HeNe激光联合超短波治疗对慢性膝骨关节炎患者疼痛因子及抗炎促炎因子的影响

Effects of HeNe laser combined with ultrashort wave therapy on pain factors and anti-inflammatory and pro-inflammatory factors in patients with chronic knee osteoarthritis

目的探究HeNe激光联合超短波治疗对慢性膝骨关节炎(KOA)患者疼痛因子及抗炎促炎因子的影响。方法采用前瞻性研究的方法,选取2018年1月至2019年12月北京市西城区西长安街社区卫生服务中心收治的108例慢性KOA患者为研究对象,采用随机数字表法分为对照组和观察组各54例,对照组给予超短波治疗,观察组给予HeNe激光联合超短波治疗。比较两组临床疗效、疼痛因子[前列腺素E2(PGE2)、P物质(SP)、多巴胺(DA)]、抗炎促炎因子[转化生长因子β1蛋白(TGF-β1)、肿瘤坏死因子-刺激基因(TSG-6)、白细胞介素(IL)-10、肿瘤坏死因子-α(TNF-α)、IL-6、IL-1β]水平及膝关节功能。结果观察组总有效率明显高于对照组[92.59%(50/54)比75.93%(41/54)](P<0.05);治疗后,观察组PGE_(2)、SP、DA、TGF-β1、TSG-6、IL-10、TNF-α、IL-6、IL-1β水平明显低于对照组[(2.50 ± 0.29) ng/L比(2.85 ± 0.32) ng/L、(1.55 ± 0.35) ng/L比(1.73 ± 0.36) ng/L、(12.46 ± 1.82) g/L比(15.25 ± 2.20) g/L、(12.46 ± 2.06) μg/L比(15.58 ± 2.89) μg/L、(6.02 ± 0.89) ng/L比(6.84 ± 0.92) ng/L、(13.64 ± 2.92) ng/L比(16.50 ± 3.15) ng/L、(38.82 ± 7.15) ng/L比(47.05 ± 8.53) ng/L、(21.92 ± 4.19) ng/L比(25.41 ± 5.08) ng/L、(26.49 ± 6.74) ng/L比(31.53 ± 7.95) ng/L],差异有统计学意义(P<0.05);观察组膝关节功能优良率明显高于对照组[(87.04% (47/54)比64.81%(35/54)],差异有统计学意义(P<0.05)。结论针对慢性KOA患者,HeNe激光联合超短波治疗具有更好的临床疗效,可缓解患者疼痛,调节机体因子失衡,改善膝关节功能。

Objective To investigate the effects of HeNe laser combined with ultrashort wave therapy on pain factors,anti-inflammatory and pro-inflammatory factors in patients with chronic knee osteoarthritis(KOA).Methods Using prospective research methods,108 patients with chronic KOA in Xicheng District Xichang′an Street Community Health Service Center from January 2018 to December 2019 were selected as the research objects,and randomly divided into control group and observation group,with 54 cases in each group.The control group was given shortwave treatment,while the observation group was given HeNe laser combined with ultra-short wave treatment.The clinical efficacy,levels of pain factors,anti-inflammatory and pro-inflammatory factors and knee function were compared between the two groups,and the pain factors including prostaglandin E2(PGE2),substance P(SP),dopamine(DA);the anti-inflammatory and pro-inflammatory factors including transforming growth factorβ1 protein(TGF-β1),tumor necrosis factor-stimulating gene(TSG-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β).Results The total effective rate of observation group was significantly higher than that of control group:92.59%(50/54)vs.75.93%(41/54),P<0.05.After treatment,the levels of PGE2,SP,DA,TGF-β1,TSG-6,IL-10,TNF-α,IL-6 and IL-1βin the observation group were significantly lower than those in the control group:(2.50±0.29)ng/L vs.(2.85±0.32)ng/L,(1.55±0.35)ng/L vs.(1.73±0.36)ng/L,(12.46±1.82)g/L vs.(15.25±2.20)g/L,(12.46±2.06)μg/L vs.(15.58±2.89)μg/L,(6.02±0.89)ng/L vs.(6.84±0.92)ng/L,(13.64±2.92)ng/L vs.(16.50±3.15)ng/L,(38.82±7.15)ng/L vs.(47.05±8.53)ng/L,(21.92±4.19)ng/L vs.(25.41±5.08)ng/L,(26.49±6.74)ng/L vs.(31.53±7.95)ng/L,P<0.05.After treatment,the levels of PGE2,SP,DA,TGF-β1,TSG-6,IL-10,TNF-α,IL-6 and IL-1βin the observation group were significantly lower than those in the control group(P<0.05).The excellent rate of knee function in the observation group was significantly higher than that in the control group:87.04%(47/54)vs.64.81%(35/54),P<0.05.Conclusions For patients with chronic KOA,HeNe laser combined with ultrashort wave therapy has better clinical efficacy,which can relieve pain,regulate the imbalance of body factors and improve the function of knee joint.