From the Department of General Medicine, Cathy General Hospital, Taipei, Taiwan (W-CC, C-HC); Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan (W-HH); Center of Evidence-based Medicine, Department of Education, Taipei Medical University Hospital, Taipei, Taiwan (W-HH); Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan (W-HH); and Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W-HH).
Am J Phys Med Rehabil. 2021 Nov 1;100(11):1078-1086. doi: 10.1097/PHM.0000000000001711.
The aim of the study was to examine the effects of laser therapy on rheumatoid arthritis.
A search of controlled trials was conducted in different medical electronic databases. The primary outcome was immediate pain relief after treatment. Secondary outcomes were level of functional disability, morning stiffness duration, and 3-mo follow-up for pain.
Ten trials met the inclusion criteria. Rheumatoid arthritis treatment with laser therapy significantly improved immediate pain relief (standardized mean difference = -0.839, 95% confidence interval = -1.336 to -0.343) and overall functional score (standardized mean difference = -0.309, 95% confidence interval = -0.587 to -0.031). There was no significant improvement in morning stiffness duration (standardized mean difference = -0.519, 95% confidence interval = -1.176 to 0.138), and 3-mo follow-up for pain (standardized mean difference = -1.125, 95% confidence interval = -2.311 to 0.061). There was no publication bias (Egger regression, P = 0.277). However, heterogeneity was noted despite the removal of an outlier (Q = 18.646, I2 = 57.096). Results of subgroup analyses suggested that high-intensity laser therapy and nerve irradiation are better suited for immediate pain relief. Meta-regression analyses showed no significant linear relationship between the treatment effect with laser wavelength or number of treatment sessions.
Laser therapies provide significant immediate pain relief and improve function for rheumatoid arthritis patients, but without significant improvement in morning stiffness duration and 3-mo follow-up for pain.Systematic review registration number: CRD42020192906.
研究旨在探讨激光疗法对类风湿关节炎的影响。
在不同的医学电子数据库中进行了对照试验搜索。主要结局是治疗后即刻疼痛缓解。次要结局是功能障碍程度、晨僵持续时间和 3 个月时的疼痛随访。
10 项试验符合纳入标准。激光治疗类风湿关节炎显著改善了即刻疼痛缓解（标准化均数差=-0.839，95%置信区间=-1.336 至-0.343）和总体功能评分（标准化均数差=-0.309，95%置信区间=-0.587 至-0.031）。晨僵持续时间（标准化均数差=-0.519，95%置信区间=-1.176 至 0.138）和 3 个月时的疼痛随访（标准化均数差=-1.125，95%置信区间=-2.311 至 0.061）没有显著改善。没有发表偏倚（Egger 回归，P=0.277）。然而，尽管去除了一个异常值，但仍存在异质性（Q=18.646，I2=57.096）。亚组分析结果表明，高强度激光治疗和神经照射更适合即刻止痛。Meta 回归分析显示，激光波长或治疗次数与治疗效果之间没有显著的线性关系。
激光治疗为类风湿关节炎患者提供了显著的即刻疼痛缓解和功能改善，但对晨僵持续时间和 3 个月时的疼痛随访没有显著改善。系统评价注册号：CRD42020192906。
