Heussler J K, Hinchey G, Margiotta E, Quinn R, Butler P, Martin J, Sturgess A D
Department of Rheumatology, St George Hospital, Sydney, Australia.
Ann Rheum Dis. 1993 Oct;52(10):703-6. doi: 10.1136/ard.52.10.703.
To define the value of low power laser treatment in small joint rheumatoid arthritis.
Twenty five women with active disease were recruited. The metacarpophalangeal and proximal interphalangeal joints of one hand were treated with 12 J/cm2 for 30 s with a gallium-aluminium-arsenate laser. The other hand received a sham laser treatment designed so that neither therapist nor patient could distinguish the active laser from the sham laser. Each patient received 12 treatments over four weeks. The following parameters were measured: pain as assessed by visual analogue scale; range of joint movements; grip strength; duration of early morning stiffness, joint circumference, Jebsen's hand assessment; drug usage; total swollen joint counts; Arthritis Impact Measurement Scales; three phase bone scans; haematological and serological tests.
A total of 72% of patients reported pain relief but this reduction was reported equally in both hands. No significant changes were seen in other clinical, functional, scintigraphic, or laboratory features. Neither patients nor staff were able to detect which hand was treated with the active laser.
When this specific laser and dose regimen was used, low power laser treatment had no objective effect on patients with rheumatoid arthritis. It did appear to produce analgesia through a powerful placebo effect.
确定低功率激光治疗在小关节类风湿性关节炎中的价值。
招募了25名患有活动性疾病的女性。用砷化镓铝激光以12 J/cm²的能量密度照射一只手的掌指关节和近端指间关节30秒。另一只手接受假激光治疗，其设计使得治疗师和患者都无法区分活性激光和假激光。每位患者在四周内接受12次治疗。测量了以下参数：通过视觉模拟量表评估的疼痛；关节活动范围；握力；晨僵持续时间、关节周长、杰布森手部评估；药物使用情况；肿胀关节总数；关节炎影响测量量表；三相骨扫描；血液学和血清学检查。
共有72%的患者报告疼痛减轻，但两只手的疼痛减轻程度相同。在其他临床、功能、闪烁扫描或实验室特征方面未观察到显著变化。患者和工作人员均无法检测出哪只手接受了活性激光治疗。
当使用这种特定的激光和剂量方案时，低功率激光治疗对类风湿性关节炎患者没有客观效果。它似乎确实通过强大的安慰剂效应产生了镇痛作用。
