Zinman Lorne H, Ngo Mylan, Ng Eduardo T, Nwe Khin T, Gogov Sven, Bril Vera
Toronto General Hospital, Toronto, Ontario, Canada.
Diabetes Care. 2004 Apr;27(4):921-4. doi: 10.2337/diacare.27.4.921.
Low-intensity laser therapy (LILT) has been advocated for treatment of chronic pain disorders. Although the mechanism of pain relief is uncertain, this therapy has been suggested for relief of painful symptoms of diabetic sensorimotor polyneuropathy (DSP). The objective of this study was to determine whether LILT relieves the pain of DSP.
We conducted a randomized, double-masked, sham therapy-controlled clinical trial in 50 patients with painful DSP diagnosed with the Toronto Clinical Neuropathy Score. All patients received sham therapy over a 2-week baseline period and were then randomized to receive biweekly sessions of either sham or LILT for 4 weeks. The primary efficacy parameter was the difference in the weekly mean pain scores on a visual analog scale (VAS).
The patients had similar baseline characteristics for pain intensity, HbA(1c), and duration of DSP. Both groups noted a decrease in weekly mean pain scores during sham treatment. After the 4-week intervention, the LILT group had an additional reduction in weekly mean pain scores of -1.0 +/- 0.4 compared with -0.0 +/- 0.4 for the sham group (P = 0.07). LILT had no effect on the Toronto Clinical Neuropathy Score, nerve conduction studies, sympathetic skin response, or quantitative sensory testing.
Although an encouraging trend was observed with LILT, the study results do not provide sufficient evidence to recommend this treatment for painful symptoms of DSP.
低强度激光疗法(LILT)已被推荐用于治疗慢性疼痛疾病。尽管疼痛缓解机制尚不确定,但该疗法已被建议用于缓解糖尿病感觉运动性多发性神经病变(DSP)的疼痛症状。本研究的目的是确定LILT是否能缓解DSP的疼痛。
我们对50例根据多伦多临床神经病变评分诊断为疼痛性DSP的患者进行了一项随机、双盲、假治疗对照的临床试验。所有患者在为期2周的基线期接受假治疗,然后随机分为两组,每两周分别接受假治疗或LILT治疗,为期4周。主要疗效参数是视觉模拟量表(VAS)上每周平均疼痛评分的差异。
患者在疼痛强度、糖化血红蛋白(HbA1c)和DSP病程方面具有相似的基线特征。两组在假治疗期间每周平均疼痛评分均有所下降。4周干预后,LILT组每周平均疼痛评分额外降低-1.0±0.4,而假治疗组为-0.0±0.4(P=0.07)。LILT对多伦多临床神经病变评分、神经传导研究、交感皮肤反应或定量感觉测试均无影响。
尽管LILT观察到了令人鼓舞的趋势,但研究结果并未提供足够证据推荐将该治疗用于DSP的疼痛症状。