Woodruff Lynda D, Bounkeo Julie M, Brannon Windy M, Dawes Kenneth S, Barham Cameron D, Waddell Donna L, Enwemeka Chukuka S
Department of Physical Therapy, North Georgia College and State University, Dahlonega, Georgia, USA.
Photomed Laser Surg. 2004 Jun;22(3):241-7. doi: 10.1089/1549541041438623.
We determined the overall effects of laser therapy on tissue healing by aggregating the literature and subjecting studies meeting the inclusion and exclusion criteria to statistical meta-analysis.
Low-level laser therapy (LLLT) devices have been in use since the mid sixties, but their therapeutic value remains doubtful, as the literature seems replete with conflicting findings.
Pertinent original research papers were gathered from library sources, online databases and secondary sources. The papers were screened and coded; those meeting every inclusion and exclusion criterion were subjected to meta-analysis, using Cohen's d. statistic to determine the treatment effect size of each study.
Twenty-four studies with 31 effect sizes met the stringent inclusion and exclusion criteria. The overall mean effect of laser therapy on wound healing was highly significant (d = +2.22). Sub-analyses of the data revealed significant positive effects on wound healing in animal experiments (d = +1.97) as well as human clinical studies (d = +0.54). The analysis further revealed significant positive effects on specific indices of healing, for example, acceleration of inflammation (d = +4.45); augmentation of collagen synthesis (d = +1.80); increased tensile strength (d = +2.37), reduced healing time (d = +3.24); and diminution of wound size (d = +0.55). The Fail-Safe number associated with the overall effect of laser therapy was 509; a high number representing the number of additional studies-in which laser therapy has negative or no effect on wound healing-required to negate the overall large effect size of +2.22. The corresponding Fail-Safe number for clinical studies was 22.
We conclude that laser therapy is an effective tool for promoting wound repair.
我们通过汇总文献并对符合纳入和排除标准的研究进行统计荟萃分析,确定激光疗法对组织愈合的总体影响。
低强度激光疗法(LLLT)设备自60年代中期以来一直在使用,但其治疗价值仍存疑问,因为文献中似乎充斥着相互矛盾的研究结果。
从图书馆资源、在线数据库和二手资料中收集相关的原始研究论文。对论文进行筛选和编码;对符合每项纳入和排除标准的论文进行荟萃分析,使用科恩d统计量来确定每项研究的治疗效果大小。
24项研究的31个效应量符合严格的纳入和排除标准。激光疗法对伤口愈合的总体平均效应非常显著(d = +2.22)。对数据的亚组分析显示,在动物实验(d = +1.97)以及人体临床研究(d = +0.54)中,激光疗法对伤口愈合有显著的积极影响。分析还显示,激光疗法对愈合的特定指标有显著的积极影响,例如,炎症加速(d = +4.45);胶原蛋白合成增加(d = +1.80);拉伸强度增加(d = +2.37);愈合时间缩短(d = +3.24);伤口大小减小(d = +0.55)。与激光疗法总体效应相关的失效安全数为509;这个高数字代表了需要有多少额外的研究(其中激光疗法对伤口愈合有负面或无影响)才能抵消+2.22这个总体大效应量。临床研究的相应失效安全数为22。
我们得出结论,激光疗法是促进伤口修复的有效工具。