Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
BMJ Open. 2023 Jan 23;13(1):e062322. doi: 10.1136/bmjopen-2022-062322.
To investigate the efficacy and safety of hyperbaric oxygen therapy (HBOT) for fibromyalgia (FM).
A systematic review and meta-analysis.
PubMed, EMBASE, Cochrane Library, Web of Science, VIP (China Science and Technology Journal Database), CNKI (China National Knowledge Infrastructure) and WanFang database were searched from from inception to 22 October 2022.
We included clinical trials (randomised controlled and non-randomised controlled trials) of HBOT for FM.
Two researchers independently screened the literature, extracted data and evaluated the quality of the included studies, with disagreements resolved by a third researcher. The Cochrane Collaboration checklists and the Methodological Index for Non-randomised Studies were used to assess the risk of bias. Meta-analysis was performed by RevMan V.5.4.1 software. Random effect models were used for meta-analysis.
Nine studies were included in this review, with a total of 288 patients. For pain assessment, we combined the results of the Visual Analogue Scale and Widespread Pain Index. The results showed that HBOT could relieve the pain of FM patients compared with the control intervention (standardised mean difference=-1.56, 95% CI (-2.18 to -0.93), <0.001, =51%). Most included studies reported that HBOT ameliorated tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM. Adverse events occurred in 44 of 185 patients (23.8%). Twelve patients (6.5%) withdrew because of adverse reactions. No serious adverse events or complications were observed.
HBOT might have a positive effect in improving pain, tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM, with reversible side effects. Low pressure (less than 2.0 atmospheric absolute) may be beneficial to reduce adverse events in FM. Further studies should be carried out to evaluate the optimal protocol of HBOT in FM.
CRD42021282920.
探讨高压氧治疗（HBOT）纤维肌痛（FM）的疗效和安全性。
系统评价和荟萃分析。
从建库至 2022 年 10 月 22 日，检索 PubMed、EMBASE、Cochrane 图书馆、Web of Science、VIP（中国科技期刊数据库）、CNKI（中国国家知识基础设施）和万方数据库。
纳入 HBOT 治疗 FM 的临床试验（随机对照和非随机对照试验）。
两位研究者独立筛选文献、提取数据并评价纳入研究的质量，意见不一致时由第三位研究者解决。使用 Cochrane 协作清单和非随机研究方法学指数评估偏倚风险。使用 RevMan V.5.4.1 软件进行荟萃分析。Meta 分析采用随机效应模型。
本综述纳入 9 项研究，共 288 例患者。对于疼痛评估，我们结合视觉模拟量表和广泛疼痛指数的结果。结果表明，与对照组干预相比，HBOT 可缓解 FM 患者的疼痛（标准化均数差=-1.56，95%CI（-2.18 至-0.93），<0.001， =51%）。大多数纳入研究报告 HBOT 改善了 FM 患者的压痛、疲劳、多维功能、患者整体和睡眠障碍。185 例患者中有 44 例（23.8%）发生不良事件。12 例（6.5%）患者因不良反应退出。未观察到严重不良事件或并发症。
HBOT 可能对改善 FM 患者的疼痛、压痛、疲劳、多维功能、患者整体和睡眠障碍有积极作用，且具有可逆的副作用。低压（低于 2.0 绝对大气压）可能有利于减少 FM 中的不良事件。应开展进一步研究，以评估 FM 中 HBOT 的最佳方案。
PROSPERO 注册号：CRD42021282920。
