虚拟现实技术对颈部慢性疼痛患者干预效果的meta分析

doi:10.3969/j.issn.1004-583X.2025.09.001

摘要/Abstract

摘要：

目的评价虚拟现实技术干预对颈部慢性疼痛患者疼痛症状及康复管理的效果。方法通过计算机检索中国知网、维普、万方医学网、中国生物医学文献服务系统、PubMed、Web of Science、EMbase和the Cochrane Library数据库,检索时限为建库至2024年12月27日。两名研究人员独立对文献进行筛选、数据提取及质量评价,采用Stata 16.0软件进行meta分析。结果共纳入7篇研究,182例患者。Meta分析结果显示,虚拟现实技术干预对颈部慢性疼痛患者的疼痛程度(NRS评分, $M D$ =-2.16,95% $C I$ :-2.70,-1.62, $P$ <0.01;VAS评分, $M D$ =-1.42,95% $C I$ :-1.82,-1.01, $P$ <0.01)、颈部功能障碍(NDI评分, $M D$ =-3.85,95% $C I$ :-4.70,-3.00, $P$ <0.01)、运动恐惧(TSK评分, $M D$ =-2.29,95% $C I$ :-4.42,-0.16, $P$ <0.01)产生了显著改善效果。结论虚拟现实技术通过营造沉浸式虚拟环境和互动训练,可改善颈部慢性疼痛患者的疼痛程度、颈部功能障碍、运动恐惧。其在临床应用中的规范化和标准化,仍需进一步研究支持。

关键词: 颈痛, 虚拟现实技术, 慢性疼痛, Meta分析

Abstract:

Objective To evaluate the effect of virtual reality (VR)-based intervention on pain symptoms and rehabilitation management in patients with chronic neck pain. Methods Articles reporting VR-based interventions against chronic neck pain published from the establishment of the databases to December 27, 2024 were searched in China National Knowledge Infrastructure (CNKI), VIP, Wanfang Medical Database, China Biomedical Literature Service System, PubMed, Web of Science, EMbase, and the Cochrane Library. Two researchers independently screened the literatures, extracted data, and evaluated the quality. Meta-analysis was performed using Stata 16.0 software. Results A total of 7 studies involving 182 patients were included. The meta-analysis results showed that VR-based intervention significantly alleviated the pain intensity (the Numerical Rating Scale [NRS] score: $M D$ =-2.16, 95% $C I$ : -2.70, -1.62, $P$ <0.01; the Visual Analogue Scale [VAS] score: $M D$ =-1.42, 95% $C I$ : -1.82, -1.01, $P$ <0.01), neck dysfunction (Neck Disability Index [NDI]: $M D$ =-3.85, 95% $C I$ : -4.70, -3.00, $P$ <0.01), and kinesiophobia (Tampa Scale of Kinesiophobia [TSK] score: $M D$ =-2.29, 95% $C I$ : -4.42, -0.16, $P$ <0.01) in patients with chronic neck pain. Conclusion VR technology, by creating immersive virtual environments and interactive training, can improve the pain intensity, neck dysfunction, and kinesiophobia in patients with chronic neck pain. Its normalization and standardization in clinical application still need further research support.

Key words: neck pain, virtual reality technology, chronic pain, meta-analysis

中图分类号:

R747

鲜奇男, 徐弋雯, 李鑫, 孙妍. 虚拟现实技术对颈部慢性疼痛患者干预效果的meta分析[J]. 临床荟萃, 2025, 40(9): 773-780.

Xian Qinan, Xu Yiwen, Li Xin, Sun Yan. Intervention effect of virtual reality technology on chronic neck pain: A meta-analysis[J]. Clinical Focus, 2025, 40(9): 773-780.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2025.09.001

https://www.lchc.cn/CN/Y2025/V40/I9/773

图/表 11

图1 文献检索步骤

Fig.1 Procedure diagram of article screening

表1 纳入研究基本特征

Tab.1 Basic characteristics of the included studies

纳入研究	国家	样本量		疼痛性质	干预措施		干预时间	结局指标
纳入研究	国家	T	C	疼痛性质	T	C	干预时间	结局指标
Guo等^[14] 2024	中国	32	32	慢性颈部疼痛	VR康复加常规康复	常规康复	4周	① ③
Tejera等^[15] 2020	西班牙	22	22	慢性颈部疼痛	VR康复	常规康复	4周	②③④
Nusser等^[16] 2020	德国	17	20	慢性颈部疼痛	VR康复加常规康复	常规康复	3周	①③
I等^[17] 2019	伊朗	22	22	慢性颈部疼痛	VR康复	常规康复	4周	②③
Sarig Bahat等^[18] 2018	澳大利亚	48	51	慢性颈部疼痛	VR康复	无	4周	②③④
Emedoli等^[19] 2024	意大利	20	20	慢性颈部疼痛	VR康复加常规康复	常规康复	6周	①③④
Cetin等^[20] 2022	土耳其	21	20	慢性颈部疼痛	VR康复加常规康复	常规康复	6周	②

表2 偏倚风险评估结果

Tab.2 Results of bias risk assessment

纳入研究	随机方法	分配隐藏	研究者受试者施盲	结局盲法	结局数据完整	选择性报告研究结果	其他偏倚来源
Guo等^[14] 2024	低风险	低风险	高风险	不清楚	低风险	低风险	低风险
Tejera等^[15] 2020	不清楚	不清楚	高风险	低风险	低风险	低风险	低风险
Nusser等^[16] 2020	低风险	低风险	高风险	不清楚	低风险	低风险	低风险
I等^[17] 2019	低风险	低风险	高风险	低风险	低风险	低风险	不清楚
Sarig Bahat等^[18] 2018	低风险	低风险	高风险	不清楚	低风险	低风险	低风险
Emedoli等^[19] 2024	低风险	低风险	高风险	不清楚	低风险	低风险	不清楚
Cetin等^[20] 2022	不清楚	不清楚	高风险	不清楚	低风险	低风险	低风险

图2 偏倚风险图

Fig.2 Bias risk graph

图3 NRS量表森林图

Fig.3 Forest map of the NRS scale

图4 VAS量表森林图

Fig.4 Forest map of the VAS scale

图5 NDI量表森林图

Fig.5 Forest map of the NDI scale

图6 TSK量表森林图

Fig.6 Forest plot of the TSK scale

图7 NRS量表敏感性分析

Fig.7 Sensitivity analysis of the NRS scale

图8 VAS量表敏感性分析

Fig.8 Sensitivity analysis of VAS scale

表3 Egger检验结果

Tab.3 Egger test results

	$t$ 值	$P$ 值
NRS量表	1.73	0.33
VAS量表	2.00	0.18
NDI量表	0.16	0.88
TSK量表	4.14	0.15

表3 Egger检验结果

Tab.3 Egger test results

	$t$ 值	$P$ 值
NRS量表	1.73	0.33
VAS量表	2.00	0.18
NDI量表	0.16	0.88
TSK量表	4.14	0.15

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