Federal University of Piaui, Piaui, Brazil.
Int J Low Extrem Wounds. 2021 Sep;20(3):198-207. doi: 10.1177/1534734620914439. Epub 2020 May 12.
Diabetic foot ulcers (DFUs) are considered one of the most aggressive and expensive complications of diabetes. Low-level laser therapy (LLLT) has been highlighted as a potential modality of treatment to accelerate the healing of ulcers. This systematic review and meta-analysis aimed to investigate the efficacy of LLLT in the treatment of DFU and identify the LLLT application parameters recommended for the treatment of DFU over the past 10 years. A systematic search was conducted in PubMed, BVS, PEDro, Scopus, Web of Science, and CINAHL up to March 31, 2019. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, randomized controlled trials (RCTs) that assessed the effect of LLLT on the treatment of DFU were included. Thirteen RCTs with a total of 361 participants were included in this review. Three RCTs reported a reduction in the percentage size of the ulcers and were included in the meta-analysis. The meta-analysis of the percentage size difference demonstrated a significant reduction in ulcer size in the LLLT group compared with controls (22.96 [95% confidence interval = 18.22-27.69; = 9.51, < .0001]). Treatment with 632.8 to 685 nm, 50 mW/cm, 3 to 6 J/cm, and irradiation for 30 to 80 seconds, 3 times weekly for a month is of benefit to patients with DFU. LLLT is effective and safe for the treatment of DFU. Additionally, well-designed, high-quality studies are needed to allow its ideal parameterization for clinical practice.
糖尿病足溃疡（DFU）被认为是糖尿病最具侵袭性和最昂贵的并发症之一。低水平激光疗法（LLLT）已被强调为加速溃疡愈合的一种潜在治疗方法。本系统评价和荟萃分析旨在研究 LLLT 在治疗 DFU 中的疗效，并确定过去 10 年来治疗 DFU 推荐的 LLLT 应用参数。系统检索了 PubMed、BVS、PEDro、Scopus、Web of Science 和 CINAHL 数据库，检索时间截至 2019 年 3 月 31 日。根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南，纳入了评估 LLLT 对 DFU 治疗效果的随机对照试验（RCT）。本综述共纳入了 13 项 RCT，共计 361 名参与者。其中 3 项 RCT 报告了溃疡面积百分比的减少，并纳入了荟萃分析。荟萃分析显示，与对照组相比，LLLT 组的溃疡面积显著缩小（22.96 [95%置信区间 = 18.22-27.69； = 9.51， <.0001]）。632.8 至 685nm、50mW/cm、3 至 6J/cm 和 30 至 80 秒的辐照时间，每周 3 次，持续 1 个月的治疗对 DFU 患者有益。LLLT 治疗 DFU 有效且安全。此外，需要进行设计良好、高质量的研究，以确定其在临床实践中的理想参数化。
