de Oliveira Alves Renata, Faccioli Ragghianti Matheus Henrique, Nunes Larissa Pereira, Ferreira Mayra Fernanda, Alves de Toledo Priscila Toninatto, Ferrisse Túlio Morandin, Passadori Martins Tamires, Nunes Gabriel Pereira
Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil.
Laboratory for Bone Metabolism and Regeneration (Bonelab), Faculty of Dental Medicine, University of Porto, Porto, Portugal.
Lasers Med Sci. 2025 Jun 12;40(1):276. doi: 10.1007/s10103-025-04531-7.
Nipple injuries are common and can cause intense pain, leading to early weaning in breastfeeding. This study investigates the efficacy of photobiomodulation therapy (PBM) in reducing pain and promoting the healing of nipple lesions in lactating women. The protocol of this study was registered in PROSPERO and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020). Electronic searches were conducted (PubMed/MEDLINE, Web of Science, Scopus, Embase, Cochrane Library and grey literature) until March-2024. The eligibility criteria were randomized clinical trials (RCTs). Meta-analysis was conducted using R software with the "META" package. The Odds Ratio (OR) effect measurement was calculated, and a fixed-effect model was applied with a confidence interval of 95%. The Cochrane collaboration tool was used to assess the risk of bias, and the GRADE approach was used to assess the quality of evidence. A total of 924 records were screened, and 7 studies meeting the criteria were included in this review. The findings indicated a notable decrease in breastfeeding-related pain, along with expedited healing of nipple injuries and improvement in quality of life among participants receiving PBM compared with control group. In addition, a meta-analysis confirmed less sucking pain for the PBM group OR 0.43 ([95% CI - 0.23 to 0.79]; p = 0.001). Most studies had a low risk of bias, and the certainty of evidence was classified as low. The results suggest that PBM may be a promising therapeutic approach to reduce pain and improve the healing of nipple lesions. However, more robust, and methodologically standardized randomized clinical trials are needed to confirm and elucidate these results.
乳头损伤很常见，会引起剧痛，导致母乳喂养提前中断。本研究调查了光生物调节疗法（PBM）在减轻哺乳期妇女乳头损伤疼痛和促进愈合方面的疗效。本研究方案已在国际前瞻性系统评价注册库（PROSPERO）注册，并遵循系统评价和Meta分析的首选报告项目（PRISMA 2020）指南。截至2024年3月进行了电子检索（PubMed/MEDLINE、科学网、Scopus、Embase、Cochrane图书馆和灰色文献）。纳入标准为随机临床试验（RCT）。使用R软件和“META”包进行Meta分析。计算比值比（OR）效应量，并应用固定效应模型，置信区间为95%。使用Cochrane协作工具评估偏倚风险，采用GRADE方法评估证据质量。共筛选了924条记录，本综述纳入了7项符合标准的研究。研究结果表明，与对照组相比，接受PBM的参与者与母乳喂养相关的疼痛显著减轻，乳头损伤愈合加快，生活质量得到改善。此外，Meta分析证实PBM组的吸吮疼痛较轻，OR为0.43（[95%CI - 0.23至0.79]；p = 0.001）。大多数研究的偏倚风险较低，证据确定性被归类为低。结果表明，PBM可能是一种有前景的治疗方法，可减轻疼痛并促进乳头损伤的愈合。然而，需要更有力且方法学标准化的随机临床试验来证实和阐明这些结果。
