摘要
目的 观察改良耳穴压豆联合局部按摩治疗儿童特发性异常瞬目症的临床疗效。方法 纳入2019年10月—2022年4月在上海市松江区中心医院眼科门诊确诊的4~12岁特发性异常瞬目症患儿90例,随机分成观察组(A组)、中医组(B组)和对照组(C组)各30例(60只眼)。分别予改良耳穴压豆、经典耳穴压豆和常规心理—行为疗法配合滴眼液治疗。3组均观察21 d。分别于治疗前、治疗后测量患儿瞬目频率、学习能力的数据。结果(1)瞬目频率评分:3组治疗前瞬目频率评分比较,差异无统计学意义(P>0.05)。治疗后A组与B组瞬目频率评分均较治疗前降低,差异均有统计学意义(t_(A组)=19.313、t_(B组)=15.000,均P=0.000),C组较治疗前,差异无统计学意义(P>0.05)。治疗后3组间比较,差异有统计学意义(F=1093.886,P=0.000)。与C组比较,A组和B组瞬目频率评分均较低,差异均有统计学意义(t_(A组)=-11.655,t_(B组)=-11.171,均P=0.000);A组和B组比较,差异无统计学意义(P>0.05)。(2)阅读速度比较:治疗后A组与B组阅读速度均较治疗前增加,差异均有统计学意义(t_(A组)=-60.647,t_(B组)=-61.465,均P=0.000),C组较治疗前,差异无统计学意义(P>0.05)。治疗后3组间阅读速度比较,差异有统计学意义(F=19.150,P=0.000)。与C组比较,A组与B组阅读速度均较快,差异均有统计学意义(t_(A组)=4.744、t_(B组)=4.033,均P=0.000);A组与B组比较,差异无统计学意义(P>0.05)。(3)听写速度比较:治疗后A组与B组听写速度均较治疗前增加,差异均有统计学意义(t_(A组)=-115.348、t_(B组)=-109.133,均P=0.000),C组较治疗前,差异无统计学意义(P>0.05)。治疗后3组间比较,差异有统计学意义(F=91.933,P=0.000)。与C组比较,A组与B组听写速度均较快,差异均有统计学意义(t_(A组)=9.751、t_(B组)=8.203,均P=0.000);A组与B组听写速度比较,差异无统计学意义(P>0.05)。(4)中医症候积分:3组治疗前中医症候积分比较,差异无统计学意义(P>0.05)。治疗后A组与B组中医症候积分均较治疗前降低,差异均有统计学意义(t_(A组)=-4.365、t_(B组)=-4.062,均P=0.000),C组较治疗前,差异无统计学意义(P>0.05)。治疗后3组间比较,差异有统计学意义(F=17.259,P=0.000)。与C组比较,A组和B组中医症候积分均较低,差异均有统计学意义(t_(A组)=-4.979、t_(B组)=-4.625,均P=0.000);A组和B组比较,差异无统计学意义(P>0.05)。(5)临床疗效:A组(96.67%)与B组(93.33%)总有效率均优于C组(66.67%),差异均有统计学意义(χ^(2) A组=9.017,P=0.003;χ^(2) B组=6.667,P=0.010),而A组与B组比较,差异无统计学意义(P>0.05)。(6)复发率:A组(10.34%)与B组(14.29%)复发率均低于C组(80.00%),差异均有统计学意义(χ^(2) A组=24.191、χ^(2) B组=20.728,均P=0.000);而A组与B组比较,差异无统计学意义(P>0.05)。结论 改良耳穴压豆联合局部按摩治疗儿童特发性异常瞬目症临床疗效较好,具有操作简单、疗效可靠、复发率低等优势,值得临床推广。
OBJECTIVE To observe the clinical efficacy of improved auricular acupressure combined with local massage in the treatment of children with idiopathic intermittent squint.METHODS A total of 90 children aged 4 to 12 diagnosed with idiopathic intermittent squint at Shanghai Songjiang District Central Hospital from October 2019 to April 2022,were randomly assigned to the observation group(Group A),Traditional Chinese Medicine(TCM)group(Group B),and control group(Group C),with 30 children(60 eyes)in each group.They received improved auricular acupressure,classical auricular acupressure,and the combination of conventional psycho-behavioral therapy with eye drops treatment,respectively.All groups were observed for 21 days.Squint frequency,reading speed and dictation speed were measured before and after treatment.RESULTS Before treatment,there were no significant differences in squint frequency scores,reading speed and dictation speed among the three groups(P>0.05).(1)Squint frequency scores:After treatment,both Group A and Group B showed a significant decrease in squint frequency scores compared to before treatment,with statistically significant differences(t_(A)=19.313,t_(B)=15.000,both P=0.000).Group C showed no significant difference after treatment compared to before treatment(P>0.05).Post-treatment comparisons among the three groups showed significant differences(F=1093.886,P=0.000).Compared to Group C,both Group A and Group B had lower squint frequency scores(t_(A)=-11.655,t_(B)=-11.171,both P=0.000),while there was no significant difference between Group A and Group B(P>0.05).