| Theory and literature researchObjective: To systematically summarize the understanding of the etiology and pathogenesis of amblyopia in Traditional Chinese Medicine and the progress of clinical research,to explore the application characteristics of tuina in the clinical treatment of amblyopia,to summarize the rules of acupoint selection and composition of tuina in the treatment of amblyopia,in order to better guide the clinical research of amblyopia,optimize the treatment plan,improve the treatment effect,and provide the theoretical basis for the clinical treatment of amblyopia.Methods: Search the clinical research of tuina therapy for amblyopia collected and published by CNKI,Wanfang Data knowledge service platform and VIP before December 31,2019,and summarize the included literature,respectively,and sort out the time of literature publication,tuina acupoint selection,acupoint location,acupoint meridian tropism and specific acupoint attribute,establish the corresponding database,and use the version of Chinese Medicine Inheritance assistant platform(v2.5)for statistical analysis.Results: A total of 38 articles of tuina therapy for amblyopia were selected,and the top five acupoints were: Sibai,Jingming,Yuyao,Cuanzhu,Chengqi;most of the meridians which were closely related to the eyes and along the head,such as the bladder meridian of foot-Taiyang,stomach meridian of foot-Yangming,etc.,were used more frequently;from the point distribution,the use frequency of acupoints on the head,face,back and waist was higher;from the attribute analysis of specific acupoints,the frequency of intersection acupoints is much higher than that of other specific acupoints.Two groups of acupoint combinations with the highest degree of confidence were obtained,and three new prescriptions based on entropy hierarchical clustering were obtained.Conclusion: 1.Tuina therapy can effectively treat amblyopia,it is safe and reliable,it is worthy of clinical promotion.2.The treatment of amblyopia by tuina is based on the personal experience of doctors,and there is no standardized treatment plan,which limits the clinical application of tuina in amblyopia to some extent.3.By analyzing the included literature,three new methods of modern tuina treatment for amblyopia are obtained,with a view to providing a reference for the formation of standardized treatment programs for tuina treatment for amblyopia,so as to facilitate the clinical promotion and application of tuina treatment for amblyopia.Clinical research1.Clinical study on the treatment of amblyopia in children by kneading“siming” acupoint combined with whirling vibrationObjective: To observe the improvement of amblyopia's visual acuity,the integral of clinical symptoms before and after treatment,the improvement of naked visual acuity,near and far stereoscopic vision,and the long-term clinical effect,and to evaluate the therapeutic effect of amblyopia's treatment by tuina combined with whirling vibration,so as to improve the clinical diagnosis and treatment level of children's amblyopia.Methods: 177 children with amblyopia were randomly divided into three groups: the treatment group(kneading “siming” acupoint and whirling vibration plus covering eyes and getting eyeglasses method)59 cases,the control group 1(kneading“siming” acupoint and whirling vibration method group)59 cases,the control group 2(covering eyes and getting eyeglasses method)59 cases.All cases were treated for 3 months.The naked vision,symptom scores,changes of near far stereopsis and long-term clinical effect were observed before and after treatment.Spss22.0 software was used for statistical analysis.Results:1.Analysis of general data: there was no significant difference in gender,age,type of amblyopia and degree of amblyopia among the three groups before treatment(P>0.05).The baseline data of the three groups before treatment were comparable;there was no statistical difference in symptom score,naked eye vision,near far stereo vision among the three groups before treatment.2.Comparison of clinical symptom scores: after treatment,there was significant difference in the total score of main symptoms among the three groups(P<0.01);treatment group compared with control group 2,P<0.05;control group 1 compared with control group 2,P<0.05,indicating that tuina therapy based on kneading “siming” acupoint combined with whirling vibration was better than those of the patients with covering eyes and getting eyeglasses method in improving the clinical symptoms of amblyopia children.3.Comparison of naked eye vision: the naked eye vision of the three groups was significantly improved compared with that before treatment(P<0.01);treatment group compared with control group 2,P<0.05;control group 1 compared with control group 2,P<0.05,indicating that the tuina therapy based on kneading“siming”acupoint combined with whirling vibration was better than covering eyes and getting eyeglasses method in improving the naked eye vision.4.Far and near stereopsis comparison: after the treatment,the far and near stereopsis of the three groups of children were significantly improved.5.Comparison of clinical efficacy:(1)after three months of treatment: the total effective rate of the treatment group(91.58%)was significantly higher than that of the control group 1(85.57%)and the control group 2(70.10%),the difference was statistically significant(P<0.05),which indicated that the total effective rate of tuina therapy based on kneading “siming” acupoint combined with whirling vibration was better than those of the patients with covering eyes and getting eyeglasses method,and the combination of the two has better clinical effect.(2)Comparison of the clinical effects of different types of amblyopia: after three months of treatment: the curative effect of ametropic amblyopia and anisometropic amblyopia is statistically significant(P<0.05).(3)Comparison of clinical effects in different degrees: in the treatment of mild amblyopia,the total effective rate of tuina therapy based on kneading“siming” acupoint combined with whirling vibration is 92.00%,and the total effective rate of covering eyes and getting eyeglasses therapy is 78.57%,which indicated that the total effective rate of tuina therapy based on kneading“siming” acupoint combined with whirling vibration was better than those of the patients with covering eyes and getting eyeglasses method,and the combination of the two has better clinical effect(94.12%).In the treatment of moderate and severe amblyopia,the difference is statistically significant(P<0.05),which shows that the combination of tuina therapy based on kneading “siming” acupoint combined with whirling vibration and covering eyes and getting eyeglasses therapy can significantly improve the clinical efficiency of amblyopia.6.From the perspective of long-term effect comparison:after 3 months and 6 months of treatment,the naked visual acuity of the three groups decreased in varying degrees,but the tuina therapy based on kneading“siming” acupoint combined with whirling vibration was superior to covering eyes and getting eyeglasses method in stabilizing long-term visual acuity.The combination of traditional Chinese medicine and Western medicine has better long-term effect.Conclusion: 1.As a characteristic therapy of external treatment of traditional Chinese medicine,tuina therapy based on kneading“ siming ” acupoint combined with whirling vibration has significant advantages in improving the TCM Syndromes of amblyopia children,regulating children's physique and regulating the functions of viscera.2.The tuina therapy based on kneading “siming” acupoint combined with whirling vibration can significantly improve the visual acuity of children with amblyopia.3.The tuina therapy based on kneading “siming” acupoint combined with whirling vibration can improve the far and near stereoscopic vision of amblyopic children.Combined with covering eyes and getting eyeglasses method,the effect is better.4.The total clinical effective rate and long-term effect of tuina therapy based on kneading “siming” acupoint combined with whirling vibration are significantly better than that of covering eyes and getting eyeglasses method,and the effect of combination of Chinese and Western medicine is better.2.Professor Yujuan clinical experience in the treatment of amblyopiaBased on the analysis of liver,spleen and kidney,the supervisor Professor Yujuan understanding of the pathogenesis of amblyopia was summarized: “Based on the physiological and pathological characteristics,grasped the pathogenesis of amblyopia”,“conditions the function of viscera and spleen to enrich the congenital essence”,“specimen The clinical diagnosis and treatment ideas and methods of concurrent treatment,timely correction of accompanying syndromes”,“clearing the meridians,regulating the movement of qi and blood”,“combining traditional Chinese and western medical theories,and good at using vibrating methods”,“advocate early treatment and emphasize regular consolidation and home protection”.And analyze the typical clinical medical cases,in order to provide ideas and reference for the clinical diagnosis and treatment of amblyopia. |
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