression in the experimental group was higher than that in the control group(63.96%vs.48.04%),and after the follow-up,the control rate of myopia progression in the experimental group was also higher than that in the control group(42.59%vs.28.43%).②Naked eye vision:the difference of naked eye vision between the two groups at 12 weeks and 24 weeks was statistically significant(P<0.05),and the difference before and after therapy was also statistically significant(P<0.05).There was no statistical significance in the experimental group before and after intervention(P>0.05),but positive in control group(P<0.05),indicating that the vision of the treatment group was stable.③ SE-Diopter:the difference between two groups before and after the intervention was statistically significant(P<0.05).The comparison between the two groups was statistically significant at 12 weeks and 24 weeks(P<0.05),indicating that both groups can control the increase of diopter,and the effect of the experimental group is better.④ Eye axis length:there was no statistical significance between the two groups at each node before and after the intervention(P>0.05),but the change value of AL between the two groups was statistically significant.The amount of progress in the experimental group was 0.16 ± 0.28 and that in the control group was 0.23±0.52.The difference in the growth rate of ocular axis was also statistically significant(P<0.05),indicating that appropriate technology of TCM can delay the growth of ocular axis.⑤ Corneal curvature:there was no significant difference between the two groups and within the group(P>0.05).⑥Adjustment range:there was no difference between the two groups at each observation node group(P>0.05).The results of the comparison between the two groups before and after the group were statistically significant in the experimental group(P<0.05)and not in the control group(P>0.05),indicating that the combination of auricular point pressing pill and pressing needle can improve the adjustment range of patients.⑦TCM syndrome and score:there was significant difference between the two groups in improving blurred vision,poor accommodation/less accommodation,dry stool/constipation,irritability,thin pulse,red tongue and less moss(P<0.05).The symptoms of hand foot heart heat,fear of cold and like hot drink,irritability,less/poor appetite,dry stool/constipation,thin pulse and red tongue with less moss in the auricular point pressing pill combined with auricular point pressing needle group were improved(P<0.05).The total score between the experimental group and the control group was statistically significant(P<0.05).⑧Systemic symptoms and signs:there was significant difference in improving sleep between the experimental group and the control group(P<0.05).Finally,the compliance was evaluated.The treatment compliance of auricular point pressing pill combined with auricular point pressing needle group was higher than that of the control group(97.05%vs.94.44%),and there was no obvious adverse reaction event in the study,indicating that the treatment was safe.Conclusion1 Auricular acupoint pressing combined with auricular acupuncture is effective in controlling the progression of low-grade myopia,effectively controlling the progression of myopia in 42.59%of patients.2 Auricular acupoint pressing combined with auricular acupuncture can effectively control the growth of refractive power of children and adolescents with low myopia,stabilize uncorrected vision,and have good long-term curative effect.3 Auricular acupoint pressing combined with auricular acupuncture can delay the growth of the eye axis of children and adolescents with myopia and control the progress of myopia.4 Auricular acupoint pressing combined with auricular acupuncture can significantly improve the clinical symptoms of myopic children and adolescents,such as blurred vision,poor appetite/anorexia,dry stool/constipation,and can improve the sleep condition of myopic children and adolescents. |
PDF Full Text Request