CAJ | 학술논문

目的：采用半导体激光照射与针刺急性佐剂性关节炎大鼠足三里穴疗效对比,探究激光穴位照射的生物累积效应的机制,观察其镇痛疗效,为临床使用半导体激光治疗急性关节炎性痛的疗程提供实验理论基础和依据。方法大鼠足趾皮下注射完全弗氏佐剂建立AA大鼠模型。将80只大鼠随机分为8组,分别为模型组、空白组,激光照射和针刺3 d治疗组、5 d治疗组、7 d治疗组,每组10只。3组激光组分别用650 nm半导体激光照射,3组针刺组分别用毫针针刺穴位,穴位均选用致炎患侧足三里穴。观察大鼠的一般情况,体重、痛阈值、踝关节肿胀度,并采用ELISA法检测血清炎性因子IL-1、TNF-α、IFN-γ的含量变化。结果治疗后激光治疗组与针刺治疗组大鼠的体重、关节肿胀度以及痛阈都具有统计学差异(P＜0.05)；其中激光治疗3 d、5 d、7 d3组的关节肿胀度相比具有统计学差异(P＜0.05)；激光3 d治疗组与针刺3 d治疗组的痛阈均在治疗第5天出现最低值,治疗第7天有所上升。激光治疗组与针刺治疗组IL-1含量整体呈下降趋势,在治疗第3天到第5天均呈下降趋势,而激光治疗组在治疗第7天达到最低值,针刺治疗组却呈明显上升趋势；激光治疗组与针刺治疗组 IFN-γ含量在治疗第3天到第5天呈上升趋势,激光治疗组治疗第5天到第7天IFN-γ含量趋于平缓,而针刺治疗第5天到第7天IFN-γ含量呈下降趋势,但仍高于针刺3 d治疗组；激光治疗组与针刺治疗组TNF-α含量在治疗第3天到第5天呈下降趋势,激光治疗组第5天到第7天下降趋于平缓,针刺治疗组第5天到第7天TNF-α含量却呈轻微上升趋势。结论半导体激光照射和针刺足三里都具有一定消炎镇痛作用,都能使 AA 大鼠一般症状减轻,但半导体激光照射消炎镇痛作用明显优于针刺疗法,且疗效更加及时有效。半导体激光穴位照射治疗后,AA 大鼠相关血清细胞因子均在治疗出现转折点后呈缓慢增长或者下降趋势,即体现了激光照射治疗具有抛物线特征,说明随激光照射时长的增加,激光生物效应的产生累积,提示在激光治疗过程中要重视累积作用。目的：採用半導體激光照射與針刺急性佐劑性關節炎大鼠足三裏穴療效對比,探究激光穴位照射的生物纍積效應的機製,觀察其鎮痛療效,為臨床使用半導體激光治療急性關節炎性痛的療程提供實驗理論基礎和依據。方法大鼠足趾皮下註射完全弗氏佐劑建立AA大鼠模型。將80隻大鼠隨機分為8組,分彆為模型組、空白組,激光照射和針刺3 d治療組、5 d治療組、7 d治療組,每組10隻。3組激光組分彆用650 nm半導體激光照射,3組針刺組分彆用毫針針刺穴位,穴位均選用緻炎患側足三裏穴。觀察大鼠的一般情況,體重、痛閾值、踝關節腫脹度,併採用ELISA法檢測血清炎性因子IL-1、TNF-α、IFN-γ的含量變化。結果治療後激光治療組與針刺治療組大鼠的體重、關節腫脹度以及痛閾都具有統計學差異(P＜0.05)；其中激光治療3 d、5 d、7 d3組的關節腫脹度相比具有統計學差異(P＜0.05)；激光3 d治療組與針刺3 d治療組的痛閾均在治療第5天齣現最低值,治療第7天有所上升。激光治療組與針刺治療組IL-1含量整體呈下降趨勢,在治療第3天到第5天均呈下降趨勢,而激光治療組在治療第7天達到最低值,針刺治療組卻呈明顯上升趨勢；激光治療組與針刺治療組 IFN-γ含量在治療第3天到第5天呈上升趨勢,激光治療組治療第5天到第7天IFN-γ含量趨于平緩,而針刺治療第5天到第7天IFN-γ含量呈下降趨勢,但仍高于針刺3 d治療組；激光治療組與針刺治療組TNF-α含量在治療第3天到第5天呈下降趨勢,激光治療組第5天到第7天下降趨于平緩,針刺治療組第5天到第7天TNF-α含量卻呈輕微上升趨勢。結論半導體激光照射和針刺足三裏都具有一定消炎鎮痛作用,都能使 AA 大鼠一般癥狀減輕,但半導體激光照射消炎鎮痛作用明顯優于針刺療法,且療效更加及時有效。半導體激光穴位照射治療後,AA 大鼠相關血清細胞因子均在治療齣現轉摺點後呈緩慢增長或者下降趨勢,即體現瞭激光照射治療具有拋物線特徵,說明隨激光照射時長的增加,激光生物效應的產生纍積,提示在激光治療過程中要重視纍積作用。
목적：채용반도체격광조사여침자급성좌제성관절염대서족삼리혈료효대비,탐구격광혈위조사적생물루적효응적궤제,관찰기진통료효,위림상사용반도체격광치료급성관절염성통적료정제공실험이론기출화의거。방법대서족지피하주사완전불씨좌제건립AA대서모형。장80지대서수궤분위8조,분별위모형조、공백조,격광조사화침자3 d치료조、5 d치료조、7 d치료조,매조10지。3조격광조분별용650 nm반도체격광조사,3조침자조분별용호침침자혈위,혈위균선용치염환측족삼리혈。관찰대서적일반정황,체중、통역치、과관절종창도,병채용ELISA법검측혈청염성인자IL-1、TNF-α、IFN-γ적함량변화。결과치료후격광치료조여침자치료조대서적체중、관절종창도이급통역도구유통계학차이(P＜0.05)；기중격광치료3 d、5 d、7 d3조적관절종창도상비구유통계학차이(P＜0.05)；격광3 d치료조여침자3 d치료조적통역균재치료제5천출현최저치,치료제7천유소상승。격광치료조여침자치료조IL-1함량정체정하강추세,재치료제3천도제5천균정하강추세,이격광치료조재치료제7천체도최저치,침자치료조각정명현상승추세；격광치료조여침자치료조 IFN-γ함량재치료제3천도제5천정상승추세,격광치료조치료제5천도제7천IFN-γ함량추우평완,이침자치료제5천도제7천IFN-γ함량정하강추세,단잉고우침자3 d치료조；격광치료조여침자치료조TNF-α함량재치료제3천도제5천정하강추세,격광치료조제5천도제7천하강추우평완,침자치료조제5천도제7천TNF-α함량각정경미상승추세。결론반도체격광조사화침자족삼리도구유일정소염진통작용,도능사 AA 대서일반증상감경,단반도체격광조사소염진통작용명현우우침자요법,차료효경가급시유효。반도체격광혈위조사치료후,AA 대서상관혈청세포인자균재치료출현전절점후정완만증장혹자하강추세,즉체현료격광조사치료구유포물선특정,설명수격광조사시장적증가,격광생물효응적산생루적,제시재격광치료과정중요중시루적작용。
Objective To explore the mechanism of the cumulative biological effect of acupoint laser radiation and investigate its analgesic effect by comparing the therapeutic effects of semiconductor laser radiation versus acupuncture at point Zusanli(ST36) in acute adjuvant arthritis rats and to provide the experiment-based theoretical foundation and basis for the course of treatment of acute arthritis pain by clinical use of semiconductor laser. Method A rat model of AA was made