针刺治疗近视的系统评价

发布时间：2018-03-03 13:37

本文选题：针刺　切入点：近视　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：系统评价针刺治疗近视的疗效和安全性,为临床提供循证医学证据,并为未来临床研究方向提供新的思路。方法：参照制定的文献纳入标准和排除标准,计算机全面检索VIP(1989-2016.1)、CBM(1980-2016.1)、CNKI(1980-2016.1)和万方数据资源系统(1998-2016.1)、The Cochrane Library(2016, Issue 1)、PubMed(1980-2016.1)、 MEDLINE (1980-2016.1)。手工检索成都中医药大学图书馆相关资料。用http://www.controlled-trials.com,http://www.clinicaltrials.gov进行补充检索。将检索到的文献根据制定好的纳入排除标准进行筛选,然后将筛选得到的文献进行质量评价和资料提取。采用临床总有效率、裸眼视力、屈光度、晶状体厚度、睫状体厚度、眼轴长度评价针刺治疗近视的疗效,并对针刺治疗近视进行安全性分析。统计学分析采用Cochrane协作网提供的Revman5.2软件对所有结果进行数据分析。证据等级评定采用GRADE profiler 3.6软件和标准评估证据质量。结果：共检索到相关文献482篇,最终纳入12篇中文文献。提取数据进行Meta分析,结果如下：①总有效率：针刺或针刺结合其他疗法优于西药或热水蒸汽熏眼(OR=3.57,95%CI[2.80,4.53],P0.00001),敏感性分析与总体一致；单纯针刺优于滴眼液(OR=2.96,95%CI[2.10,3.89],P0.00001)；针刺为主结合其他疗法优于西药或热水蒸汽熏眼(OR=4.99,95%CI[3.39,7.36],P0.00001)。②裸眼视力：针刺或针刺结合西药优于西药或佩戴眼镜(MD=0.14,95%CI[0.08,0.21],P0.0001)；根据年龄差异进行亚组分析,针刺或针刺结合西药优于西药(MD=0.11,95%CI[0.08,0.13],P0.00001)。③屈光度：梅花针与西药或佩戴眼镜比较没有明显的差异(MD=0.01'95%CI[-0.08,0.10],P=0.82)。④晶状体厚度：梅花针与西药或配戴眼镜比较没有明显差异(MD=-0.04,95%CI[1-0.11,0.02],P=0.20)；⑤睫状体厚度：梅花针与西药或配戴眼镜比较没有明显差异(MD=-0.01,95%CI[-0.05,0.03],P=0.64)。⑥眼轴长度：梅花针优于西药或配戴眼镜(MD=-0.09,95%CI[-0.14,-0.03],P=0.004)。⑦安全性：无不良反应报道。结论：在总有效率、裸眼视力改善、眼轴长度改善方面,针刺疗法治疗近视优于其他疗法(西药、热水蒸汽熏眼、配戴眼镜)；在屈光度、晶状体长度、睫状体长度改善方面,针刺疗法与其他疗法(西药、配戴眼镜)比较没有统计学差异。由于本研究纳入文献质量较低,尚需要更多研究证据证实。且没有足够证据证实针刺治疗近视的远期疗效。在安全性方面,初步认为针刺治疗近视有良好的安全性,但需要更多研究证据证实。
[Abstract]:Objective: to evaluate the efficacy and safety of acupuncture in the treatment of myopia, to provide evidence-based medical evidence for clinical practice, and to provide new ideas for future clinical research. A comprehensive computer search of the Cochrane library of Chengdu University of traditional Chinese Medicine was conducted from 1989 to 2016.1c) and the Wanfang data Resource system 1998-2016.2016,1980-2016, MEDLINE 1980-2016.1. manually search the library of Chengdu University of traditional Chinese Medicine. Use httpw: www.controlled-trialals.comhttptrals.gov to carry out supplementary searches. The documents retrieved are screened according to the exclusion criteria. Then the quality evaluation and data extraction of the selected literature were used to evaluate the therapeutic effect of acupuncture on myopia by clinical total effective rate, naked visual acuity, diopter, lens thickness, ciliary body thickness and axial length. The safety of acupuncture for myopia was analyzed. The data of all the results were analyzed by Revman5.2 software provided by Cochrane Cooperative Network. The quality of evidence was evaluated by GRADE profiler 3.6 and standard. : a total of 482 articles were retrieved. Finally, 12 Chinese literatures were included. The data were extracted for Meta analysis. The results were as follows: acupuncture or acupuncture combined with other therapies was superior to western medicine or hot water steam fumigation of eyes (CI = 3.5795 CI [2.804.53] P 0.00001), and the sensitivity analysis was consistent with that of the whole; Simple acupuncture is better than eye drops (2.96-95 CI [2.100.89] P0.00001; Acupuncture combined with other therapies is superior to western medicine or hot water vapor fumigation of Organ 4.99.95CI [3.3997.36] P0.00001n.2 naked eyesight: acupuncture or acupuncture combined with western medicine is superior to western medicine or eyeglasses MD0.149595 CI [0.080.21] P0.0001; according to the age difference, the subgroup analysis was carried out. Acupuncture or Acupuncture combined with Western Medicine is superior to Western Medicine MDD 0.11995 CI [0.080.13] P0.00001t.3 diopter: there is no significant difference between plum blossom needle and western medicine or wearing glasses. There is no significant difference in lens thickness of P0. 82.4 lens between plum needle and western medicine or spectacles. There is no significant difference in ciliary body thickness between plum needle and western medicine or glasses. : there is no significant difference between plum blossom needle and western medicine or wearing glasses. There is no significant difference between plum blossom needle and western medicine or wearing glasses. There is no significant difference between plum blossom needle and western medicine or wearing glasses. Conclusion: in the total effective rate, the plum blossom needle is superior to the western medicine or wearing glasses in the safety of MDU -0.09 ~ 95CI [-0.14 ~ -0.03] P 0.004.7: no adverse reaction is reported. For the improvement of naked eyesight and the improvement of axial length, acupuncture therapy is superior to other treatments in treating myopia (western medicine, hot water steam fumigating eyes, wearing glasses, and improving diopter, lens length, ciliary body length, etc.). There was no statistical difference between acupuncture therapy and other therapies (western medicine, wearing glasses). There is not enough evidence to prove the long-term efficacy of acupuncture in the treatment of myopia. In terms of safety, it is preliminarily considered that acupuncture has good safety in treating myopia, but more research evidence is needed to prove it.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.82

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