(2)Reading speed:After treatment,both Group A and Group B showed a significant increase in reading speed compared to before(t_(A)=-60.647,t_(B)=-61.465,both P=0.000),while Group C showed no significant difference after treatment compared to before treatment(P>0.05).Post-treatment comparisons among the three groups showed significant differences(F=19.150,P=0.000).Compared to Group C,both Group A and Group B had increased reading speeds(t_(A)=4.744,t_(B)=4.033,both P=0.000),while there was no significant difference between Group A and Group B(P>0.05).(3)Dictation speed:After treatment,both Group A and Group B showed a significant increase in dictation speed compared to before treatment(t_(A)=-115.348,t_(B)=-109.133,both P=0.000),while Group C showed no significant difference after treatment compared to before treatment(P>0.05).Post-treatment comparisons among the three groups showed significant differences(F=91.933,P=0.000).Compared to Group C,both Group A and Group B had increased dictation speeds(t_(A)=9.751,t_(B)=8.203,both P=0.000),while there was no significant difference between Group A and Group B(P>0.05).(4)TCM efficacy:TCM Symptom Scores:After treatment,both Group A and Group B showed a significant decrease in TCM Symptom Scores compared to before treatment,with statistically significant differences(t_(A)=-4.365,t_(B)=-4.062,both P=0.000).Group C showed no significant difference after treatment compared to before treatment(P>0.05).Post-treatment comparisons among the three groups showed significant differences(F=17.259,P=0.000).Compared to Group C,both Group A and Group B had lower squint frequency scores(t_(A)=-4.979,t_(B)=-4.625,both P=0.000), while there was no significant difference between Group A and Group B (P>0.05). (5)Clinical efficacy: Group A (96.67%) and Group B (93.33%) both demonstrated significantly higher total effective rates compared to Group C (66.67%), with statistically significant differences observed (χ^(2) A=9.017, P=0.003;χ^(2) B=6.667, P=0.010). However, there was no statistically significant difference between Group A and Group B (P>0.05). (6)Recurrence rate: The recurrence rates in Group A (10.34%) and Group B (14.29%) were both lower than that in Group C (80.00%), and these differences were statistically significant (χ^(2) A=24.191, χ^(2) B=20.728, both P=0.000). However, there was no statistically significant difference between Group A and Group B (P>0.05). CONCLUSIONS Improved auricular acupressure combined with local massage shows good clinical efficacy in treating children with idiopathic intermittent squint. It has advantages such as simplicity, reliable efficacy, and a low recurrence rate, making it worthy of clinical promotion.
作者
郑新宝
张奇佳
陈春峰
魏嘉洪
陈佳玉
赵永旺
彭清华
ZHENG Xinbao;ZHANG Qi-jia;CHEN Chunfeng;WEI Jiahong;CHEN Jiayu;ZHAO Yongwang;PENG Qinghua(Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201600,China)
出处
《中国中医眼科杂志》
2024年第1期16-21,28,共7页
China Journal of Chinese Ophthalmology
基金
上海市松江区科技攻关项目(2023SJKJGG024)
上海市松江区公共卫生协同能力提升项目(SJGW6-24)
湖南省中医学国内一流建设学科建设项目
湖南省普通高校科技创新团队建设项目。
关键词
耳穴压豆
局部按摩
儿童
特发性异常瞬目症
auricular acupressure
local massage
children
idiopathic intermittent squint
作者简介
通讯作者:赵永旺,E-mail:zywang1@126.com。
