低强度超声治疗肌筋膜疼痛综合征的疗效与安全性：一项系统评价与荟萃分析
Efficacy and safety of low-intensity ultrasound therapy for myofascial pain syndrome: a systematic review and meta-analysis.
作者信息
Li Xize, Lin Yijun, He Peijue, Wang Qian
机构信息
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.
出版信息
BMC Musculoskelet Disord. 2024 Dec 23;25(1):1059. doi: 10.1186/s12891-024-08174-7.
BACKGROUND
Myofascial Pain Syndrome (MPS) is a common pain disorder characterized by the presence of trigger points within the muscles or fascia. Low-intensity ultrasound therapy, as a noninvasive modality, has indeed found application in the management of MPS, but its efficacy for myofascial pain syndrome has still been controversial. The objective of this systematic review was to assess the safety and efficacy of low-intensity ultrasound therapy for MPS.
METHODS
We searched PubMed, Embase, PEDro, Web of Science, and CENTRAL for RCTs on ultrasound therapy in MPS patients. We included RCTs comparing ultrasound with other therapies or placebo-sham ultrasound. Clinical outcomes included pain scores and physical functional performance. Risk of bias and heterogeneity were assessed. Two authors of the review independently evaluated the risk of bias of each trial and extracted the data.
RESULTS
This systematic review included sixteen RCTs involving a total of 1063 participants with MPS. None of the included studies reported adverse events. Comparing with sham or no treatment, the application of low-intensity ultrasound yielded additional benefits for pain (SMD [CI] = - 1.04 [- 1.72, - 0.36], P < 0.0003), with high heterogeneity (χ = 116.63, P < 0.00001, I = 91%). Patients receiving low-intensity ultrasound had improved on pressure pain threshold. Compared with other treatments, there were no differences in outcomes functional scores.
CONCLUSIONS
The current study indicates that low-intensity ultrasound effectively reduces pain intensity in MPS patients. The heterogeneity regarding the parameters of ultrasound, including frequency, intensity, time was found to be high among the included studies. Each therapeutic modality works differently in various situations and may lead to multitudinous effects. The positive impact of low-intensity ultrasound on functional improvement needs to be further analyzed through more high-quality clinical trials with large sample sizes in the future.
TRIAL REGISTRATION
This study was registered on the following website: https://www.crd.york.ac.uk/PROSPERO/ . The PROSPERO registered ID is CRD42023472032.
背景
肌筋膜疼痛综合征（MPS）是一种常见的疼痛性疾病，其特征是肌肉或筋膜内存在触发点。低强度超声治疗作为一种非侵入性治疗方式，确实已应用于MPS的管理，但它对肌筋膜疼痛综合征的疗效仍存在争议。本系统评价的目的是评估低强度超声治疗MPS的安全性和疗效。
方法
我们在PubMed、Embase、PEDro、Web of Science和CENTRAL中检索关于MPS患者超声治疗的随机对照试验（RCT）。我们纳入了将超声与其他治疗或安慰剂 - 假超声进行比较的RCT。临床结局包括疼痛评分和身体功能表现。评估了偏倚风险和异质性。该评价的两位作者独立评估每个试验的偏倚风险并提取数据。
结果
本系统评价纳入了16项RCT，共涉及1063例MPS患者。纳入的研究均未报告不良事件。与假治疗或不治疗相比，低强度超声的应用在疼痛方面产生了额外的益处（标准化均数差[可信区间] = -1.04[-1.72，-0.36]，P < 0.0003），异质性高（χ = 116.63，P < 0.00001，I² = 91%）。接受低强度超声治疗的患者压力疼痛阈值有所改善。与其他治疗相比，功能评分结局无差异。
结论
当前研究表明，低强度超声可有效降低MPS患者的疼痛强度。在所纳入的研究中，发现超声参数（包括频率、强度、时间）的异质性很高。每种治疗方式在不同情况下的作用不同，可能会产生多种效果。低强度超声对功能改善的积极影响未来需要通过更多高质量、大样本量的临床试验进一步分析。
试验注册
本研究在以下网站注册：https://www.crd.york.ac.uk/PROSPERO/ 。PROSPERO注册编号为CRD42023472032。
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