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[循证医学与肌肉骨骼系统的治疗性超声]

[Evidence-based medicine and therapeutic ultrasound of the musculoskeletal system].

作者信息

Ebenbichler G

机构信息

Universitätsklinik für Physikalische Medizin & Rehabilitation, MUW, AKH Wien, Währinger Gürtel 18-20, 1090, Wien, Osterreich.

出版信息

Z Rheumatol. 2009 Sep;68(7):543-8. doi: 10.1007/s00393-009-0457-z.

Abstract

The aim of this review is to critically analyze the evidence of therapeutic ultrasound between 0.8 and 3 MHz for treating musculoskeletal diseases. Relevant randomized, controlled, clinical trials and systematic reviews published on this topic have been taken into consideration.There was evidence of effectiveness for the following indications: inflammatory and degenerative diseases of joints and the vertebral column, overuse syndromes of tendons and muscles and the facilitation of bone tissue healing.According to the current knowledge an evidence-based recommendation could be most clearly made for the facilitation of bone fracture healing with ultrasound. For all other indications evidence was based on overly sparse data from low quality randomized controlled trials that would not allow clear recommendations. However, there is also a lack of data from methodologically sound clinical trials that could have proven the inefficacy of this treatment. As beneficial effects with ultrasound are frequently observed in everyday clinical practice, this therapeutic modality should continue to be considered in the future as a treatment option for musculoskeletal diseases.

摘要

本综述的目的是批判性地分析0.8至3兆赫兹治疗超声用于治疗肌肉骨骼疾病的证据。已考虑关于该主题发表的相关随机对照临床试验和系统评价。有证据表明以下适应症有效:关节和脊柱的炎性和退行性疾病、肌腱和肌肉的过度使用综合征以及促进骨组织愈合。根据目前的知识,对于超声促进骨折愈合可以最明确地提出基于证据的建议。对于所有其他适应症,证据基于来自低质量随机对照试验的过于稀少的数据,这些数据不允许做出明确的建议。然而,也缺乏来自方法合理的临床试验的数据,这些试验本可以证明这种治疗方法无效。由于在日常临床实践中经常观察到超声的有益效果,这种治疗方式在未来应继续被视为肌肉骨骼疾病的一种治疗选择。

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