首页|中药明视方干预儿童低度近视心阳不足证的多中心、随机双盲安慰剂对照临床研究

中药明视方干预儿童低度近视心阳不足证的多中心、随机双盲安慰剂对照临床研究

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目的 观察中药明视方颗粒控制儿童心阳不足证低度近视的有效性和安全性.方法 采用多中心、随机、双盲安慰剂对照的研究方法,将就诊于8家分中心的290例心阳不足证低度近视患儿随机分为治疗组和对照组各145例,治疗组给予宣教+配镜+中药明视方颗粒,对照组给予宣教+配镜+明视方安慰剂颗粒.明视方及安慰剂颗粒均口服,每次1袋(3g),每日2次,口服4周休息2周为1个疗程,共治疗4个疗程(共24周).分别在治疗前、治疗第12周、治疗第24周、36周随访时、48周随访时观察等效球镜、最佳裸眼远视力、眼轴、角膜曲率K1、调节幅度、中医证候评分、等效球镜进展量,并于治疗第24周判定近视进展控制率,治疗前后分别进行安全性指标检测.结果 48周随访时治疗组等效球镜进展量低于对照组(P<0.05).治疗组近视进展控制率(57.60%,72/125)高于对照组(44.63%,54/121)(P<0.05).治疗组36周随访时最佳裸眼远视力高于对照组(P<0.05);两组各观察时点等效球镜与治疗前比较均明显降低(P<0.05),48周随访时治疗组高于对照组(P<0.05);两组眼轴治疗及随访各观察时点与治疗前比较均明显升高(P<0.05),治疗组眼轴增长量在治疗第24周及48周随访时均低于对照组(P<0.05);治疗组角膜曲率K1治疗第24周较治疗前明显降低(P<0.05);治疗组调节幅度在36周及48周随访时均较治疗前明显提高(P<0.05).两组患儿在治疗第12周、第24周及36周、48周随访时面色淡白/晦滞、苔白脉细、神疲乏力评分及中医证候总积分均较治疗前明显降低(P<0.05);治疗第24周及36周随访时视物模糊评分均较治疗前明显降低(P<0.05);48周随访时治疗组视物模糊评分较治疗前明显降低(P<0.05).治疗组36周随访时神疲乏力评分高于对照组,48周随访时视物模糊评分低于对照组(P<0.05).两组治疗过程均未发现不良反应,治疗前后安全性指标未见明显异常.结论 中药明视方具有控制低度近视度数进展、提高最佳裸眼远视力、减缓眼轴增长、改善部分中医症状等作用,且具有较好安全性.
Mingshi Formula(明视方)for Low Myopia in Children with Heart Yang Insufficiency Syndrome:A Multi-centre,Double-Blind,Randomised Placebo-Controlled Study
Objective To observe the effectiveness and safety of the Chinese herbal medicine Mingshi Granules(明视方颗粒)for low myopia in children with heart yang insufficiency.Methods A multicentre,prospective,double-blind randomised controlled study was conducted,in which 290 children with low myopia from 8 centres were ran-domly divided into 145 cases in the treatment group and 145 cases in the control group,and the treatment group was given education,dispensing glasses,and Chinese herbal medicine Mingshi Granules,while the control group was given education,dispensing glasses,and granules placebo.Both Mingshi Granules and placebo granules were taken orally,1 bag each time,twice daily,4 weeks of oral intake and 2 weeks of rest as 1 course of treatment,a total of 4 courses of treatment(24 weeks).Equivalent spherical lenses,best naked-eye distance visual acuity,ocular axis,corneal cur-vature K1,adjustment amplitude,traditional Chinese medicine(TCM)symptom scores,calculate the amount of pro-gression of equivalent spherical lenses,were observed at the 12th and the 24th week of treatment,at the 36th week and 48th week of follow-up,resectively,the control rate of myopia progression was evaluated at the 24th week,and safety indexes were observed before treatment.Results The amount of progression of equivalent spherical lenses was lower in the treatment group than in the control group at the 48-week follow-up(P<0.05).The control rate of myopia progression at 24 weeks after treatment in the treatment group was higher(57.60%,72/125)than that in the control group(44.63%,54/121)(P<0.05).The best naked-eye distance visual acuity at 36-week follow-up in the treatment group was higher than that in the control group(P<0.05).Equivalent spherical lenses were significantly lower in both groups at all observation time points compared with pre-treatment(P<0.05),and were higher in the treatment group than in the control group at the 48-week follow-up(P<0.05).The ocular axes of both groups were significantly higher at each observation time point after treatment and at follow-up compared with before treatment(P<0.05).The amount of eye axis growth in the treatment group was lower than that in the control group at 24 weeks after treatment and at the 48-week follow-up(P<0.05).Corneal curvature K1 was significantly lower in the treatment group at the 24th week of treatment compared to pre-treatment(P<0.05).The magnitude of adjustment in the treatment group was significantly higher at the 36-week follow-up and at the 48-week follow-up than before treat-ment(P<0.05).The scores of white/dark complexion,white coating thin pulse,fatigue and total TCM symptom scores of children in both groups at the 12th,24th,36th and 48th weeks of follow-up were significantly lower than those before treatment(P<0.05);the scores of blurred vision at the 24th and 36th weeks of follow-up were signifi-cantly lower than those before treatment(P<0.05);and the scores of blurred vision in the treatment group at the 48th week of follow-up were signi-ficantly lower than those before treatment(P<0.05).In the treatment group,the score of fatigue was higher than that of the control group at the 36-week follow-up,and the score of blurred vision was lower than that of the control group at the 48-week follow-up(P<0.05).No adverse reactions or obvious abnormali-ties of the safety indexes were observed of the two groups during the treatment.Conclusion Chinese herbal medicine Mingshi Granules showed the effect of controlling the progression of low myopia,improving the best naked eye dis-tance visual acuity,slowing down the growth of the eye axis,improving some of the TCM symptoms,with good safety.

low myopiachildrenMingshi Formula(明视方)imbalance of essence and sinewheart yang insuffi-ciency syndrome

王健全、侯昕玥、亢泽峰、杨迎新、刘新泉、沈志华、俞晓艺、姚靖、梁凤鸣、张风梅、喻京生、王宁利、宋曼、孙宏睿、晏鑫

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中国中医科学院眼科医院,北京市石景山区鲁谷路33号,100040

首都医科大学附属北京中医医院

上海中医药大学附属龙华医院

深圳市中医院

广州中医药大学第一附属医院

黑龙江中医药大学附属第一医院

天津中医药大学第一附属医院

河南省中医院

湖南中医药大学第一附属医院

首都医科大学附属北京同仁医院

福建中医药大学附属福州中医院

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低度近视 儿童 明视方 精筋失衡 心阳不足证

中国中医科学院中央级公益性科研院所基本科研业务费专项国家重点研发计划国家中医药管理局中医药传承与创新"百千万"人才工程(岐黄工程)岐黄学者项目福建省卫生健康委第三批柔性引进医疗卫生高层次人才团队项目

2022YFC3502500闽卫人函[2023]1480

2024

中医杂志
中华中医药学会 中国中医科学院

中医杂志

CSTPCD北大核心
影响因子:1.464
ISSN:1001-1668
年,卷(期):2024.65(6)
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