低水平激光治疗缺血性心脏病患者的康复:循证研究综述

Реабилитации Больных, ишемической болезнью, Сердца Обзор, Доказательных Исследований, Л.Я. Васильева-Линецкая
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引用次数: 1

摘要

心脏康复是20世纪下半叶心脏病学和物理康复医学的主要成果之一。基于循证医学的方法论,心脏康复在短时间内从一个“虚构的”“替代的”未经证实的治疗方向演变为完全没有争议和证实的多学科项目。本文介绍了缺血性心脏病患者低强度激光治疗的心脏康复的最新发现,并分析了低强度激光治疗效果的循证实验和临床研究。目的:探讨低水平激光治疗在缺血性心脏病患者康复中的应用的循证研究,并分析其主要主张和建议。材料和方法。在PEDro、EMBASE、PubMed和Cochrane图书馆电子数据库中检索2000-2019年间的随机临床试验、系统评价、荟萃分析和临床方案。结果与讨论:仔细考虑实验和临床研究,分析以下发现:低水平激光治疗的作用机制,对心肌重塑、减少梗死面积、预防再狭窄的积极影响,并具有心脏保护作用。光生物调节在外科手术和经皮心肌血运重建术中的应用以及在无创心脏科和物理康复医学中的临床循证研究受到了更多的关注。结论:评价低水平激光治疗缺血性心脏病患者康复的疗效,应定期分析已有的研究,并实现新的循证调查。
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Low-level laser therapy in rehabilitation of patients with ischemic heart disease: review of evidence-based studies
Cardiac rehabilitation is one of the main achievements of cardiology and physical rehabilitation medicine in the second half of the 20th century. Based on the methodology of evidence-based medicine, cardiac rehabilitation in a short time evolved from a “fictional” “alternative” unproven treatment direction to completely uncontested and proven multidisciplinary programs. This article presents contemporary findings on cardiorehabilitation and analysis of evidence-based experimental and clinical studies of low-level laser therapy efficiency in patients with ischemic heart disease. Aim. To search for evidence-based investigations on application of low-level laser therapy for rehabilitation of patients with ischemic heart disease and to analyze their major propositions and recommendations.Materials and methods. PEDro, EMBASE, PubMed and Cochrane library electronic databases were searched for randomized clinical trials, systematic reviews, meta-analyses and clinical protocols using the key words within 2000–2019 years. Results and discussion: experimental and clinical investigations were carefully considered and the following findings were analyzed: action mechanisms of low-level laser therapy, its positive influence on myocardial remodeling, infarction area reduction, restenosis prevention and presented cardioprotective effect. More attention was focused at clinical evidence-based studies on application of photobiomodulation in order to increase the efficacy of surgical and percutaneous myocardial revascularization, and in non-invasive cardiology and physical rehabilitation medicine. Conclusion: regular analysis of performed studies and realization of new evidence-based investigation should be conducted to evaluate the efficiency of low-level laser therapy in rehabilitation of patients with ischemic heart disease.
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