Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China.
School of Medicine, Guilin Medical University, Guilin, Guangxi, PR China.
Arch Phys Med Rehabil. 2021 Nov;102(11):2219-2230. doi: 10.1016/j.apmr.2021.02.009. Epub 2021 Mar 17.
OBJECTIVE: To evaluate the effects and safety of therapeutic ultrasound in patients with neck pain. DATA SOURCES: The PubMed, EMBASE, CENTRAL, and Physiotherapy Evidence databases were searched for articles published before December 1, 2020. STUDY SELECTION: Randomized controlled trials that compared the effects of therapeutic ultrasound on neck pain were included in this review. The included studies compared therapeutic ultrasound plus other treatments with the other treatments alone or compared therapeutic ultrasound with sham or no treatment. Outcome measures involved the effects on pain, disability, and quality of life. Other treatments included all nonultrasonic therapies (eg, various exercises, massage, electrotherapy). DATA EXTRACTION: Data on the study population, therapeutic ultrasound intervention, combined intervention, outcome measures, and follow-up were extracted. DATA SYNTHESIS: Twelve randomized controlled trials (705 patients) fulfilled the inclusion criteria. Seven studies compared therapeutic ultrasound plus other treatments vs the other treatments alone (449 patients). Therapeutic ultrasound yielded additional benefits for pain, but there was high heterogeneity and we could not draw a clear conclusion. Ultrasound did not have a better effect on disability or quality of life when it was combined with other treatments. Five studies compared therapeutic ultrasound with sham or no treatment (256 patients), and the pooled data showed that therapeutic ultrasound significantly reduced pain intensity. No adverse events of therapeutic ultrasound were reported in the included studies. CONCLUSIONS: Therapeutic ultrasound may reduce the intensity of pain more than sham or no treatment, and it is a safe treatment. Whether therapeutic ultrasound in combination with other conventional treatments produced additional benefits on pain intensity, disability, or quality of life is not clear. The randomized trials included in this review had different levels of quality and high heterogeneity. A large trial using a valid methodology is warranted.
目的：评估治疗性超声治疗颈痛的疗效和安全性。
资料来源：检索了 PubMed、EMBASE、CENTRAL 和 Physiotherapy Evidence 数据库，以获取截至 2020 年 12 月 1 日发表的文章。
研究选择：本综述纳入了比较治疗性超声对颈痛影响的随机对照试验。纳入的研究将治疗性超声加其他治疗与其他治疗单独比较，或将治疗性超声与假治疗或无治疗比较。结局指标包括疼痛、残疾和生活质量的影响。其他治疗包括所有非超声治疗（如各种运动、按摩、电疗）。
资料提取：提取了研究人群、治疗性超声干预、联合干预、结局指标和随访的数据。
资料综合：符合纳入标准的随机对照试验共 12 项（705 例患者）。7 项研究将治疗性超声加其他治疗与其他治疗单独比较（449 例患者）。治疗性超声在疼痛方面有额外的获益，但存在高度异质性，我们无法得出明确的结论。超声联合其他治疗对残疾或生活质量没有更好的效果。5 项研究将治疗性超声与假治疗或无治疗比较（256 例患者），汇总数据显示治疗性超声显著降低了疼痛强度。纳入研究均未报告治疗性超声的不良事件。
结论：治疗性超声可能比假治疗或无治疗更能减轻疼痛强度，且是一种安全的治疗方法。治疗性超声联合其他常规治疗是否在疼痛强度、残疾或生活质量方面有额外获益尚不清楚。本综述纳入的随机试验质量参差不齐，异质性较高。需要进行一项采用有效方法学的大型试验。
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