Low level laser therapy for treating tuberculosis

 

Abstract

Background

The main treatment for tuberculosis is antituberculous drugs. Low level laser therapy is used as an adjunct to antituberculous drugs, predominantly in the former Soviet Union and India.

Objectives

To compare low level laser therapy plus antituberculous drugs with antituberculous drugs alone for treating tuberculosis.

Search methods

We searched the Cochrane Infectious Diseases Group Specialized Register (October 2009), CENTRAL (The Cochrane Library 2009, Issue 4), MEDLINE (1966 to October 2009), EMBASE (1974 to October 2009), CINAHL (1982 to October 2009), Science Citation Index (1945 to October 2009), PEDro (1929 to October 2009 ), the Central Medical Library of Moscow catalogue (1988 to April 2009), the Internet, hand search of the journal Probl. Tuberk. Bolezn. Legk. (1980 to April 2009), where most relevant articles were published in previous years, and searched reference lists of articles. We contacted relevant organizations and researchers for the original version.

Selection criteria

Randomized trials comparing low level laser therapy plus antituberculous drugs with antituberculous drugs alone in people with tuberculosis.

Data collection and analysis

Two authors independently assessed trial quality and extracted data, including adverse events.

Main results

One randomized controlled trial (130 participants) conducted in India met the inclusion criteria. This trial was poorly reported, with no information on the generation of allocation sequence or allocation concealment. The trial report did not provide details on the group that each of the participants were randomized into or which group those participants that left the trial were from. This precluded the use of its data on time to sputum conversion and other outcome measures for analysis.

Authors' conclusions

The use of low level laser therapy for treating tuberculosis is still not supported by reliable evidence. Researchers need to focus on conducting well-designed randomized controlled trials to justify the continued participation of volunteers for studies of this experimental intervention.

 

Plain language summary

Not enough evidence to support using low level laser therapy alongside drug treatments for tuberculosis

Tuberculosis (TB) is a serious bacterial infection that can affect different parts of the body; most frequently it affects the lungs (pulmonary TB). Some bacteria can be drug resistant, and some people may have the infection alongside another medical condition. People suffer from severe cough, weakness and sweats, and some people still die from TB even though effective drug treatment has been around for many years. It is has been proposed that low level laser therapy may help the drugs to be more effective. There are a number of different devices for giving the laser treatment, some giving the treatment externally (to the body or acupuncture sites), some using for internal treatment (for blood or lungs) at varying doses. The review of trials found only one randomized trial where the data were poorly reported, and it did not clarify the potential benefits and harms. Low level laser therapy should only be used in randomized controlled trials until its value is evaluated.

 

摘要

背景

以低能量雷射療法治療結核病

治療結核病主要的方法就是抗結核病藥物。低能量雷射療法已經被用來當作抗結核病藥物的1種輔助治療，主要使用者為前蘇維埃聯合大公國與印度。

目標

比較低能量雷射療法加上抗結核病藥物與單獨使用抗結核病藥物治療結核病。

搜尋策略

我們搜尋Cochrane Infectious Diseases Group Specialized Register (October 2009)、 CENTRAL (Cochrane Library 2009, Issue 4)、 MEDLINE (1966年−2009年10月)、 EMBASE (1974年−2009年10月)、 CINAHL (1982年−2009年10月)、 Science Citation Index (1945年−2009年10月)、 PEDro (1929年−2009年10月)、 Central Medical Library of Moscow catalogue (1988年−2009年4月)、 網路、人工搜尋Probl. Tuberk. Bolezn. Legk.等期刊(1980年 – 2009年4月)，而這些期刊是之前發表最多相關文章的期刊，並且搜尋文章的參考資料清單。我們與相關機構以及研究人員聯繫以取得原始的版本。

選擇標準

低能量雷射療法加上抗結核病藥物與單獨使用抗結核病藥物進行比較的隨機臨床試驗。

資料收集與分析

兩位作者獨立地評估了試驗的品質並擷取出資料，其中包括不良事件。

主要結論

壹項在印度所進行的隨機對照試驗(130名參與者)符合了收案標準。這份試驗並沒有被妥善地報告，其中針對如何產生分配的順序或是分配當中的隱藏方式，都沒有提供相關的資訊。每1位參與者被隨機分配到哪個組別，或是那些離開該試驗的參與者來自於哪個組別也都沒有提供。這種情況導致痰陰轉時間方面的資料以及其他應分析的結果測量均無法使用。

作者結論

目前仍沒有可靠的證據能夠支持我們使用低能量的雷射療法治療結核病。研究人員需要將焦點集中在執行妥善設計過的隨機對照試驗以對志願者的持續參與實驗性治療來負責。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

並沒有足夠的證據支持將低能量的雷射療法合併藥物一起使用治療結核病：結核病(TB)是1種嚴重的細菌性感染病，它可能會影響到身體的各個不同部位；最常見的情況是它會對肺部造成影響(肺結核)。某些細菌可能會產生抗藥性，而且有些病人除了感染之外，還會合併發生其他醫療方面的問題。人們會受到嚴重咳嗽、虛弱，以及冒汗的困擾，而且即便是有效的藥物治療以經流傳了許多年，但有些人還是會因為結核病而身亡。低能量的雷射治療被認為或許可以幫助這些藥物發揮更大的功效。有很多種不同的設備可以用來進行雷射治療，有一些是在外部給予治療(針對身體或是針灸的穴位)，有些是用來以不同的劑量來進行內部的治療(針對血液或是肺部)。本篇回顧發現在僅有的1份隨機試驗當中，這些資料並沒有被妥善地報告出來，而且它也沒有釐清各項優點與危害。除非其價值已被清楚評估，低能量雷射療法應該只能在隨機對照試驗中使用。