by subcutaneous injection of complete Freund's adjuvant into rat toe. Eighty rats were randomly allocated to eight groups:model, blank, three-day laser radiation, five-day laser radiation, seven-day laser radiation, three-day acupuncture, five-day acupuncture and seven-day acupuncture treatment groups, 10 rats each. The three laser groups separately received 650 nm semiconductor laser radiation. The three acupuncture groups separately received acupuncture with a filiform needle at point Zusanli(ST36) on the inflammation-affected side. Rat general condition, body weight, pain threshold value and ankle swelling degree were observed. Serum inflammatory factors IL-1、TNF-αand IFN-γcontents were measured by ELISA. Result There were statistically significant posttreatment differences in body weight, joint swelling degree and pain threshold between the laser treatment and acupuncture treatment groups of rats (P<0.05). There was a statistically significant post-treatment difference in joint swelling degree between three-day laser, five-day laser and seven-day laser treatment groups (P<0.05). Pain threshold was lowest at five days after treatment and increased somewhat at seven days after treatment in both the three-day laser and three-day acupuncture treatment groups. The IL-1 content tended to decrease on the whole and had a decreasing tendency at three and five days after treatment in both laser and acupuncture treatment groups. At seven days after treatment, it reached the lowest value in the laser treatment group but had a marked increasing tendency in the acupuncture treatment group. The IFN-γcontent had an increasing tendency at three and five days after treatment in both laser and acupuncture treatment groups. The IFN-γcontent tended to change gently in the laser treatment group from day five to seven after treatment. It tended to decrease from day five to seven after acupuncture treatment but was still higher than in the three-day acupuncture treatment group. The TNF-αcontent tended to decrease from day three to five after treatment in both laser and acupuncture treatment groups. From day five to seven after treatment, it tended to decrease gently in the laser treatment group but tended to increase slightly in the acupuncture treatment group. Conclusion Both semiconductor laser radiation and acupuncture at point Zusanli have an anti-inflammatory and analgesic effect and can relieve the general symptoms in AA rats, but semiconductor laser radiation is significantly superior to acupuncture treatment in eliminating inflammation and easing pain and produces a more timely and better therapeutic effect. After semiconductor laser radiation at acupoints, the related serum cytokines tended to increase or decrease slowly in AA rats after the turning point appeared during the treatment, which embodies the parabola feature of laser radiation treatment. It is showed that with an increase in laser radiation length, the biological effect of laser accumulates, suggesting that attention should be paid to the cumulative effect during laser treatment.