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目的 观察低强度激光血管内照射 (ILIB)治疗老年类风湿性关节炎的疗效 ,探讨其作用机理。方法 老年类风湿性关节炎患者 90例 ,随机分为激光组和对照 1组、对照 2组 ,每组 30例。激光组用激光加半量非甾体类消炎药 ,对照 1组用全量非甾体类消炎药 ,对照 2组用半量非甾体类消炎药 ,疗程均为 1个月。观察晨僵时间、关节压痛指数、关节肿胀指数、握力 4项临床指标及不良反应表现 ,并于治疗前和疗程结束后分别测定血沉 (ESR)、C反应蛋白 (CRP)、类风湿因子 (RF)、免疫球蛋白IgG、IgM、IgA、转化生长因子 β1(TGF β1)、超氧化物歧化酶 (SOD)及丙二醛 (MDA) ,作自身对照及组间比较。结果 激光组与对照 1组临床疗效相似 ,激光组毒副作用明显少于对照 1组 ,激光组、对照 1组临床疗效明显优于对照 2组 ;激光组血清IgG、IgM、IgA、TGF β1、SOD、MDA指标改善显著优于对照 1组和对照 2组 (P <0 .0 0 5 ,P <0 .0 0 1)。结论 ILIB对老年类风湿性关节炎有良好的治疗作用 ,可减少一半以上非甾体类消炎药的用量 ,不但可消炎止痛 ,还有免疫调节、增加保护性因子、纠正自由基代谢紊乱等作用
Objective To observe the therapeutic effect of low intensity laser intravascular irradiation (ILIB) on senile rheumatoid arthritis and to explore its mechanism. Methods 90 elderly rheumatoid arthritis patients were randomly divided into laser group and control group 1, control group 2, 30 cases in each group. Laser group with laser plus half the amount of non-steroidal anti-inflammatory drugs, control group 1 with a full amount of non-steroidal anti-inflammatory drugs, control 2 groups with semi-non-steroidal anti-inflammatory drugs, treatment were 1 month. The indexes of morning stiffness, joint tenderness index, joint swelling index and grip strength were observed and their clinical manifestations and adverse reactions were observed. ESR, C-reactive protein (CRP) and rheumatoid factor (RF) were measured before treatment and after treatment. ), Immunoglobulin IgG, IgM, IgA, TGFβ1, SOD and MDA were compared between the two groups. Results The clinical efficacy of laser group was similar to that of control group 1, and the side effects of laser group were obviously less than those of control group 1. The clinical efficacy of laser group and control group 1 was better than that of control group 1. The levels of serum IgG, IgM, IgA, TGFβ1, SOD , And the improvement of MDA index was significantly better than the control group 1 and the control group 2 (P <0. 05, P <0. 001). Conclusion ILIB has a good therapeutic effect on senile rheumatoid arthritis and can reduce the dosage of more than half of non-steroidal anti-inflammatory drugs, not only anti-inflammatory and analgesic, but also immune regulation, protective factors, and the correction of metabolic disorders of free radicals