Law Dina, McDonough Suzanne, Bleakley Chris, Baxter George David, Tumilty Steve
Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
Centre for Health, Activity and Rehabilitation Technologies, University of Ulster, Londonderry, UK.
J Acupunct Meridian Stud. 2015 Feb;8(1):2-16. doi: 10.1016/j.jams.2014.06.015. Epub 2014 Jul 10.
Laser acupuncture has been studied extensively over several decades to establish evidence-based clinical practice. This systematic review aims to evaluate the effects of laser acupuncture on pain and functional outcomes when it is used to treat musculoskeletal disorders and to update existing evidence with data from recent randomized controlled trials (RCTs). A computer-based literature search of the databases MEDLINE, AMED, EMBASE, CINAHL, SPORTSDiscus, Cochrane Library, PubMed, Current Contents Connect, Web of Science, and SCOPUS was used to identify RCTs comparing between laser acupuncture and control interventions. A meta-analysis was performed by calculating the standardized mean differences and 95% confidence intervals, to evaluate the effect of laser acupuncture on pain and functional outcomes. Included studies were assessed in terms of their methodological quality and appropriateness of laser parameters. Forty-nine RCTs met the inclusion criteria. Two-thirds (31/49) of these studies reported positive effects, were of high methodological quality, and reported the dosage adequately. Negative or inconclusive studies commonly failed to demonstrate these features. For all diagnostic subgroups, positive effects for both pain and functional outcomes were more consistently seen at long-term follow-up rather than immediately after treatment. Moderate-quality evidence supports the effectiveness of laser acupuncture in managing musculoskeletal pain when applied in an appropriate treatment dosage; however, the positive effects are seen only at long-term follow-up and not immediately after the cessation of treatment.
几十年来,人们对激光针灸进行了广泛研究,以建立循证临床实践。本系统评价旨在评估激光针灸用于治疗肌肉骨骼疾病时对疼痛和功能结局的影响,并利用近期随机对照试验(RCT)的数据更新现有证据。通过对MEDLINE、AMED、EMBASE、CINAHL、SPORTSDiscus、Cochrane图书馆、PubMed、Current Contents Connect、Web of Science和SCOPUS等数据库进行基于计算机的文献检索,以识别比较激光针灸与对照干预措施的RCT。通过计算标准化平均差和95%置信区间进行荟萃分析,以评估激光针灸对疼痛和功能结局的影响。纳入的研究根据其方法学质量和激光参数的适宜性进行评估。49项RCT符合纳入标准。其中三分之二(31/49)的研究报告了积极效果,方法学质量高,且对剂量进行了充分报告。阴性或不确定的研究通常未能证明这些特征。对于所有诊断亚组,在长期随访而非治疗后立即观察到疼痛和功能结局的积极效果更为一致。中等质量的证据支持在适当治疗剂量下应用激光针灸治疗肌肉骨骼疼痛的有效性;然而,积极效果仅在长期随访中出现,而非治疗停止后立即出现。