| Myopia is a major public health problem and China is the first country with myopia in the world.It is gradually showing a trend of low age,high incidence and rapid progress.The epidemiological survey shows that the prevalence rate of myopia among primary and secondary school students is 52.7%in 2020.It not only affects the overall health quality of the people,but also lays hidden dangers for the problems of national defense security.Therefore,early myopia prevention is particularly critical.There are various methods of myopia prevention in Western medicine,such as frame lens,corneal shaping lens,low concentration atropine eye drops,etc.And those methods have certain curative effects,but there are restrictions such as high price and drugs not listed in China.Hence,exploring new myopia prevention measures is an urgent problem to be solved in clinic.Traditional Chinese medicine has unique theoretical and therapeutic advantages in myopia prevention.There are many prevention methods,such as acupuncture,auricular point pressing,acupoint application and so on.In recent years,it has been widely used in clinical research because of its simplicity,effectiveness and safety.The purpose of this study is to obtain a safe and effective comprehensive prevention scheme of traditional Chinese medicine for myopia that can be popularized for a long time.Therefore,Meta-analysis of relevant literature in recent 10 years is carried out to provide a scientific basis for the feasibility of comprehensive treatment of traditional Chinese medicine in the intervention of adolescent myopia.And the following hypothesis is put forward:comprehensive treatment of traditional Chinese medicine can slow down the progress of myopia and improve the regulation function.The aim is to give full play to the advantages of traditional Chinese medicine in myopia prevention,contribute to reducing the prevalence,progress and blindness rate of adolescent myopia in China,and obtain good social and economic benefits.Study 1 Meta-analysis of comprehensive therapy of traditional Chinese medicine in the intervention of adolescent myopiaPurpose:It is aiming to evaluating systematically evaluate the effectiveness of comprehensive therapy of traditional Chinese medicine in the intervention of adolescent myopia.Method:The computer comprehensively searched the Chinese and English databases of clinical randomized controlled trials on the intervention of traditional Chinese medicine in adolescent myopia in recent 10 years.The included studies were evaluated by "Cochrane bias risk assessment" tool for conducting methodological quality evaluation and RevMan 5.3 was used for data analysis.The evidence quality was assessed with GRADE profiler 3.6.1 software.Results:A total of 15 randomized controlled studies met the inclusion criteria.The results showed that compared with the control group,traditional Chinese medicine comprehensive therapy could increase the clinical efficacy of myopia prevention,improve the visual acuity of adolescent myopia patients,slow down the growth rate of diopter,partly or generally improve discomfort symptoms,enhance the quality of life,and have no serious adverse reactions.However,the GRADE quality rating of clinical outcome index shows that the effective rate,visual acuity,diopter and clinical symptoms are low,suggesting that the overall effect of traditional Chinese medicine comprehensive therapy on myopia is better than that of conventional Western medicine,but the evidence quality level of this conclusion is low.To strengthen the strength of evidence,its effectiveness and safety need to be verified by a large number of clinical studies with higher quality.Conclusion:The effect of comprehensive therapy of traditional Chinese medicine on adolescent myopia is better than that of western conventional therapy.It can be considered that comprehensive therapy of traditional Chinese medicine is safe and effective.However,the relevant literatures are not enough and further studies are still needed.Study 2 Clinical study of comprehensive therapy of traditional Chinese medicine on adolescent mild myopiaPurpose:Based on the basis of systematic evaluation,a prospective,stratified,randomized and controlled clinical trial design was used to objectively evaluate the clinical efficacy and safety of traditional Chinese medicine comprehensive therapy in the intervention of adolescent mild myopia.Method:The prospective,stratified,randomized and controlled clinical trial design was adopted.The patients were stratified according to the eye with higher diopter(SE>-1.00DS and-3.00DS≤SE≤-1.00DS),and then randomly divided into treatment group and control group.With 256 cases totally,62 cases in the treatment group and control group of SE>-1.00DS and 66 cases in the