激光治疗腰痛效果的Meta分析
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摘要
目的探讨激光治疗腰痛(LBP)的临床效果,并进行Meta分析。方法计算机检索国内外数据库,如Pub Med、Embase、The Cochrane Library、中国知网、维普和万方等,筛选符合要求的文献,根据干预措施分为实验组和对照组,并评价其方法学质量,通过RevMan 5.3软件对纳入文献相关指标进行Meta分析。结果最终纳入14个随机对照实验,共1117例患者。Meta分析结果显示:实验组视觉模拟评分(VAS)改善优于对照组[MD=-0.77;95%CI(-1.04,-0.50);P <0.000 01];实验组Roland-Morris功能障碍问卷(RDQ)改善评分优于对照组[MD=-1.37;95%CI(-1.97,-0.76);P <0.000 01];实验组改良Oswestry功能障碍问卷(MODQ)改善评分优于对照组[MD=-2.69;95%CI(-4.45,-0.94);P=0.003]。结论激光疗法在改善腰痛患者疼痛症状和腰部活动方面具有一定的疗效及优势。
Objective To investigate the clinical efficacy of laser treatment of low back pain(LBP), and Meta analgsis was porformed. Methods Domestic and foreign databases, such as PubMed, Embase, the Cochrane Library, CNKI, WIP and Wanfang, were searched by computer, and the eligible literatures were screened, and divided into experimental group and control group according to intervention weasures, and their methodological quality was evaluated. Meta analysis was conducted on the included literatures through RevMan 5.3 software. Results Finally, 14 randomized controlled trials were included, with a total of 1117 patients. Meta analysis results showed that visual simulation score(VAS) in the laser group was better than that in the control group [MD =-0.77; 95%CI(-1.04,-0.50); P < 0.000 01]. The improvement score of the Roland-Morris dysfunction questionnaire(RDQ) in the laser group was better than that in the control group [MD =-1.37; 95%CI(-1.97,-0.76); P < 0.000 01]. The modified oswestry disability questionnaire(MODQ) score in the laser group was superior to that in the control group [MD =-2.69; 95%CI(-4.45,-0.94); P = 0.003]. Conclusion Laser therapy has certain curative effect and advantage in improving the pain symptoms and lumbar activities of patients with low back pain.
Objective To investigate the clinical efficacy of laser treatment of low back pain(LBP), and Meta analgsis was porformed. Methods Domestic and foreign databases, such as PubMed, Embase, the Cochrane Library, CNKI, WIP and Wanfang, were searched by computer, and the eligible literatures were screened, and divided into experimental group and control group according to intervention weasures, and their methodological quality was evaluated. Meta analysis was conducted on the included literatures through RevMan 5.3 software. Results Finally, 14 randomized controlled trials were included, with a total of 1117 patients. Meta analysis results showed that visual simulation score(VAS) in the laser group was better than that in the control group [MD =-0.77; 95%CI(-1.04,-0.50); P < 0.000 01]. The improvement score of the Roland-Morris dysfunction questionnaire(RDQ) in the laser group was better than that in the control group [MD =-1.37; 95%CI(-1.97,-0.76); P < 0.000 01]. The modified oswestry disability questionnaire(MODQ) score in the laser group was superior to that in the control group [MD =-2.69; 95%CI(-4.45,-0.94); P = 0.003]. Conclusion Laser therapy has certain curative effect and advantage in improving the pain symptoms and lumbar activities of patients with low back pain.
引文
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[3]张逸,查贵盛,阳煦,等.红外偏振光联合三维牵引治疗腰椎间盘突出症临床分析[J].华西医学,2008,23(4):716-717.
[4]Glazov G,Schattner P,Lopez D,et al.Laser acupuncture for chronic non-specific low backpain:a controlled clinical trial[J].Acupunct Med,2009,27(3):94-100.
