| Objective: To provide objective indicators and clinical guidance for the prevention and treatment of pathological myopia.By collecting clinical information from pathological myopia patients and emmetropia or low-grade myopia volunteers,summarizing the Chinese medical physique and distribution characteristics of syndrome types and detecting the expression levels of the four hormones FT3,FT4,E2 and T in their serum.To explore the correlation between the myopia macular degeneration grade and hormone expression levels of pathological myopia patients and the TCM constitution,syndrome types of traditional Chinese medicine,as well as the differences from those with emmetropia and low-grade myopia.Methods: Recruited pathological myopia patients treated in the Eye Hospital Affiliated to Shandong University of Traditional Chinese Medicine in the past year and included in pathological myopia group,emmetropia and low-grade myopia volunteers were included in control group,after obtaining the consent of the patients and their family members and signing the informed letter,their gender,age,uncorrected vision,corrected vision,refractive power,intraocular pressure,anterior chamber depth,axial length,corneal curvature,laser scanning fundus photography,posterior segment OCT and other clinical information were collected,the degree of myopia macular degeneration was graded according to the results of various eye examinations and the myopia macular degeneration grading standard issued by the International Myopia Research Institute,filled in the physique questionnaire,invited TCM experts to differentiate its symptoms through looking,listening,asking and feeling the pulse,and the dialectical classification criteria of “being close to being far away” in “Chinese Medicine Industry Standard of the People’s Republic of China Criteria for diagnosis and efficacy of TCM ophthalmological diseases”(ZY/T001.5-94).Volunteers who met the requirements and were willing to accept blood sampling were drawn from peripheral venous blood under fasting conditions to detect the expression levels of the four hormones FT3,FT4,E2 and T in their serum.And then analyzed the differences in the levels of various hormones in patients with pathological myopia and those with normal and low-grade myopia,as well as the correlation between the syndrome types of patients with pathological myopia and the levels of various hormones in the body.Results: 1.The distribution regularity of TCM constitution and syndrome types in pathological myopia patients Among the 125 cases of pathological myopia group,55 were males and 70 were females;among the 145 control groups,66 were males and 79 were females.There were significant differences in the distribution of TCM constitution and syndrome types between the two groups(P<0.05).In the pathological myopia group,the most common TCM syndromes were spleen deficiency and weak qi(58.40%)and liver and kidney deficiency(28.80%).The control group was in a state of balance between Yin and Yang;the pathological myopia group was biased by Yang-deficiency(26.40%)and Qi-deficiency quality(12.80%),which were significantly higher than those in the control group(P<0.05),and the proportion of the moderate population in the pathological myopia group was significantly lower than that in the control group(P<0.05).In the pathological myopia group,spleen deficiency and weak qi(73.33%)were the most common syndrome in 18-40 years old patients,and spleen deficiency and weak qi(50.00%)and liver and kidney deficiency(31.25%)were the most common syndrome in 41-85 years old patients.In male pathological myopia patients,Yangdeficiency(18.18%)and Qi-deficiency(12.73%)were more common,female pathological myopia patients were mostly with Yang-deficiency(32.86%),and their proportions were significantly higher than that in the control group(P<0.05).In the pathological myopia group,the biased constitution of 18-40 years old patients is common with Qi-deficiency(24.44%),and the biased constitution of 41-85 years old patients is common with Yangdeficiency(36.25%).2.The pathological myopia group myopia macular degeneration and the correlation of TCM constitution and syndrome type The grading status of myopic macular degeneration in the pathological myopia group was as follows: C2 grade 84 eyes,C3 grade 9 eyes,C4 grade 32 eyes,of which C2 grade(67.20%)was the most common.The myopia macular degeneration in the control group was graded as C0.In the pathological myopia group,patients with grade C2 of myopic macular degeneration had the most syndrome of spleen deficiency and weak qi(66.67%),and patients with grade C4 of myopia macular degeneration had the most syndrome of liver and kidney deficiency(56.25%).The myopia of myopia in pathological myopia patients with of calm quality,Yang-deficiency quality,and Qi-deficiency quality is C2 the most.3.Complicated diseases in patients with pathological myopia Among the many eye diseases associated with pathological myopia,retinal detachment was the most common,up to 69.66%,followed by 59.55% of patients with varying degrees of cataract,and another 17.98% of patients with glaucoma,which were the three most common concomitant eye diseases of pathological myopia.4.Correlation study of hormone levels and syndrome types in patients with pathological myopia The abnormal expression of FT3,FT4,and T three hormones in male patients with pathological myopia is significantly correlated with the types of TCM syndromes.Among male patients with pathological myopia,patients with liver blood insufficiency syndrome have the highest proportion of people with abnormal levels of three hormones,patients with liver and kidney deficiency syndrome have the highest proportion of people with abnormal levels of one hormone,and patients with spleen deficiency and weak qi syndrome have the highest proportion of two hormones.The proportion of the population is the highest.The FT3 level of the pathological myopia group was significantly higher than that of the control group,and there was significant statistical difference between the two groups(P<0.05);after splitting by gender,the FT3 level of population in the pathological myopia group was significantly higher than that of the control group,the difference was statistically significant;the serum FT3 level of the MMD4 population in the pathological myopia group was significantly higher than that of the MMD2 population(P<0.05);The serum FT3 level of the Qi deficiency population was significantly lower than that of the other physique population(P<0.05).The level of serum FT4 in the control group was positively correlated with the length of the eye axis.The T expression level of the pathological myopia group was significantly higher than that of the control group,and there was a significant statistical difference between the two groups(P<0.05).In the pathological myopia group,the serum T level of women aged 18-40 was significantly higher than that of people over 41 years old,and there was a significant statistical difference between the two age groups(P<0.05).Conclusion:(1)There was significant differences in TCM constitution and syndrome distribution between the pathological myopia group and the control group.The proportion of calm quality people in the pathological myopia group was significantly lower than that in the control group,indicated that there was a certain correlation between the biased constitution and the incidence of pathological myopia.Yang-deficiency constitution is the biased physique type most related to pathological myopia,and its proportion is significantly higher in the population of emmetropia and low-grade myopia;Qi-deficiency is the most common in young and middle-aged patients with pathological myopia,and Yang-deficiency is the most common in elderly patients with pathological myopia,suggested that we need to focus on the prevention and treatment of pathological myopia for these two types of people in the future.(2)In the pathological myopia group,the types of TCM syndromes were more common in spleen deficiency and weak qi,liver and kidney deficiency,as the patient ages and the grade of myopia macular degeneration increase,the proportion of spleen deficiency and weak qi decreases,the degree of liver and kidney deficiency increases,suggested that for young pathological myopia patient and patients with lower grades of myopia macular degeneration,clinical diagnosis and treatment should focus on strengthening the spleen and replenishing Qi;for elderly patients and patients with higher grades of myopia macular degeneration,clinical diagnosis and treatment should mainly nourish the liver and kidneys.(3)This study also found that the serum FT3 level of the pathological myopia group was significantly higher than that of the control group,and the serum T expression level of the pathological myopia group was significantly higher than that of the control group,suggested that the higher levels of FT3 and T in our serum may have a certain correlation with the pathological myopia,which may increase the risk of pathological myopia.(4)The abnormal expression of FT3,FT4,and T three hormones in male pathological myopia patients are significantly correlated with the types of TCM syndromes. |
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