Department of Physical Therapy, Georgia State University, Atlanta, Georgia, USA.
Am J Sports Med. 2018 Jan;46(1):224-233. doi: 10.1177/0363546517697957. Epub 2017 Mar 29.
There is debate as to whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is beneficial after acute skeletal muscle injury. Some studies have suggested that NSAID use may be detrimental to injured muscle.
To determine whether NSAID use affects recovery from skeletal muscle injury as assessed by strength loss, soreness, and/or blood creatine kinase level.
Systematic review and meta-analysis.
An extensive systematic review was completed searching 16 databases (eg, PubMed, Cochrane Library, EMBASE). Inclusion criteria were (1) acute injury to skeletal muscle, (2) use of a control condition, (3) certainty of the NSAID dose administered, and (4) use of 1 or more of the 3 desired outcome measures. A total of 5343 study reports were screened, of which 41 studies were deemed suitable for inclusion. The standardized mean difference was used as the effect size (ES) and was calculated such that a positive ES indicated NSAID efficacy. Meta-analyses were run using a random-effects model.
For all studies, time points after injury, and injury markers combined, NSAID use was found to elicit a small to medium, significant decrease in the markers of injury (overall ES = +0.34; P = .0001). Because heterogeneity in study ES was apparent (ie, Q- df = 52.4, P = .000005; I = 57%), subgroup meta-analyses and meta-regressions were run in an attempt to explain the heterogeneity. In human studies, study ESs were higher when lower body muscles were injured ( P = .045). In animal studies, study ESs were lower with longer NSAID administration durations ( P = .023) and at longer follow-up times after injury ( P = .010).
Overall, our analysis supports NSAID use for reducing strength loss, soreness, and blood creatine kinase level after an acute muscle injury, at least for humans and in the short term. Additional research is required to determine why NSAID use appears to be more effective when lower-body muscles in humans are injured. It would also be important to determine why NSAID use appears detrimental at later times after injury in animals but not humans.
对于急性骨骼肌损伤后使用非甾体抗炎药（NSAIDs）是否有益，目前存在争议。一些研究表明，NSAID 的使用可能对受伤肌肉有害。
确定 NSAID 的使用是否会影响骨骼肌损伤的恢复，通过力量下降、酸痛和/或血肌酸激酶水平来评估。
系统评价和荟萃分析。
进行了广泛的系统综述，共检索了 16 个数据库（例如，PubMed、Cochrane 图书馆、EMBASE）。纳入标准为：（1）骨骼肌急性损伤，（2）使用对照条件，（3）确定给予的 NSAID 剂量，（4）使用 1 种或多种 3 种期望的结果测量指标。共筛选出 5343 份研究报告，其中 41 项研究被认为适合纳入。标准化均数差被用作效应量（ES），其计算方法为正值 ES 表示 NSAID 的疗效。使用随机效应模型进行荟萃分析。
对于所有研究、损伤后时间点和综合损伤标志物，发现 NSAID 的使用会导致损伤标志物出现小到中等、显著的降低（总体 ES = +0.34；P =.0001）。由于研究 ES 的异质性明显（即，Q- df = 52.4，P =.000005；I = 57%），因此进行了亚组荟萃分析和元回归分析，以试图解释这种异质性。在人体研究中，下肢肌肉受伤时研究 ES 更高（P =.045）。在动物研究中，随着 NSAID 给药时间延长（P =.023）和损伤后随访时间延长（P =.010），研究 ES 更低。
总体而言，我们的分析支持在急性肌肉损伤后使用 NSAID 来减少力量下降、酸痛和血肌酸激酶水平，至少对于人类和短期来说是如此。需要进一步的研究来确定为什么 NSAID 的使用在人类下肢肌肉受伤时似乎更有效。同样重要的是，要确定为什么 NSAID 的使用在动物中受伤后较晚的时间似乎有害，但在人类中却没有。