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[7]Fiore P,Panza F,Cassatella G,et al.Short-term effects of high-intensity laser therapy versusultrasound therapy in the treatment of low back pain[J].Eur J Phys Rehabil Med,2011,47(3):367-373.
[8]Lin ML,Wu HC,Hsieh YH,et al.Evaluation of the effect of laser acupuncture and cuppingwith ryodoraku and visual analog scale on low back pain[J].Evid Based Complement Alternat Med,2012,2012:521612.
[9]Alayat M,Atya A,Ali M,et al.Long-term effect of highintensity laser therapy in thetreatment of patients with chronic low back pain[J].Lasers Med Sci,2014,29(3):1065-1073.
[10]Glazov G,Yelland M,Emery J.Low-dose laser acupuncture for non-specific chronic low back pain:a doubleblind randomised controlled trial[J].Acupunct Med,2014,32(2):116-123.
[11]Hsieh RL,Lee WC.Short-term therapeutic effects of890-nanometer light therapy for chronic low back pain:a double-blind randomized placebo-controlled study[J].Lasers Med Sci,2014,29(2):671-679.
[12]Vallone F,Benedicenti S,Sorrenti E,et al.Effect of diode laser in the treatment of patients with nonspecific chronic low back pain:a randomized controlled trial[J].Photomed Laser Surg,2014,32(9):490-494.
[13]任国玲.偏振光照射配合电针治疗椎间盘源性腰痛的疗效[J].实用疼痛学杂志,2014,10(2):114-117.
[14]Boyraz I,Yildiz A,Koc B,et al.Comparison of high-intensity laser therapy and ultrasound treatment in the patients with lumbar discopathy[J].Biomed Res Int,2015,2015:304 328.
[15]路睿.点式偏振光治疗仪联合脊椎减压系统治疗腰椎间盘突出症的疗效观察[J].临床医学研究与实践,2016,1(19):110-111.
[16]刘晓东,凌雪唯,林娟,等.直线偏振光近红外线对老年慢性非特异性腰痛的疗效研究[J].中国疗养医学,2017,26(10):1011-1014.
[17]段生艳,陈广超.慢性腰痛与体质指数相关性研究进展[J].中外医疗,2011,30(35):187-190.
[18]叶建辉,何煜才,欧永祯,等.腰椎间盘内注射结合超激光治疗椎间盘源性腰痛的远期疗效分析[J].中国医学创新,2018,15(8):116-119.
[19]潘小华,翟浩瀚,李浅峰,等.不同物理康复疗法对颈肩腰腿痛的治疗效果[J].中国医药科学,2017,7(5):165-168.
[20]Mester E,Ludany G,Sellyei M,et al.On the biologic effect of laser rays[J].Bull Soc Int Chir,1968,27(1):68-73.
[21]Nazari A,Moezy A,Nejati P,et al.Efficacy of high-intensity laser therapy in comparison with conventional physiotherapy and exercise therapy on pain and function of patients with knee osteoarthritis[J].Lasers Med Sci,2018,18:66-72.
[22]Francio VT,Dima RS,Towery C,et al.Prolotherapy and Low Level Laser Therapy:A Synergistic Approach to Pain Management in Chronic Osteoarthritis[J].Anesthe Pain Med,2017,7(5):168-176.
[23]Bjordal JM.Low level laser therapy(LLLT)and World Association for Laser Therapy(WALT)dosage recommendations[J].Photomed Laser Surg,2012,30(2):61-62.
[2]Jang H,Lee H.Meta-analysis of pain relief effects by laser irradiation on joint areas[J].Photomed Laser Surg,2012,30(8):405-417.
[3]张逸,查贵盛,阳煦,等.红外偏振光联合三维牵引治疗腰椎间盘突出症临床分析[J].华西医学,2008,23(4):716-717.
[4]Glazov G,Schattner P,Lopez D,et al.Laser acupuncture for chronic non-specific low backpain:a controlled clinical trial[J].Acupunct Med,2009,27(3):94-100.
