高能量激光疗法治疗常见运动损伤与骨科疾病

High intensity laser therapy for common sports injuries and orthopedic diseases

背景:高能量激光疗法具有更好的穿透性,更高的输出功率,在常见骨科疾病以及常见运动损伤如骨关节退行性疾病、慢性肌肉软组织损伤、脊柱疾病等的治疗方面具有广阔的前景。目前,临床对这种疗法的应用缺少统一标准,适应证、参数、疗程等缺乏循证医学支持,需要更多随机对照研究来验证。目的:为高能激光疗法在治疗常见运动损伤和骨科疾病方面提供理论和方法依据。方法:于2018年5至7月以主题词检索PubMed、中国学术期刊全文数据库和万方数据库收录的文献。中文检索词为"高能量激光疗法"、"运动损伤"、"物理治疗"、"骨关节退行性疾病"、"慢性肌肉软组织损伤"、"脊柱疾病";英文检索词为"high Intensity laser therapy"、"sports injuries"、"Physical therapy"、"Osteoarthritis degenerative disease"、"Chronic muscle soft tissue injury"、"Spinal disease"。检索时限为2010至2018年。结果与结论:①共21篇文献纳入研究、其中包括骨关节退行性疾病、慢性肌肉软组织损伤、脊柱疾病、代谢性疾病和急性肌肉软组织损伤等疾病;②应对相同的疾病时,高能量激光疗法的参数也有不同的选择。疾病的病程、病情的严重程度、体表阻挡组织的厚度等都有可能影响治疗方法的调整;③结果提示高能量激光疗法可减少炎症反应、疼痛物质产生,促进血液循环和淋巴循环,修复受损肌腱,并可治愈局部骨质流失和刺激新骨形成,且对常见运动损伤及骨科疾病的治疗效果是可以预期的。

BACKGROUND: High energy laser therapy has good penetration and high output power, and has broad prospects in the treatment of common orthopedic diseases and common sports injuries, such as degenerative diseases of bone and joints, chronic muscle and soft tissue injuries, and spinal diseases. At present, the clinical application of this therapy lacks a unified standard, and there is a lack of evidence-based medical support in terms of indications, parameters and courses of treatment.Therefore, more randomized controlled studies are needed.OBJECTIVE: To provide theoretical and methodological basis for high-energy laser therapy in the treatment of common sports injuries and orthopedic diseases.METHODS: Databases of PubMed, CNKI, and WanFang were searched from May-July, 2018. The keywords were 'high intensity laser therapy, sports injuries, physical therapy, osteoarthritis degenerative disease, chronic muscle soft tissue injury, spinal disease' in English and Chinese, respectively for the articles published from 2010 to 2018.RESULTS AND CONCLUSION:(1) Twenty-one eligible articles were included in the study, including diseases such as osteoarticular degenerative diseases, chronic muscle soft tissue injuries, spinal diseases, metabolic diseases, and acute muscle and soft tissue injuries.(2)When dealing with the same disease, the parameters of high energy laser therapy have different choices. The course of the disease, the severity of the condition, and the thickness of the body’s blocking tissue may affect the adjustment of the treatment.(3) High energy laser therapy can reduce inflammation, production of painful substances, promote blood circulation and lymph circulation, and repair damaged tendons. High energy laser therapy can cure local bone loss and stimulate new bone formation. The treatment effect on common sports injuries and orthopedic diseases is expected.