Yurtkuran M, Alp A, Konur S, Ozçakir S, Bingol U
Division of Rheumatology, Uludag University Atatürk Rehabilitation Center, Bursa, Turkey.
Photomed Laser Surg. 2007 Feb;25(1):14-20. doi: 10.1089/pho.2006.1093.
The purpose of this study was to investigate the effects and minimum effective dose of laser acupuncture in knee osteoarthritis (KOA), and to determine if it is superior to placebo treatment (sham) in the evaluation of clinical-functional outcome and quality of life.
In this randomized, placebo-controlled study, patients with grade 2 and 3 primary KOA were selected. Group I (n = 27) received 904-nm low-level laser irradiation with 10 mW/cm(2) power density, 4 mW output power, 0.4 cm(2) spot size, 0.48 J dose per session, and 120-sec treatment time on the medial side of the knee to the acupuncture point Sp9. Group II (n = 25) received placebo-laser therapy at the same place on the same point. Patients in both of the groups had treatment 5 days per week (total duration of therapy was 10 days) and 20 min per day. The study was comprised of a 2-week (10-session) intervention. Participants were evaluated before treatment (baseline), after treatment (2nd week), and at the 12th week. In this double-blind study, a blind examiner carried out all outcome assessments. The main outcome measures were as follows: pain on movement (pVAS), 50-foot walking time (50 foot w), knee circumference (KC), medial tenderness score (MTS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and Nottingham Health Profile (NHP).
Statistically significant improvement was observed in PVAS, 50 foot w, and KC in group 1. In Group II, statistically significant improvement was observed in PVAS, 50 foot w, and WOMAC. When groups were compared with each other, the improvement observed in KC was superior in Group I at the 2(nd) week (p = 0.005).
Laser acupuncture was found to be effective only in reducing periarticular swelling when compared with placebo laser.
本研究旨在探讨激光针刺对膝骨关节炎（KOA）的疗效及最小有效剂量，并确定在临床功能结局和生活质量评估方面，其是否优于安慰剂治疗（假针刺）。
在这项随机、安慰剂对照研究中，选取2级和3级原发性KOA患者。第一组（n = 27）接受904纳米低强度激光照射，功率密度为10毫瓦/平方厘米，输出功率为4毫瓦，光斑大小为0.4平方厘米，每次治疗剂量为0.48焦耳，治疗时间为120秒，照射膝关节内侧的三阴交穴位。第二组（n = 25）在同一点的相同位置接受安慰剂激光治疗。两组患者均每周治疗5天（治疗总时长为10天），每天治疗20分钟。该研究包括为期2周（10次治疗）的干预。在治疗前（基线）、治疗后（第2周）和第12周对参与者进行评估。在这项双盲研究中，由一名盲法检查者进行所有结局评估。主要结局指标如下：运动时疼痛（视觉模拟评分法，pVAS）、50英尺步行时间（50 foot w）、膝关节周长（KC）、内侧压痛评分（MTS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及诺丁汉健康概况（NHP）。
第一组在pVAS、50 foot w和KC方面观察到具有统计学意义的改善。在第二组中，在pVAS、50 foot w和WOMAC方面观察到具有统计学意义的改善。当两组相互比较时，在第2周时第一组在KC方面的改善更显著（p = 0.005）。
与安慰剂激光相比，发现激光针刺仅在减轻关节周围肿胀方面有效。