treatment group and control group of-3.00DS ≤SE≤-1.00DS.Both the treatment group and the control group were given health education and mydriatic optometry(subjects of-3.00DS≤SE≤-1.00DS needing to wear glasses).In addition,the treatment group need to combine pyonex,auricular point pressing and acupoint application therapy,patients were treated twice a week with one course of treatment per month for treating six courses eventually.The curative effects of the two groups were evaluated after every three courses of treatment.Results:A total of 256 patients participated in the clinical study.One patient of the control group fell out eventually.Finally,the data of 255 cases(469 eyes)aged 6～13 years were included in the statistics.2.1 According to the judgment standard of myopia diopter progress in the White Paper on Myopia Management(2019),after intervention,the proportion of none progressive myopia in the treatment group was higher than that in the control group,and the proportion of progressive myopia in the treatment group was lower than that in the control group.The difference between the two groups was statistically significant(P<0.01).2.2 Comparison results between groups2.2.1 After three months of intervention(1)After the intervention,the naked visual acuity,diopter and corneal curvature of the treatment group with SE>-1.00DS were better than those of the control group(P<0.05);(2)After the intervention,the naked visual acuity of the treatment group with-3.00DS ≤SE≤-1.00DS was better than that of the control group(P<0.05).2.2.2 After six months of intervention(1)The naked eye visual acuity,diopter and adjustment sensitivity of the treatment group with SE>-1.00DS were better than those of the control group(P<0.05);(2)After the intervention,the naked visual acuity,binocular adjustment amplitude and adjustment sensitivity of the treatment group with-3.00DS≤SE≤-1.00DS were better than those of the control group(P<0.05).2.3 Comparison results of before-after intervention2.3.1 After three months of intervention(1)After intervention,the diopter and binocular adjustment sensitivity of SE>-1.00DS treatment group increased,and the difference was statistically significant compared with that before intervention(P<0.05).In SE>-1.00DS control group,the naked eye visual acuity decreased and the diopter increased after intervention.Compared with that before intervention,the difference was statistically significant(P<0.05).(2)-3.00DS≤SE≤-1.00DS treatment group and control group had decreased naked eye vision,increased diopter,negative relative adjustment,adjustment amplitude and adjustment sensitivity,which were significantly higher than those before intervention(P<0.05).In the control group with-3.00DS ≤ SE ≤-1.00DS,the sensitivity of the control group was higher than that before intervention,and the difference was statistically significant(P<0.05).2.3.2 After six months of intervention(1)After intervention,the naked eye visual acuity decreased,diopter increased,eye axis increased and adjustment sensitivity increased in the SE>-1.00DS treatment group,which was statistically significant compared with that before intervention(P<0.05).SE>-1.00DS control group had decreased naked eye vision,increased diopter and increased ocular axis after intervention,which was significantly different from that before intervention(P<0.05);(2)-3.00DS≤SE≤-1.00DS treatment group,after intervention,the naked eye visual acuity decreased,the diopter increased,the eye axis increased,and the negative relative adjustment,adjustment amplitude and adjustment sensitivity were higher than those before intervention(P<0.05).-3.00DS≤SE≤-1.00DS control group,compared with before and after intervention,the naked eye visual acuity decreased,diopter increased and eye axis increased,the difference was statistically significant(P<0.05).Conclusion;(1)The comprehensive therapy of traditional Chinese medicine plays a positive role in controlling the progress of myopia and slowing down the growth rate of myopia degree.It can improve the regulation function to a certain extent,which may be related to the role of pyonex,auricular point pressing and acupoint application therapy in dredging meridians,regulating muscles and harmonizing Qi and blood.(2)The effectiveness of comprehensive therapy of traditional Chinese medicine in the treatment of adolescent myopia is positively correlated with the treatment time,that is,the longer the intervention time,the more obvious the improvement of patients’ regulatory function.(3)During the implementation of this study,no obvious adverse events occurred,which shows that the comprehensive therapy of traditional Chinese medicine has high safety,which is worthy of clinical application. |
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