激光穴位照射佐剂性关节炎大鼠的生物效应累积及其镇痛疗效观察

Observations on the Cumulative Biological Effect of Acupoint Laser Radiation and Its Analgesic Effect in Adjuvant Arthritis Rats

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-?、IFN-?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-?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-?含量趋于平缓,而针刺治疗第5天到第7天IFN-?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-?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-?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。

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＆#39;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.＆amp;nbsp;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.