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一种用于系统性硬化症中手指溃疡的新型低强度光疗法的可行性研究。

A feasibility study of a novel low-level light therapy for digital ulcers in systemic sclerosis.

作者信息

Hughes M, Moore T, Manning J, Wilkinson J, Watson S, Samraj P, Dinsdale G, Roberts C, Rhodes L E, Herrick A L, Murray A

机构信息

a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK.

b Department of Rheumatology , Salford Royal NHS Foundation Trust , Salford , UK.

出版信息

J Dermatolog Treat. 2019 May;30(3):251-257. doi: 10.1080/09546634.2018.1484875. Epub 2018 Jul 31.

Abstract

BACKGROUND

Locally acting, well-tolerated treatments for systemic sclerosis (SSc) digital ulcers (DUs) are needed.

OBJECTIVES

Our primary aim was to investigate the safety, feasibility, and tolerability of a novel low-level light therapy (LTTT). A secondary aim was to tentatively assess efficacy.

METHODS

A custom-built device comprising infrared (850 nm), red (660 nm), and violet (405 nm) LEDs was utilized. DUs were irradiated with 10 J/cm twice weekly for 3 weeks, with follow-up at weeks 4 and 8. Any safety concerns were documented. Patient opinion on time to deliver, feasibility, and pain visual analogue score (VAS; 0-100, 100 most severe) was collected. Patient and clinician DU global assessment VAS were documented. DUs were evaluated by laser Doppler perfusion imaging pre- and post-irradiation.

RESULTS

In all, 14 DUs in eight patients received a total of 46 light exposures, with no safety concerns. All patients considered LTTT 'took just the right amount of time' and was 'feasible', with a low associated mean pain VAS of 1.6 (SD: 5.2). Patient and clinician global DC VAS improved during the study (mean change: -7.1 and -5.2, respectively, both p < .001). DU perfusion significantly increased post-irradiation.

CONCLUSIONS

LTTT for DUs is safe, feasible, and well tolerated. There was an early tentative suggestion of treatment efficacy.

摘要

背景

系统性硬化症(SSc)指端溃疡(DU)需要局部作用且耐受性良好的治疗方法。

目的

我们的主要目的是研究一种新型低强度光疗法(LTTT)的安全性、可行性和耐受性。次要目的是初步评估其疗效。

方法

使用一种定制设备,该设备包含红外(850nm)、红色(660nm)和紫色(405nm)发光二极管。每周两次对指端溃疡照射,剂量为10J/cm²,共照射3周,在第4周和第8周进行随访。记录任何安全问题。收集患者对治疗时间、可行性和疼痛视觉模拟评分(VAS;0-100,100表示最严重)的意见。记录患者和临床医生对指端溃疡的整体评估VAS。在照射前后通过激光多普勒灌注成像对指端溃疡进行评估。

结果

8名患者的14个指端溃疡共接受了46次光照,未出现安全问题。所有患者都认为LTTT“时间恰到好处”且“可行”,相关的平均疼痛VAS较低,为1.6(标准差:5.2)。在研究期间,患者和临床医生的整体指端溃疡VAS有所改善(平均变化分别为-7.1和-5.2,均p<0.001)。照射后指端溃疡灌注显著增加。

结论

指端溃疡的低强度光疗法安全、可行且耐受性良好。有早期初步迹象表明该治疗方法有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97de/6484448/9d71f459b19f/IJDT_A_1484875_F0001_C.jpg

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