Adly Afnan Sedky, Adly Aya Sedky, Adly Mahmoud Sedky, Serry Zahra M H
Medical Applications of Laser in Physical Medicine, Physical Therapy for Cardiovascular-Respiratory Disorders and Geriatrics, Cairo University Kasr El Aini Medical School, Cairo, Egypt.
Computer Science, Biomedical Informatics, Helwan University Faculty of Computers and Information, Cairo, Egypt.
Lasers Med Sci. 2017 Jul;32(5):1097-1103. doi: 10.1007/s10103-017-2213-y. Epub 2017 Apr 27.
The purposes of this study are to determine and compare efficacy of laser acupuncture versus reflexology in elderly with rheumatoid arthritis. Thirty elderly patients with rheumatoid arthritis aged between 60 and 70 years were classified into two groups, 15 patients each. Group A received laser acupuncture therapy (904 nm, beam area of 1cm, power 100 mW, power density 100 mW/cm, energy dosage 4 J, energy density 4 J/cm, irradiation time 40 s, and frequency 100,000 Hz). The acupuncture points that were exposed to laser radiation are LR3, ST25, ST36, SI3, SI4, LI4, LI11, SP6, SP9, GB25, GB34, and HT7. While group B received reflexology therapy, both offered 12 sessions over 4 weeks. The changes in RAQoL, HAQ, IL-6, MDA, ATP, and ROM at wrist and ankle joints were measured at the beginning and end of treatment. There was significant decrease in RAQoL, HAQ, IL-6, and MDA pre/posttreatment for both groups (p < 0.05); significant increase in ATP pre/posttreatment for both groups (p < 0.05); significant increase in ankle dorsi-flexion, plantar-flexion, wrist flexion, extension, and ulnar deviation ROM pre/posttreatment in group A (p < 0.05); and significant increase in ankle dorsi-flexion and ankle plantar-flexion ROM pre/posttreatment in group B (p < 0.05). Comparison between both groups showed a statistical significant decrease in MDA and a statistical significant increase in ATP in group A than group B. Percent of changes in MDA was 41.82%↓ in group A versus 21.68%↓ in group B; changes in ATP was 226.97%↑ in group A versus 67.02%↑ in group B. Moreover, there was a statistical significant increase in ankle dorsi-flexion, ankle plantar-flexion, wrist flexion, wrist extension, and radial deviation in group A than group B. Laser therapy is associated with significant improvement in MDA and ATP greater than reflexology. In addition, it is associated with significant improvement in ankle dorsi-flexion, ankle plantar-flexion, wrist flexion, wrist extension, and radial deviation greater than reflexology in elderly patients with rheumatoid arthritis.
本研究的目的是确定并比较激光针灸与反射疗法对老年类风湿性关节炎患者的疗效。30名年龄在60至70岁之间的老年类风湿性关节炎患者被分为两组，每组15名。A组接受激光针灸治疗（904纳米，光束面积1平方厘米，功率100毫瓦，功率密度100毫瓦/平方厘米，能量剂量4焦耳，能量密度4焦耳/平方厘米，照射时间40秒，频率100,000赫兹）。接受激光辐射的穴位有肝经3穴、胃经25穴、胃经36穴、小肠经3穴、小肠经4穴、大肠经4穴、大肠经11穴、脾经6穴、脾经9穴、胆经25穴、胆经34穴和心经7穴。而B组接受反射疗法，两组均在4周内进行12次治疗。在治疗开始和结束时测量类风湿性关节炎患者生活质量（RAQoL）、健康评估问卷（HAQ）、白细胞介素-6（IL-6）、丙二醛（MDA）、三磷酸腺苷（ATP）以及手腕和踝关节活动度（ROM）的变化。两组治疗前后RAQoL、HAQ、IL-6和MDA均有显著下降（p<0.05）；两组治疗前后ATP均有显著升高（p<0.05）；A组治疗前后踝关节背屈、跖屈、手腕屈曲、伸展和尺侧偏斜的ROM有显著增加（p<0.05）；B组治疗前后踝关节背屈和跖屈的ROM有显著增加（p<0.05）。两组比较显示，A组的MDA有统计学意义的显著下降，ATP有统计学意义的显著升高，且优于B组。A组MDA的变化百分比下降41.82%，而B组下降21.68%；A组ATP的变化为升高226.97%，而B组升高67.02%。此外，A组踝关节背屈、跖屈、手腕屈曲、手腕伸展和桡侧偏斜的增加幅度在统计学上显著高于B组。与反射疗法相比，激光疗法能使MDA和ATP有更显著的改善。此外，与反射疗法相比，激光疗法能使老年类风湿性关节炎患者的踝关节背屈、跖屈、手腕屈曲、手腕伸展和桡侧偏斜有更显著的改善。
