Enwemeka Chukuka S, Parker Jason C, Dowdy David S, Harkness Erin E, Sanford Leif E, Woodruff Lynda D
School of Health Professions, Behavioral and Life Sciences, New York Institute of Technology, Old Westbury, NY 11568-8000, USA.
Photomed Laser Surg. 2004 Aug;22(4):323-9. doi: 10.1089/pho.2004.22.323.
We used statistical meta-analysis to determine the overall treatment effects of laser phototherapy on tissue repair and pain relief.
Low-power laser devices were first used as a form of therapy more than 30 years ago. However, their efficacy in reducing pain or promoting tissue repair remains questionable.
Following a literature search, studies meeting our inclusion criteria were identified and coded. Then, the effect size of laser treatment, that is, Cohen's d, was calculated from each study using standard meta-analysis procedures.
Thirty-four peer-reviewed papers on tissue repair met our inclusion criteria and were used to calculate 46 treatment effect sizes. Nine peer-reviewed papers on pain control met the inclusion criteria and were used to calculate nine effect sizes. Meta-analysis revealed a positive effect of laser phototherapy on tissue repair (d = +1.81; n = 46) and pain control (d = +1.11; n = 9). The positive effect of treatment on specific indices of tissue repair was evident in the treatment effect sizes determined as follows: collagen formation (d = +2.78), rate of healing (d = +1.57), tensile strength (d = +2.13), time needed for wound closure (d = +0.76), tensile stress (d = +2.65), number and rate of degranulation of mast cells (d = +1.87), and flap survival (d = +1.95). Further, analysis revealed the positive effects of various wavelengths of laser light on tissue repair, with 632.8 nm having the highest treatment effect (d = +2.44) and 780 nm the least (d = 0.60). The overall treatment effect for pain control was positive as well (d = +1.11). The fail-safe number-that is, the number of studies in which laser phototherapy has negative or no effect-needed to nullify the overall outcome of this analysis was 370 for tissue repair and 41 for pain control.
These findings mandate the conclusion that laser phototherapy is a highly effective therapeutic armamentarium for tissue repair and pain relief.
我们采用统计元分析来确定激光光疗对组织修复和疼痛缓解的总体治疗效果。
低功率激光设备在30多年前首次被用作一种治疗形式。然而，其在减轻疼痛或促进组织修复方面的疗效仍存在疑问。
在进行文献检索后，识别并编码符合我们纳入标准的研究。然后，使用标准元分析程序从每项研究中计算激光治疗的效应大小，即科恩d值。
34篇关于组织修复的同行评审论文符合我们的纳入标准，并用于计算46个治疗效应大小。9篇关于疼痛控制的同行评审论文符合纳入标准，并用于计算9个效应大小。元分析显示激光光疗对组织修复（d = +1.81；n = 46）和疼痛控制（d = +1.11；n = 9）有积极作用。治疗对组织修复特定指标的积极作用在以下确定的治疗效应大小中很明显：胶原蛋白形成（d = +2.78）、愈合率（d = +1.57）、拉伸强度（d = +2.13）、伤口闭合所需时间（d = +0.76）、拉伸应力（d = +2.65）、肥大细胞脱颗粒数量和速率（d = +1.87）以及皮瓣存活率（d = +1.95）。此外，分析揭示了不同波长的激光光对组织修复的积极作用，其中632.8 nm的治疗效果最高（d = +2.44），780 nm的治疗效果最低（d = 0.60）。疼痛控制的总体治疗效果也是积极的（d = +1.11）。为使该分析的总体结果无效所需的失效安全数，即激光光疗具有负面或无效果的研究数量，对于组织修复为370项，对于疼痛控制为41项。
这些发现得出结论，激光光疗是用于组织修复和疼痛缓解的一种高效治疗手段。
