| 葛薇,李秋实,诸力伟,等.中医针刺联合低浓度阿托品对低度近视儿童黄斑微循环的影响[J].浙江中医药大学学报,2024,48(10):1233-1239. |
| 中医针刺联合低浓度阿托品对低度近视儿童黄斑微循环的影响 |
| Effects of Traditional Chinese Medicine Acupuncture Combined with Low-Dose Atropine on Macular Microcirculation in Chil?dren with Low Myopia |
| DOI：10.16466/j.issn1005-5509.2024.10.005 |
| 中文关键词: 低度近视 儿童 黄斑血管密度 视网膜厚度 中医针刺 低浓度阿托品 神经节细胞-内丛状层 光学相干断层扫描血管成像 |
| 英文关键词: low myopia children macular vascular density retinal thickness traditional Chinese medicine acupuncture low-dose atropine ganglion cells-inner plexiform layer optical coherence tomography angiography |
| 基金项目:浙江省中医药科技计划项目(2022ZB261)；杭州市医药卫生科技项目(A20210130、A20230193)；浙江省医药卫生科技计划项目(2024KY1359)；杭州市培育重点学科(眼科学0020200468) |
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| 中文摘要: |
| [目的] 探究中医针刺联合0.01%阿托品滴眼液对低度近视儿童黄斑血管密度及视网膜厚度的影响。[方法] 将84例(156眼)首次诊断为低度近视的患儿随机分为实验组和对照组，实验组使用中医针刺联合0.01%阿托品滴眼液治疗，对照组使用0.01%阿托品滴眼液治疗。两组患儿治疗前及治疗6个月后进行眼科检查，包括裸眼远视力(uncorrected distance visual acuity，UCVA)、眼轴(axial length，AL)、等效球镜度数(spherical equivalent，SE)、裂隙灯检查，使用光学相干断层扫描(optical coherence tomography，OCT)常规模式测量黄斑神经节细胞-内丛状层(macular ganglion cell-inner plexiform layer，mGCIPL)厚度，使用光学相干断层扫描血管成像(optical coherence tomography angiography，OCTA)测量黄斑区血管密度、中心凹无血管区面积等，比较两组治疗前后各项指标的变化。[结果] 治疗6个月后，两组患儿AL及SE均较治疗前增长，差异有统计学意义(P<0.01，P<0.01)，但实验组AL、SE差值小于对照组，差异有统计学意义(P<0.05，P<0.05)。两组患儿眼压(intraocular pressure，IOP)较治疗前后无明显变化，差异无统计学意义(P>0.05)。与治疗前比较，实验组及对照组mGCIPL厚度均增加，差异有统计学意义(P<0.01，P<0.05)；实验组中心圆黄斑血管密度(central circle macular vessel density，cCVD)增加，差异有统计学意义(P<0.01)，外圆黄斑血管密度(outer circle macular vessel density，oCVD)、内圆黄斑血管密度(inner circle macular vessel density，iCVD)、全圆黄斑血管密度(whole circle macular vesseldensity，wCVD)及黄斑中心凹无血管区(foveal avascular zone，FAZ)无明显改变，差异无统计学意义(P>0.05)。治疗6个月后，实验组cCVD和AL、SE之间均无相关性(P>0.05)，cCVD与mGCIPL厚度呈低度正相关(r=0.448，P<0.05)。[结论] 中医针刺联合0.01%阿托品滴眼液能够进一步降低低度近视患儿AL增长及屈光度增长速度，并能够增加低度近视患儿cCVD及mGCIPL厚度。 |
| 英文摘要: |
| [Objective] To investigate the effects of traditional Chinese medicine acupuncture combined with 0.01% atropine eye drops on macular vascular density and retinal thickness in children with low myopia. [Methods] A total of 84 children (156 eyes) newly diagnosed as low myopia were randomly divided into an experimental group and a control group. The experimental group received traditional Chinese medicine acupuncture combined with 0.01% atropine eye drops， while the control group was treated with 0.01% atropine eye drops alone.Ophthalmic examinations were performed before and after six months of treatment， including uncorrected distance visual acuity(UCVA)，axial length(AL)， spherical equivalent(SE)， and slit-lamp examination. Optical coherence tomography(OCT) was used in routine mode to measure macular ganglion cell-inner plexiform layer(mGCIPL) thickness， and optical coherence tomography angiography(OCTA) was employed to measure macular vascular density and the area of the foveal avascular zone(FAZ). Changes in various indicators before and after treatment were compared between the two groups. [Results] After six months of treatment， both groups showed significant increases in AL and SE compared with that before treatment(P<0.01). The differences in AL and SE were significantly smaller in the experimental group than in the control group(P<0.05). No significant changes in intraocular pressure(IOP) were observed in either group before and after treatment(P>0.05). Compared to before treatment， both groups exhibited significant increases in mGCIPL thickness(P<0.01， P<0.05).Central circle macular vessel density(cCVD) increased in the experimental group(P<0.01)， while there was no significant changes in outer circle macular vessel density(oCVD)， inner circle macular vessel density(iCVD)， whole circle macular vessel density(wCVD) or FAZ(P>0.05). After six months of treatment， no correlation was found between cCVD and AL or SE in the experimental group(P>0.05)， but cCVD was positively correlated with mGCIPL thickness(r=0.448， P<0.05). [Conclusion] Traditional Chinese medicine acupuncture combined with 0.01% atropine eye drops can further reduce the growth rate of AL and diopter in children with low myopia. Additionally， this combined treatment increases cCVD and mGCIPL thickness in these children. |
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