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低强度激光疗法治疗颞下颌关节紊乱病:一项系统评价与Meta分析

Low-Level Laser Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis.

作者信息

Xu Gang-Zhu, Jia Jie, Jin Lin, Li Jia-Heng, Wang Zhan-Yue, Cao Dong-Yuan

机构信息

Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Department of Neurosurgery, First Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China.

出版信息

Pain Res Manag. 2018 May 10;2018:4230583. doi: 10.1155/2018/4230583. eCollection 2018.

Abstract

OBJECTIVES

We systematically reviewed randomized controlled trials (RCTs) of the effect of low-level laser therapy (LLLT) versus placebo in patients with temporomandibular disorder (TMD).

METHODS

A systematic search of multiple online sources electronic databases was undertaken. The methodological quality of each included study was assessed using the modified Jadad scale, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.

RESULTS

A total of 31 RCTs were included. Total modified Jadad scale scores showed that the methodological quality was high in 30 studies and low in 1 study. Combining data from all clinically heterogeneous studies revealed positive effects of LLLT on pain relief, regardless of the visual analogue scale (VAS) score or the change of VAS score between the baseline and the final follow-up time point, while dosage analyses showed discrepant results about the effects of high or low doses for patients with TMD. Follow-up analyses showed that LLLT significantly reduced pain at the short-term follow-up. Temporomandibular joint function outcomes indicated that the overall effect favored LLLT over placebo.

CONCLUSION

This systematic review suggests that LLLT effectively relieves pain and improves functional outcomes in patients with TMD.

摘要

目的

我们系统回顾了低强度激光疗法(LLLT)与安慰剂对颞下颌关节紊乱病(TMD)患者疗效的随机对照试验(RCT)。

方法

对多个在线电子数据库进行系统检索。使用改良的Jadad量表评估每项纳入研究的方法学质量,并使用推荐分级、评估、制定与评价(GRADE)系统评估证据质量。

结果

共纳入31项RCT。改良Jadad量表总分显示,30项研究的方法学质量高,1项研究的方法学质量低。综合所有临床异质性研究的数据显示,无论视觉模拟量表(VAS)评分或基线与最终随访时间点之间VAS评分的变化如何,LLLT对缓解疼痛均有积极作用,而剂量分析显示,高剂量或低剂量对TMD患者疗效的结果存在差异。随访分析显示,LLLT在短期随访时能显著减轻疼痛。颞下颌关节功能结果表明,总体效果LLLT优于安慰剂。

结论

本系统评价表明,LLLT能有效缓解TMD患者的疼痛并改善功能结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddc1/5971344/e03cfd7b2893/PRM2018-4230583.001.jpg

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