低强度激光对退役军人骨质疏松患者骨代谢和应激反应的作用

Effect of low intensity laser on bone metabolism and stress response in veterans with osteoporosis

目的探究退役军人骨质疏松患者应用低强度激光对骨代谢、氧化应激及炎症因子的影响。方法选取火箭军特色医学中心2017年6月至2022年6月收治的退役军人骨质疏松患者234例,依据随机数字表法将其分为单纯治疗组、激光辅助治疗组,每组117例。单纯治疗组予常规药物治疗,激光辅助治疗组在常规药物治疗基础上再进行低强度激光干预。监测两组患者的骨密度、疼痛评分、骨代谢指标[骨钙素(BGP)、骨特异性碱性磷酸酶(B⁃ALP)、Ⅰ型胶原羧基端肽(CTX)]、氧化应激指标[超氧化物歧化酶(SOD)、晚期氧化蛋白产物(AOPP)]、炎症因子指标[肿瘤坏死因子⁃α(TNF⁃α)、胰岛素样生长因子1(IGF⁃1)、白细胞介素⁃6(IL⁃6)]等数值。通过比较以上数值评估低强度激光对于骨质疏松治疗的应用价值。结果治疗后,两组患者腰椎L2⁃4、股骨颈骨密度均上升,激光辅助治疗组指标值高于单纯治疗组(t=-1.245、12.376,P<0.001)。治疗后,两组患者疼痛评分均显著下降;与单纯治疗组相比,激光辅助治疗组疼痛评分下降更明显(t=-3.953,P<0.001)。治疗后,两组患者BGP升高,B⁃ALP、CTX水平降低;激光辅助治疗组BGP升高更明显,B⁃ALP、CTX水平降低更明显(t=15.945、-17.992、-8.886,P<0.001)。治疗后,两组患者TNF⁃α、LI⁃6水平降低,IGF⁃1升高;激光辅助治疗组TNF⁃α、LI⁃6水平降低更明显,IGF⁃1升高更明显(t=-20.165、-19.844、13.403,P<0.05)。结论与常规治疗方案相比,辅助以低强度激光治疗对退役军人骨质疏松患者骨密度、疼痛、骨代谢、氧化应激及炎症因子等的改善程度更高,值得临床推广。

Objective To examine the impact of low⁃intensity laser therapy on bone metabolism,oxidative stress levels,and inflammatory factors in veterans diagnosed with osteoporosis.Methods A total of 234 veterans with osteoporosis,who were admitted to our hospital between June 2017 and June 2022,were randomly assigned to two groups:the Simple Treatment Group(STG)and the Laser Adjuvant Treatment Group(ATG).Each group consisted of 117 patients.The STG received standard drug treatment,while the ATG received low⁃intensity laser intervention in addition to the standard drug treatment.The following parameters were monitored and compared between the two groups:bone density,pain score,bone metabolism indicators[including osteocalcin(BGP),bone specific alkaline phosphatase(B⁃ALP),and typeⅠcollagen carboxy terminal peptide(CTX)],oxidative stress indexes[including superoxide dismutase(SOD)and advanced oxidation protein product(AOPP)],and inflammatory factors[including tumor necrosis factor⁃α(TNF⁃α),insulin⁃like growth factor 1(IGF⁃1),and interleukin⁃6(IL⁃6)].The therapeutic efficacy of low⁃intensity laser in the treatment of osteoporosis was assessed by comparing the aforementioned indicators between the two groups.Results After treatment,both groups experienced an increase in bone density at the lumbar spine L2⁃4 and femoral neck.However,the ATG demonstrated significantly higher index values compared to the STG(t=-1.245,12.376,P<0.001).After treatment,both groups exhibited a significant reduction in pain scores.Notably,the ATG demonstrated a more substantial decrease in pain scores compared to the STG(t=-3.953,P<0.001).After treatment,the levels of BGP increased,while B⁃ALP and CTX decreased in both groups.However,the ATG exhibited higher levels of BGP and lower levels of B⁃ALP and CTX(t=15.945,-17.992,-8.886,P<0.001).After treatment,both groups experienced decreased levels of TNF⁃αand IL⁃6 and increased levels of IGF⁃1.However,the ATG demonstrated lower levels of TNF⁃αand IL⁃6 and higher levels of IGF⁃1 compared to the STG(t=-20.165,-19.844,13.403,P<0.05).Conclusion In conclusion,low intensity laser assisted therapy demonstrates a greater degree of improvement in various aspects such as bone density,pain,bone metabolism,oxidative stress,and inflammatory factors,when compared to traditional treatment regimens.These promising results highlight the potential of this therapy for clinical application in veterans with osteoporosis.