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对于减少大鼠创伤所致急性骨骼肌损伤中促炎细胞因子释放而言,最佳治疗方法是什么:低强度激光疗法、双氯芬酸还是冷冻疗法?

What is the best treatment to decrease pro-inflammatory cytokine release in acute skeletal muscle injury induced by trauma in rats: low-level laser therapy, diclofenac, or cryotherapy?

作者信息

de Almeida Patrícia, Tomazoni Shaiane Silva, Frigo Lucio, de Carvalho Paulo de Tarso Camillo, Vanin Adriane Aver, Santos Larissa Aline, Albuquerque-Pontes Gianna Móes, De Marchi Thiago, Tairova Olga, Marcos Rodrigo Labat, Lopes-Martins Rodrigo Álvaro Brandão, Leal-Junior Ernesto Cesar Pinto

机构信息

Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil.

出版信息

Lasers Med Sci. 2014 Mar;29(2):653-8. doi: 10.1007/s10103-013-1377-3. Epub 2013 Jun 30.

Abstract

Currently, treatment of muscle injuries represents a challenge in clinical practice. In acute phase, the most employed therapies are cryotherapy and nonsteroidal anti-inflammatory drugs. In the last years, low-level laser therapy (LLLT) has becoming a promising therapeutic agent; however, its effects are not fully known. The aim of this study was to analyze the effects of sodium diclofenac (topical application), cryotherapy, and LLLT on pro-inflammatory cytokine levels after a controlled model of muscle injury. For such, we performed a single trauma in tibialis anterior muscle of rats. After 1 h, animals were treated with sodium diclofenac (11.6 mg/g of solution), cryotherapy (20 min), or LLLT (904 nm; superpulsed; 700 Hz; 60 mW mean output power; 1.67 W/cm(2); 1, 3, 6 or 9 J; 17, 50, 100 or 150 s). Assessment of interleukin-1β and interleukin-6 (IL-1β and IL-6) and tumor necrosis factor-alpha (TNF-α) levels was performed at 6 h after trauma employing enzyme-linked immunosorbent assay method. LLLT with 1 J dose significantly decreased (p < 0.05) IL-1β, IL-6, and TNF-α levels compared to non-treated injured group as well as diclofenac and cryotherapy groups. On the other hand, treatment with diclofenac and cryotherapy does not decrease pro-inflammatory cytokine levels compared to the non-treated injured group. Therefore, we can conclude that 904 nm LLLT with 1 J dose has better effects than topical application of diclofenac or cryotherapy in acute inflammatory phase after muscle trauma.

摘要

目前,肌肉损伤的治疗在临床实践中是一项挑战。在急性期,最常用的治疗方法是冷冻疗法和非甾体类抗炎药。近年来,低强度激光疗法(LLLT)已成为一种有前景的治疗手段;然而,其效果尚未完全明确。本研究的目的是分析双氯芬酸钠(局部应用)、冷冻疗法和LLLT对肌肉损伤对照模型后促炎细胞因子水平的影响。为此,我们对大鼠胫前肌进行单次创伤。1小时后,动物分别接受双氯芬酸钠(11.6mg/g溶液)、冷冻疗法(20分钟)或LLLT(904nm;超脉冲;700Hz;平均输出功率60mW;1.67W/cm²;1、3、6或9J;17、50、100或150秒)治疗。在创伤后6小时采用酶联免疫吸附测定法评估白细胞介素-1β和白细胞介素-6(IL-1β和IL-6)以及肿瘤坏死因子-α(TNF-α)水平。与未治疗的损伤组以及双氯芬酸钠和冷冻疗法组相比,1J剂量的LLLT显著降低(p<0.05)IL-1β、IL-6和TNF-α水平。另一方面,与未治疗的损伤组相比,双氯芬酸钠和冷冻疗法治疗并未降低促炎细胞因子水平。因此,我们可以得出结论,1J剂量的904nm LLLT在肌肉创伤后的急性炎症期比双氯芬酸钠局部应用或冷冻疗法具有更好的效果。

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