低强度激光疗法治疗颈部疼痛：系统评价与Meta回归分析
Low Level Laser Therapy (LLLT) for Neck Pain: A Systematic Review and Meta-Regression.
作者信息
Gross Anita R, Dziengo Stephanie, Boers Olga, Goldsmith Charlie H, Graham Nadine, Lilge Lothar, Burnie Stephen, White Roger
机构信息
McMaster University, Hamilton, Canada.
出版信息
Open Orthop J. 2013 Sep 20;7:396-419. doi: 10.2174/1874325001307010396. eCollection 2013.
PURPOSE
This systematic review update evaluated low level laser therapy (LLLT) for adults with neck pain.
METHODS
Computerized searches (root up to Feb 2012) included pain, function/disability, quality of life (QoL) and global perceived effect (GPE). GRADE, effect-sizes, heterogeneity and meta-regression were assessed.
RESULTS
Of 17 trials, 10 demonstrated high risk of bias. For chronic neck pain, there was moderate quality evidence (2 trials, 109 participants) supporting LLLT over placebo to improve pain/disability/QoL/GPE up to intermediate-term (IT). For acute radiculopathy, cervical osteoarthritis or acute neck pain, low quality evidence suggested LLLT improves ST pain/function/QoL over a placebo. For chronic myofascial neck pain (5 trials, 188 participants), evidence was conflicting; a meta-regression of heterogeneous trials suggests super-pulsed LLLT increases the chance of a successful pain outcome.
CONCLUSIONS
We found diverse evidence using LLLT for neck pain. LLLT may be beneficial for chronic neck pain/function/QoL. Larger long-term dosage trials are needed.
目的
本系统评价更新评估了低强度激光疗法（LLLT）对成人颈部疼痛的疗效。
方法
计算机检索（截至2012年2月）纳入疼痛、功能/残疾、生活质量（QoL）和总体感知效应（GPE）等指标。评估了GRADE、效应量、异质性和Meta回归。
结果
17项试验中，10项显示存在高偏倚风险。对于慢性颈部疼痛，有中等质量证据（2项试验，109名参与者）支持LLLT优于安慰剂，可在中期（IT）改善疼痛/残疾/QoL/GPE。对于急性神经根病、颈椎骨关节炎或急性颈部疼痛，低质量证据表明LLLT比安慰剂更能改善疼痛/功能/QoL。对于慢性肌筋膜性颈部疼痛（5项试验，188名参与者），证据相互矛盾；对异质性试验的Meta回归表明，超脉冲LLLT增加了疼痛治疗成功的机会。
结论
我们发现使用LLLT治疗颈部疼痛的证据不一。LLLT可能对慢性颈部疼痛/功能/QoL有益。需要进行更大规模的长期剂量试验。
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