0.01%阿托品联合中药离子导入控制儿童中低度近视进展的临床观察

目的比较单独使用阿托品与阿托品联合中药离子导入控制儿童中低度近视进展的疗效。方法收集2017年4月～2018年6月在我院眼科就诊的6～12岁中低度近视儿童115例,随机分为3组,分别接受0.01%阿托品联合中药离子导入、0.05%阿托品、0.01%阿托品治疗12个月。观察治疗后等效球镜、眼轴、视力、瞳孔直径、调节近点的变化。结果治疗12个月后,0.01%阿托品联合中药离子导入组、0.05%阿托品组、单独使用0.01%阿托品组等效球镜分别为(-2.38±0.52)D、(-2.43±0.45)D、(-2.52±0.29)D,眼轴长度分别为(24.33±0.28)mm、(24.36±0.37)mm、(24.51±0.15)mm,三组等效球镜度数与眼轴长度比较,差异均有统计学意义(F=4.969,P=0.011;F=3.315,P=0.039)。0.05%阿托品组明室瞳孔直径(5.75±0.83)mm比0.01%阿托品联合中药离子导入组(5.20±0.61)mm、0.01%阿托品组(5.35±0.91)mm增加明显(P0.001)。调节近点0.05%阿托品组(10.11±0.42)cm比0.01%阿托品联合中药离子导入组(8.74±0.72)cm、0.01%阿托品组(8.55±0.83)cm增加明显(P0.001)。结论中药离子导入加强了0.01%阿托品控制近视进展作用,其作用效果相当于0.05%阿托品。同时,需要进一步观察等效球镜及眼轴的变化情况。

Clinical observation of 0.01% atropine combined with traditional Chinese medicine iontophoresis in the control of children''s middle and low myopia

Objective To compare the effect of atropine alone and atropine combined with traditional Chinese medicine iontophoresis on the development of middle and low myopia in children.Methods 115 middle and low myopia children aged 6 to 12 years treated in our hospital from April 2017 to June 2018 were selected.They were randomly divided into three groups.And the three groups were given 0.01% atropine combined with traditional Chinese medicine iontophoresis,0.05% atropine and 0.01% atropine for 12 months respectively.After treatment,the changes of equivalent spherical lens,ocular axis,visual acuity,pupil diameter and accommodation of near point were observed.Results After 12 months of treatment,the spherical equivalent in 0.01% atropine combined with traditional Chinese medicine iontophoresis group,0.05% atropine group and 0.01% atropine group were (-2.38±0.52) D,(-2.43±0.45) D,(-2.52±0.29) D respectively,and the length of the ocular axis was (24.33±0.28) mm,(24.36±0.37) mm,(24.51±0.15) mm respectively.The differences in the equivalent spherical lens and the length of the ocular axis between the three groups were statistically significant(F=4.969,P=0.011; F=3.315,P=0.039).The pupil diameter (5.75±0.83 mm) in the 0.05% atropine group was significantly higher than that in the 0.01% atropine combined with traditional Chinese medicine iontophoresis group(5.20±0.61 mm)and 0.01%atropine group(5.35±0.91 mm)(P<0.001).The accommodation of near point of 0.05% atropine group (10.11±0.42 cm) was significantly higher than that of 0.01% atropine combined with traditional Chinese medicine iontophoresis group (8.74±0.72 cm) and 0.01% atropine group (8.55±0.83 cm) (P<0.001).Conclusion Iontophoresis of traditional Chinese medicine strengthens the effect of 0.01% atropine on myopia progression,which is equivalent to 0.05% atropine.At the same time,it is necessary to further observe the changes of equivalent spherical lens and ocular axis.