低水平激光治疗慢性伤口有效性与安全性的Meta分析

目的 评价低水平激光治疗慢性伤口的有效性和安全性。方法 检索PubMed、Medline、EMbase、Cochrane Library、Web of Science、BMJ Best Practice、CBM、中国知网、万方、维普数据库,并检索伤口治疗相关专业网站,搜集关于低水平激光治疗慢性伤口的随机对照试验,检索时间均从建库至2018年12月,使用Cochrane Review Handbook 5.1.0进行质量评价,采用RevMan 5.3进行Meta分析。结果 共纳入16个随机对照研究,509例患者。结果 显示：低水平激光组未愈合伤口面积[MD=-0.63,95%CI（-0.97,-0.29）,P<0.01]、伤口面积平均减少率[MD=22.17,95%CI（19.34, 25.00）,P<0.01]、伤口治愈人数[OR=2.04,95%CI（1.33,3.12）,P<0.01]、伤口疼痛值[MD=-4.34,95%CI（-4.92,-3.75,P<0.01]与对照组比较差异均有统计学意义,而不良事件发生率[OR=0.66,95%CI（0.24,1.81）,P=0.42]与对照组比较差异无统计学意义。结论 低水平激光能加速伤口愈合,有效减轻伤口治疗期间患者疼痛,并且是安全的。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Efficacy and Safety of Low-level Laser Therapy for Chronic Wounds: A Meta-analysis

Objective To evaluate the efficacy and safety of low-level laser therapy for chronic wounds. Methods Randomized controlled trials (RCTs) of low-level laser therapy for chronic wounds were collected from PubMed, Medline, EMbase, Cochrane Library, Web of Science, BMJ Best Practice, CBM, China Knowledge Network, Wanfang data and VIP data by computer from the inception to December of 2018. The quality of the included studies was evaluated using Cochrane Review Handbook 5.1.0 and performed using RevMan 5.3 software. Results Sixteen RCTs and 509 patients were included in the study. Meta-analysis showed that the area of non-healing wounds in the low-level laser group [MD=-0.63, 95%CI (-0.97, -0.29), P<0.01], mean reduction in wound area [MD=22.17, 95%CI(19.34, 25.00), P<0.01 ], the number of wounds cured [OR=2.04, 95%CI (1.33, 3.12), P=0.01] and the value of wound pain [MD=-4.34, 95%CI (-4.92, -3.75), P<0.01] in the observation group were significantly different from those of the control group, but the incidence of adverse events [OR=0.66,95%CI（0.24, 1.81）, P=0.42] was not statistically significant. Conclusion Low-level laser can accelerate wound healing, effectively alleviate pain during wound treatment, and it is safe. Subject to the limitations of the number and quality of studies included, the above conclusions are yet to be verified by more high-quality studies.