Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Department of Physical Therapy, College of Health Sciences, Marquette University, Milwaukee, WI 53201-1881, USA.
Int J Mol Sci. 2019 Jan 16;20(2):368. doi: 10.3390/ijms20020368.
We have systematically assessed published cell studies and animal experimental reports on the efficacy of selected biophysical energies (BPEs) in the treatment of diabetic foot ulcers. These BPEs include electrical stimulation (ES), pulsed electromagnetic field (PEMF), extracorporeal shockwave (ECSW), photo energies and ultrasound (US). Databases searched included CINAHL, MEDLINE and PubMed from 1966 to 2018. Studies reviewed include animal and cell studies on treatment with BPEs compared with sham, control or other BPEs. Information regarding the objective measures of tissue healing and data was extracted. Eighty-two studies were eventually selected for the critical appraisal: five on PEMF, four each on ES and ECSW, sixty-six for photo energies, and three about US. Based on the percentage of original wound size affected by the BPEs, both PEMF and low-level laser therapy (LLL) demonstrated a significant clinical benefit compared to the control or sham treatment, whereas the effect of US did not reveal a significance. Our results indicate potential benefits of selected BPEs in diabetic wound management. However, due to the heterogeneity of the current clinical trials, comprehensive studies using well-designed trials are warranted to confirm the results.
我们系统地评估了已发表的细胞研究和动物实验报告，这些报告涉及选择的生物物理能（BPE）在治疗糖尿病足溃疡方面的疗效。这些 BPE 包括电刺激（ES）、脉冲电磁场（PEMF）、体外冲击波（ECSW）、光能量和超声（US）。搜索的数据库包括 1966 年至 2018 年的 CINAHL、MEDLINE 和 PubMed。综述的研究包括 BPE 治疗与假对照、对照或其他 BPE 治疗的动物和细胞研究。提取了有关组织愈合的客观测量和数据的信息。最终选择了 82 项研究进行批判性评估：5 项关于 PEMF，4 项关于 ES 和 ECSW，66 项关于光能量，3 项关于 US。基于 BPE 影响原始伤口面积的百分比，PEMF 和低水平激光疗法（LLLT）与对照或假对照治疗相比显示出显著的临床益处，而 US 的效果并未显示出显著差异。我们的研究结果表明，选择的 BPE 在糖尿病伤口管理中具有潜在的益处。然而，由于目前临床试验的异质性，需要进行全面的研究，使用精心设计的试验来证实这些结果。
