Liao Fang-Yin, Lin Chien-Lin, Lo Sui-Foon, Chang Chun-Ching, Liao Wen-Yen, Chou Li-Wei
Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 40432, Taiwan.
School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40433, Taiwan.
Evid Based Complement Alternat Med. 2020 Sep 24;2020:6979105. doi: 10.1155/2020/6979105. eCollection 2020.
Knee osteoarthritis (OA) presented with knee pain and limitation of mobility is common, and it may become a chronic problem resulting in major loss of function, with related impaired activity of daily living. Current traditional therapy for knee OA includes pharmacological treatment and physiotherapy, but the efficacies are limited. An alternative noninvasive treatment low-level laser therapy (LLLT) applied to acupoints is still contradictory and the efficacy needs to be assessed.
We conduct the randomized double-blind control study to investigate the efficacy of a dual-frequency LLLT (combines red light (780 nm) and near-infrared light (830 nm)) in patients suffering knee OA. Participates were randomly assigned into active laser therapy (ALT) and placebo laser therapy (PLT) groups. Subjects in the ALT group were separately treated by laser apparatus at the three acupoints (SP9, SP10, and EX-LE2) on their knee joints under continuous radiation for 15 min at the maximum intensity, three times per week for four weeks. The PLT group used laser apparatus of the same model according to similar procedures without laser light emission. Outcome Measurements including visual analog scale (VAS), pain pressure threshold (PPT), and Lequesne index were used.
A total of 30 subjects with two-sided knee OA in both groups completed the experiment. Statistically significant decreases were observed in the Lequesne index (5.27 ± 3.26 vs. 10.83 ± 3.83), conscious VAS 4 weeks after treatment (moving: 2.87 ± 1.13 vs. 5.67 ± 1.72; resting: 0.33 ± 0.62 vs. 2.67 ± 1.29), and the increase was noted in PPT (21.23 ± 1.82 kg vs. 13.02 ± 1.46 kg) in the ALT group compared with the PLT group.
It appears that the knee OA pain and disability can be decreased after a dual-frequency LLLT applied to acupoints (SP9, SP10, and EX-LE2). The clinical efficacy of LLLT is highly related to the therapeutic settings of the laser apparatus; hence, more clinical trials with diffident parameter settings are needed to be further clarified.
伴有膝关节疼痛和活动受限的膝骨关节炎（OA）很常见，它可能会成为一个导致功能严重丧失的慢性问题，并影响相关的日常生活活动。目前膝骨关节炎的传统治疗方法包括药物治疗和物理治疗，但疗效有限。一种替代的非侵入性治疗方法——应用于穴位的低强度激光疗法（LLLT），其效果仍存在争议，需要进行评估。
我们进行了一项随机双盲对照研究，以调查双频LLLT（结合红光（780nm）和近红外光（830nm））对膝骨关节炎患者的疗效。参与者被随机分为主动激光治疗（ALT）组和安慰剂激光治疗（PLT）组。ALT组的受试者在膝关节的三个穴位（SP9、SP10和EX-LE2）分别接受激光治疗仪治疗，以最大强度连续照射15分钟，每周三次，共四周。PLT组按照类似程序使用相同型号的激光治疗仪，但不发射激光。使用的结果测量指标包括视觉模拟量表（VAS）、疼痛压力阈值（PPT）和Lequesne指数。
两组共30名双侧膝骨关节炎受试者完成了实验。与PLT组相比，ALT组的Lequesne指数（5.27±3.26对10.83±3.83）、治疗4周后的自觉VAS（活动时：2.87±1.13对5.67±1.72；休息时：0.33±0.62对2.67±1.29）有统计学意义的下降，且PPT有所增加（21.23±1.82kg对13.02±1.46kg）。
应用于穴位（SP9、SP10和EX-LE2）的双频LLLT似乎可以减轻膝骨关节炎的疼痛和功能障碍。LLLT的临床疗效与激光治疗仪的治疗参数密切相关；因此，需要更多不同参数设置的临床试验来进一步明确。
