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高强度激光疗法(HILT)作为一种治疗外阴痛和慢性肌肉骨骼疼痛疾病的新兴疗法:治疗效果的系统评价

High-Intensity Laser Therapy (HILT) as an Emerging Treatment for Vulvodynia and Chronic Musculoskeletal Pain Disorders: A Systematic Review of Treatment Efficacy.

作者信息

Starzec-Proserpio Małgorzata, Grigol Bardin Marcela, Fradette Julie, Tu Le Mai, Bérubè-Lauzière Yves, Paré Josianne, Carroll Marie-Soleil, Morin Mélanie

机构信息

Department of Midwifery, Centre of Postgraduate Medical Education, 01-004 Warsaw, Poland.

Department of Obstetrics and Gynecology, School of Medical Sciences, Campinas University, São Paulo 13083-887, Brazil.

出版信息

J Clin Med. 2022 Jun 27;11(13):3701. doi: 10.3390/jcm11133701.

Abstract

High-intensity laser therapy (HILT) has been gaining popularity in the treatment of chronic musculoskeletal pain, including vulvodynia. The objective of this study was to critically appraise and synthesize the available evidence on the efficacy of HILT for reducing pain and improving function in vulvodynia and other chronic primary musculoskeletal pain conditions. Electronic databases and the grey literature were searched. Effects on pain intensity, function, and adverse events were assessed. One study investigating HILT in the treatment of vulvodynia and 13 studies on the treatment of chronic musculoskeletal pain were selected. The study assessing vulvodynia showed favorable results for reducing pain. Regarding chronic musculoskeletal pain, 12 out of the 13 studies selected consistently showed that HILT was more effective than the placebo/active comparator for reducing pain and improving function. The available effect sizes for pain showed large to huge effects. Similar effects were observed for function except for two studies showing moderate effects. The GRADE score was moderate. Conclusions: There are insufficient data to support the use of HILT in vulvodynia, but the promising results encourage further research. HILT appears to be effective in musculoskeletal pain conditions. More high-quality studies are needed to identify effective laser protocols.

摘要

高强度激光疗法(HILT)在慢性肌肉骨骼疼痛(包括外阴痛)的治疗中越来越受欢迎。本研究的目的是严格评估和综合现有证据,以证明HILT在减轻外阴痛及其他慢性原发性肌肉骨骼疼痛状况的疼痛和改善功能方面的疗效。检索了电子数据库和灰色文献。评估了对疼痛强度、功能和不良事件的影响。选择了一项研究HILT治疗外阴痛的研究以及13项关于慢性肌肉骨骼疼痛治疗的研究。评估外阴痛的研究显示在减轻疼痛方面有良好效果。关于慢性肌肉骨骼疼痛,所选择的13项研究中有12项一致表明,HILT在减轻疼痛和改善功能方面比安慰剂/活性对照更有效。现有的疼痛效应量显示出大到巨大的效果。除两项显示中等效果的研究外,在功能方面也观察到类似效果。GRADE评分为中等。结论:没有足够的数据支持在治疗外阴痛时使用HILT,但这些有前景的结果鼓励进一步研究。HILT在肌肉骨骼疼痛状况中似乎是有效的。需要更多高质量的研究来确定有效的激光治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4d2/9267539/6ad25ea7cceb/jcm-11-03701-g001.jpg

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