本文選題：針刺　切入點：近視　出處：《成都中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的：系統(tǒng)評價針刺治療近視的療效和安全性,為臨床提供循證醫(yī)學證據(jù),并為未來臨床研究方向提供新的思路。方法：參照制定的文獻納入標準和排除標準,計算機全面檢索VIP(1989-2016.1)、CBM(1980-2016.1)、CNKI(1980-2016.1)和萬方數(shù)據(jù)資源系統(tǒng)(1998-2016.1)、The Cochrane Library(2016, Issue 1)、PubMed(1980-2016.1)、 MEDLINE (1980-2016.1)。手工檢索成都中醫(yī)藥大學圖書館相關(guān)資料。用http://www.controlled-trials.com,http://www.clinicaltrials.gov進行補充檢索。將檢索到的文獻根據(jù)制定好的納入排除標準進行篩選,然后將篩選得到的文獻進行質(zhì)量評價和資料提取。采用臨床總有效率、裸眼視力、屈光度、晶狀體厚度、睫狀體厚度、眼軸長度評價針刺治療近視的療效,并對針刺治療近視進行安全性分析。統(tǒng)計學分析采用Cochrane協(xié)作網(wǎng)提供的Revman5.2軟件對所有結(jié)果進行數(shù)據(jù)分析。證據(jù)等級評定采用GRADE profiler 3.6軟件和標準評估證據(jù)質(zhì)量。結(jié)果：共檢索到相關(guān)文獻482篇,最終納入12篇中文文獻。提取數(shù)據(jù)進行Meta分析,結(jié)果如下：①總有效率：針刺或針刺結(jié)合其他療法優(yōu)于西藥或熱水蒸汽熏眼(OR=3.57,95%CI[2.80,4.53],P0.00001),敏感性分析與總體一致；單純針刺優(yōu)于滴眼液(OR=2.96,95%CI[2.10,3.89],P0.00001)；針刺為主結(jié)合其他療法優(yōu)于西藥或熱水蒸汽熏眼(OR=4.99,95%CI[3.39,7.36],P0.00001)。②裸眼視力：針刺或針刺結(jié)合西藥優(yōu)于西藥或佩戴眼鏡(MD=0.14,95%CI[0.08,0.21],P0.0001)；根據(jù)年齡差異進行亞組分析,針刺或針刺結(jié)合西藥優(yōu)于西藥(MD=0.11,95%CI[0.08,0.13],P0.00001)。③屈光度：梅花針與西藥或佩戴眼鏡比較沒有明顯的差異(MD=0.01'95%CI[-0.08,0.10],P=0.82)。④晶狀體厚度：梅花針與西藥或配戴眼鏡比較沒有明顯差異(MD=-0.04,95%CI[1-0.11,0.02],P=0.20)；⑤睫狀體厚度：梅花針與西藥或配戴眼鏡比較沒有明顯差異(MD=-0.01,95%CI[-0.05,0.03],P=0.64)。⑥眼軸長度：梅花針優(yōu)于西藥或配戴眼鏡(MD=-0.09,95%CI[-0.14,-0.03],P=0.004)。⑦安全性：無不良反應報道。結(jié)論：在總有效率、裸眼視力改善、眼軸長度改善方面,針刺療法治療近視優(yōu)于其他療法(西藥、熱水蒸汽熏眼、配戴眼鏡)；在屈光度、晶狀體長度、睫狀體長度改善方面,針刺療法與其他療法(西藥、配戴眼鏡)比較沒有統(tǒng)計學差異。由于本研究納入文獻質(zhì)量較低,尚需要更多研究證據(jù)證實。且沒有足夠證據(jù)證實針刺治療近視的遠期療效。在安全性方面,初步認為針刺治療近視有良好的安全性,但需要更多研究證據(jù)證實。
[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.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.82

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