[5]王育庆,段俊峰,王正和,等.半导体激光对腰椎间盘突出症患者疼痛症状的改善作用[J].颈腰痛杂志,2009,30(2):156-158.
[6]Ay S,Dogan SK,Evcik D,et al.Is low-level laser therapy effective in acute or chronic low back pain?[J].Clin Rheumatol,2010,29(8):905-910.
[7]Fiore P,Panza F,Cassatella G,et al.Short-term effects of high-intensity laser therapy versusultrasound therapy in the treatment of low back pain[J].Eur J Phys Rehabil Med,2011,47(3):367-373.
[8]Lin ML,Wu HC,Hsieh YH,et al.Evaluation of the effect of laser acupuncture and cuppingwith ryodoraku and visual analog scale on low back pain[J].Evid Based Complement Alternat Med,2012,2012:521612.
[9]Alayat M,Atya A,Ali M,et al.Long-term effect of highintensity laser therapy in thetreatment of patients with chronic low back pain[J].Lasers Med Sci,2014,29(3):1065-1073.
[10]Glazov G,Yelland M,Emery J.Low-dose laser acupuncture for non-specific chronic low back pain:a doubleblind randomised controlled trial[J].Acupunct Med,2014,32(2):116-123.
[11]Hsieh RL,Lee WC.Short-term therapeutic effects of890-nanometer light therapy for chronic low back pain:a double-blind randomized placebo-controlled study[J].Lasers Med Sci,2014,29(2):671-679.
[12]Vallone F,Benedicenti S,Sorrenti E,et al.Effect of diode laser in the treatment of patients with nonspecific chronic low back pain:a randomized controlled trial[J].Photomed Laser Surg,2014,32(9):490-494.
[13]任国玲.偏振光照射配合电针治疗椎间盘源性腰痛的疗效[J].实用疼痛学杂志,2014,10(2):114-117.
[14]Boyraz I,Yildiz A,Koc B,et al.Comparison of high-intensity laser therapy and ultrasound treatment in the patients with lumbar discopathy[J].Biomed Res Int,2015,2015:304 328.
[15]路睿.点式偏振光治疗仪联合脊椎减压系统治疗腰椎间盘突出症的疗效观察[J].临床医学研究与实践,2016,1(19):110-111.
[16]刘晓东,凌雪唯,林娟,等.直线偏振光近红外线对老年慢性非特异性腰痛的疗效研究[J].中国疗养医学,2017,26(10):1011-1014.
[17]段生艳,陈广超.慢性腰痛与体质指数相关性研究进展[J].中外医疗,2011,30(35):187-190.
[18]叶建辉,何煜才,欧永祯,等.腰椎间盘内注射结合超激光治疗椎间盘源性腰痛的远期疗效分析[J].中国医学创新,2018,15(8):116-119.
[19]潘小华,翟浩瀚,李浅峰,等.不同物理康复疗法对颈肩腰腿痛的治疗效果[J].中国医药科学,2017,7(5):165-168.
[20]Mester E,Ludany G,Sellyei M,et al.On the biologic effect of laser rays[J].Bull Soc Int Chir,1968,27(1):68-73.
[21]Nazari A,Moezy A,Nejati P,et al.Efficacy of high-intensity laser therapy in comparison with conventional physiotherapy and exercise therapy on pain and function of patients with knee osteoarthritis[J].Lasers Med Sci,2018,18:66-72.
[22]Francio VT,Dima RS,Towery C,et al.Prolotherapy and Low Level Laser Therapy:A Synergistic Approach to Pain Management in Chronic Osteoarthritis[J].Anesthe Pain Med,2017,7(5):168-176.
[23]Bjordal JM.Low level laser therapy(LLLT)and World Association for Laser Therapy(WALT)dosage recommendations[J].Photomed Laser Surg,2012,30(2):61-62.