首页|中青年高度近视患者中医证型与豹纹状眼底及黄斑区脉络膜相关性研究

中青年高度近视患者中医证型与豹纹状眼底及黄斑区脉络膜相关性研究

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目的:观察中青年高度近视(HM)不同中医证型患者豹纹状眼底(FT)、密度(FTD)及黄斑区脉络膜厚度(CT)的相关性差异。方法:选取2023年2月—2023年12月广东省中西医结合医院眼科收治的109例HM患者进行中医辨证分型,分为肝肾两虚33例、气血不足44例、心阳不足32例,分析比较HM患者不同证型眼轴长度(AL)、等效球镜(SE)、FT、FTD、黄斑区CT的差异。结果:共纳入HM患者109例(109眼),男54例,女55例,心阳不足证组32例(32眼,29。4%),气血不足证组44例(44眼,40。4%)、肝肾两虚证组33例(33眼,30。3%),3组一般资料比较,差异无统计学意义(P>0。05),具有可比性。气血不足证组SE绝对值小于心阳不足证组及肝肾两虚证组(P<0。05),肝肾两虚证组AL大于心阳不足证组及气血不足证组(P<0。05),心阳不足证组AL大于气血不足证组(P<0。05)。气血不足证组中央区CT大于肝肾两虚证组(P<0。05),气血不足证内环CT、外环CT均大于肝肾两虚证组、心阳不足证组(P<0。05)。气血不足证组平均Choriocapillaris's layer厚度、平均Sattler's layer厚度、平均Haller's layer厚度均大于心阳不足证组、肝肾两虚证组(P<0。05)。采用非参数秩和检验比较,3组FT分级比较,肝肾两虚证组FT分级多为2级、3级,气血不足证组多为1级,心阳不足证组多为2级、3级,差异有统计学意义(P<0。05)。采用配对样本Wilcoxon秩和检验比较,3组组内后极部FTD和黄斑区FTD比较,差异均有统计学意义(P<0。05)。结论:中青年HM患者中医证型分布以气血不足证为主,气血不足证中青年HM患者眼底萎缩程度最轻,肝肾两虚证患者眼底萎缩程度较重。
Study on Correlation Between Chinese Medicine Syndrome Types and Tessellated Fundus and Macular Choroid in Young and Middle-Aged Patients with High Myopia
Objective:To observe the differences in the correlation between tessellated fundus(FT)and fundus tessellated density(FTD),and macular choroidal thickness(CT)in young and middle-aged patients with high myopia(HM)of different Chinese medicine syndrome types.Methods:A total of 109 HM patients treated at the Ophthalmology Department of Guangdong Provincial Hospital of Intergrated Traditonal Chinese and Western Medicine from February 2023 to December 2023 were selected for Chinese medicine syndrome differentiation.They were divided into three groups:liver and kidney deficiency(33 cases),qi and blood deficiency(44 cases),and heart yang insufficiency(32 cases).The differences in axial length(AL),spherical equivalent(SE),FT,FTD,and macular CT among HM patients with different syndromes were analyzed and compared.Results:A total of 109 HM patients(109 eyes)were included,with 54 males and 55 females.The heart yang insufficiency group had 32 cases(32 eyes,29.4%),the qi and blood deficiency group had 44 cases(44 eyes,40.4%),and the liver and kidney deficiency group had 33 cases(33 eyes,30.3%).There was no significant difference in general data among the three groups(P>0.05),indicating comparability.The absolute value of SE in the qi and blood deficiency group was smaller than those in the heart yang insufficiency and the liver and kidney deficiency groups(P<0.05).The AL in the liver and kidney deficiency group was greater than those in the heart yang insufficiency and the qi and blood deficiency groups(P<0.05),and the AL in the heart yang insufficiency group was greater than that in the qi and blood deficiency group(P<0.05).The central CT in the qi and blood deficiency group was greater than that in the liver and kidney deficiency group(P<0.05).The inner ring CT and outer ring CT in the qi and blood deficiency group were greater than those in the liver and kidney deficiency and the heart yang insufficiency groups(P<0.05).The average thickness of the Choriocapillaris's layer,Sattler's layer,and Haller's layer in the qi and blood deficiency group were greater than those in the heart yang insufficiency and the liver and kidney deficiency groups(P<0.05).Using the non-parametric rank-sum test for comparison,the FT grading among the three groups showed that the liver and kidney deficiency group mostly had grade two and three FT,the qi and blood deficiency group mostly had grade one FT,and the heart yang insufficiency group mostly had grade two and three FT,with a significant difference(P<0.05).Using the paired sample Wilcoxon rank-sum test for comparison,there were significant differences in the FTD of the posterior pole and macular area within the three groups(P<0.05).Conclusion:Among young and middle-aged HM patients,the distribution of traditional Chinese medicine syndrome types is mainly qi and blood deficiency.Young and middle-aged HM patients with qi and blood deficiency have the least degree of fundus atrophy,while those with liver and kidney deficiency have a more severe degree of fundus atrophy.

High myopiaTraditional Chinese medicine syndrome typesTessellated fundusFundus tessellated densityMacular choroidal thickness

贾婕、金梅、严凯明、刘宇

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广州中医药大学,广东 广州 510006

广东省中西医结合医院,广东 佛山 528200

暨南大学,广东 广州 510632

高度近视 中医证型 豹纹状眼底 豹纹斑密度 黄斑区脉络膜厚度

2025

新中医
广州中医药大学 中华中医药学会

新中医

影响因子:0.595
ISSN:0256-7415
年,卷(期):2025.57(1)