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1.中国中医科学院眼科医院中医护理门诊,北京 100040
2.中国中医科学院眼科医院护理部,北京 100040
3.中国中医科学院眼科医院放射科,北京 100040
4.中国中医科学院眼科医院眼科门诊,北京 100040
5.中国中医科学院眼科医院视光中心,北京 100040
6.中国中医科学院眼科医院眼底病外科,北京 100040
7.中国中医科学院眼科医院眼底病内科,北京 100040
Received:21 December 2024,
Published:25 October 2025
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张琼,张翘楚,黄少兰,等.基于静息态功能磁共振成像观察梅花针治疗青少年近视的效果及功能连接研究[J].北京中医药,2025,44(10):1265-1270.
ZHANG Qiong,ZHANG Qiaochu,HUANG Shaolan,et al.Effects of plum-blossom needling on myopia in children and adolescents and its functional connectivity based on resting-state fMRI[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(10):1265-1270.
张琼,张翘楚,黄少兰,等.基于静息态功能磁共振成像观察梅花针治疗青少年近视的效果及功能连接研究[J].北京中医药,2025,44(10):1265-1270. DOI: 10.16025/j.1674-1307.2025.10.008.
ZHANG Qiong,ZHANG Qiaochu,HUANG Shaolan,et al.Effects of plum-blossom needling on myopia in children and adolescents and its functional connectivity based on resting-state fMRI[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(10):1265-1270. DOI: 10.16025/j.1674-1307.2025.10.008.
目的
2
基于静息态功能磁共振(rs-fMRI)技术,观察梅花针治疗青少年近视的效果,采用功能连接(FC)分析方法,探究其大脑视觉皮层的神经机制。
方法
2
收集2023年2月―2024年4月在中国中医科学院眼科医院视光中心、眼科门诊就诊的6~12岁青少年低中度近视患者80例(160眼),采用随机对照、单盲的方法,采取随机数字表法将患儿分为观察1组、观察2组各40例。观察1组予梅花针叩刺大椎、百会,双侧攒竹、鱼腰、太阳、目窗、风池、合谷、内关;观察2组予梅花针叩刺双侧攒竹、鱼腰、丝竹空、太阳、四白、正光1、正光2、阳白穴;梅花针治疗每周2次,每次10 min,总疗程12周。比较2组治疗前后裸眼远视力(UCDVA)、屈光度、角膜曲率、眼轴长度(AL)变化;对梅花针叩刺观察1组中同意做核磁共振的患儿于治疗前、治疗1个月后行头颅rs-fMRI。
结果
2
治疗后,观察1组UCDVA优于观察2组,差异有统计学意义(
P
<
0.05),2组屈光度、平均角膜曲率K比较差异无统计学意义(
P
>
0.05),2组平均AL较治疗前增长(
P
<
0.01),观察1组总有效率高于观察2组(
P
<
0.05)。观察1组功能连接增强的脑区:左侧V1与左侧舌回、左侧距状裂周围皮层,右侧V2与额上回,左侧V3与右枕上回和右楔叶,右侧V3与左侧枕上回和左侧枕中回(
P
<
0.01,FEW校正);功能连接降低的脑区:右侧V1与左侧颞中回、左侧角回和左侧枕中回(
P
<
0.01,FEW校正);左侧V2功能连接与视力呈正相关的脑区:左侧顶上回、右侧中央旁小叶、左侧中央旁小叶、左侧楔前叶、左侧枕上回、左侧楔叶。
结论
2
梅花针能提高近视患儿视力,治疗青少年近视有效,且优效穴位组优于眼周穴位组。其作用机制可能为梅花针叩刺优效穴位能调节以枕叶为主要视觉皮层及邻近脑区的功能连接,且左侧V2脑区FC与视力呈正相关。
Objective
2
Based on resting-state functional magnetic resonance imaging (rs-fMRI), this study observed the effects of plum-blossom needling on myopia in children and adolescents and explored the neural mechanism in the visual cortex using functional connectivity (FC) analysis.
Methods
2
A total of 80 children aged 6–12 years with low-to-moderate myopia (160 eyes) who visited the Optometry Center and Ophthalmology Department of Eye Hospital of China Academy of Chinese Medical Sciences between February 2023 and April 2024 were enrolled. Using a randomized controlled, single-blind design, participants were randomly assigned to Group 1 (
n
=40) or Group 2 (
n
=40) by random number table. Group 1 received plum-blossom needle tapping at Dazhui (GV 14), Baihui (GV 20), bilateral Cuanzhu (BL 2), Yuyao (EX-HN 4), Taiyang (EX-HN 5), Muchuang (GB 16), Fengchi (GB 20), Hegu (LI 4), and Neiguan (PC 6). Group 2 received tapping
at bilateral Cuanzhu (BL 2), Yuyao (EX-HN 4), Sizhukong (TE 23), Taiyang (EX-HN 5), Sibai (ST 2), Zhengguang 1, Zhengguang 2, and Yangbai (GB 14). Treatments were administered twice weekly for 10 min each session over a total course of 12 weeks. Changes in uncorrected visual acuity (UCVA), diopter, corneal curvature, and axial length (AL) were compared between the two groups before and after treatment. Children in Group 1 who consented underwent cranial rs-fMRI scans before treatment and 1 month after treatment.
Results
2
After treatment, UCVA in Group 1 was superior to Group 2 (
P
<
0.05). There were no significant differences in diopter or mean corneal curvature between the two groups (
P
>
0.05). AL increased in both groups compared with baseline (
P
<
0.01), and the overall effective rate was higher in Group 1 than in Group 2 (
P
<
0.05). In Group 1, brain regions with enhanced FC included left V1 with left lingual gyrus and left calcarine fissure surrounding cortex, right V2 with superior frontal gyrus, left V3 with right superior occipital gyrus and right cuneus, right V3 with left superior occipital gyrus and left middle occipital gyrus (
P
<
0.01, FWE corrected). Brain regions with decreased FC included right V1 with left middle temporal gyrus, left angular gyrus, and left middle occipital gyrus (
P
<
0.01, FWE corrected). Positive correlations between left V2 FC and visual acuity were observed in the left superior parietal gyrus, right paracentral lobule, left paracentral lobule, left precuneus, left superior occipital gyrus, and left cuneus.
Conclusion
2
Plum-blossom needle therapy can improve uncorrected visual acuity and is effective in treating myopia in children and adolescents. Its mechanism may involve modulation of FC in the occipital visual cortex and adjacent brain regions, with left V2 FC showing a positive correlation with visual acuity.
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