Zusammenfassung
Fragestellung
Die vorhandene Evidenz zur Laserakupunktur mit dem Ziel der Schmerzreduktion sollte bei ausgewählten orthopädischen Erkrankungen untersucht und bewertet werden.
Methodik
Systematische Suche in Medline und der Cochrane Library, Extraktion randomisiert kontrollierter Studien, Metaanalysen und systematischen Übersichtsartikeln und Bewertung nach Qualität an Hand von Evidenztabellen (Oxford-Schema).
Ergebnisse
Zu den hier untersuchten Krankheitsbildern (mediale und laterale Epikondylitis, Osteoarthritis und myofasziale Schulter-/Nacken-/Rückenbeschwerden) fanden sich neben Metaanalysen und systematischen Übersichtsartikeln insgesamt 8 randomisiert kontrollierte Studien, die sich explizit mit der Laserakupunktur befassen. Alle anderen publizierten Studien befassen sich mit der Lasertherapie, bei der keine Akupunkturpunkte behandelt werden. Alle Studien wiesen deutliche Schwächen bei der methodischen Qualität auf, zudem wurden meist nur sehr kleine Patientenkollektive untersucht. Generell zeigte sich eine Tendenz zu höherer methodischer Qualität bei neueren Studien. Die vorliegende Evidenz lässt z. Z. keine endgültige Bewertung der Methode zu, es zeichnen sich positive Effekte bei der Behandlung der muskulären Verspannung im Schulter-/Nacken-/Rückenbereich ab. Deutliche Vorteile der Laserakupunktur ergeben sich bei den Nebenwirkungen im Vergleich zur klassischen Akupunktur.
Schlussfolgerung
Weitere besser strukturierte Studien an größeren Patientengruppen sollten zur Laserakupunktur bei orthopädischen Erkrankungen erfolgen.
Abstract
Background and objectives
The aim of this review is to evaluate the evidence for laser acupuncture in selected orthopaedic diseases.
Material and methods
Randomized controlled studies, meta-analyses and systematic reviews were identified by a systematic search strategy in Medline and the Cochrane library. The studies were evaluated using the quality criteria of the Oxford Centre of Evidence Based Medicine.
Results
For the selected orthopedic diseases (medial and lateral epicondylitis, myofascial pain syndrome of the neck, back and shoulder and osteoarthritis), meta-analyses, systematic reviews and eight randomized controlled studies were found. All other published studies used laser therapy without consideration of classical acupuncture points. All studies had significant drawbacks in methodological quality and the number of patients included. In more recent trials, improvement towards higher methodological quality was obvious. Although current evidence is equivocal, positive effects can be assumed in myofascial pain syndromes of the neck, back and shoulder. Laser acupuncture is advantageous in terms of side effects compared to classical acupuncture techniques.
Conclusion
Better, well designed randomized studies with higher power are mandatory in orthopedic diseases.
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Schüller , B., Neugebauer, E. Evidenz zur Laserakupunktur bei orthopädischen Erkrankungen. Schmerz 22, 9–15 (2008). https://doi.org/10.1007/s00482-007-0546-3
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DOI: https://doi.org/10.1007/s00482-007-0546-3