光生物调节疗法治疗膝骨关节炎作用机制的研究进展  

Research progress on the mechanism of action of photobiomodulation therapy in the treatment of knee osteoarthritis

作　　者：徐匡英 朱朝劲 沈喆 叶晓昂 崔龙慷 吴连国 XU Kuangying;ZHU Chaojing;SHE Zhe;YE Xiaoang;CUI Longkang;WU Lianguo(The Second Clinical School of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310053;The Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310005,China)

机构地区：[1]浙江中医药大学第二临床医学院,浙江杭州310053 [2]浙江中医药大学附属第二医院,浙江杭州310005

出　　处：《中国骨质疏松杂志》2024年第11期1667-1672,共6页Chinese Journal of Osteoporosis

基　　金：2024年度浙江省“尖兵”“领雁”研发攻关计划(2024C03213);国家中医临床研究基地支撑学科(2020-JDXX-ZC01);浙江省中医药现代化专项项目(2021ZX009);浙江中医药大学科研项目资助(2023JKZKTS41);浙江省中医药科技计划项目(2024ZL514)。

摘　　要：膝骨关节炎(knee osteoarthritis,KOA)是一种好发于中老年人的退行性疾病,以软骨退变、软骨下骨重塑、滑膜炎症为主要临床表现,常导致患者慢性关节疼痛、肢体功能障碍甚至残疾,随着目前社会老龄化的加剧,给社会经济带来巨大负担。然而,目前临床上主要以早期对症治疗、晚期关节置换的方案进行治疗,尚无有效治疗方法延缓KOA进展。近年来,光生物调节疗法(photobiomodulation therapy,PBMT)因其无痛、无创、安全有效的治疗效果引起了很多研究者的关注。PBMT通过刺激ATP的合成来提升细胞的能量水平并优化其状态;它还调整血流状况,以改善血运条件;调节相关细胞因子的水平,以缓解细胞炎症反应;以及调节相关酶的分泌,以缓解软骨退变。该文概述了PBMT通过上述一系列的作用机制对KOA进行治疗,以及其在促进软骨再生、缓解滑膜炎症以及减轻疼痛方面的治疗效果及潜在机制。Osteoarthritis of the knee(KOA)is a degenerative disease that commonly affects middle-aged and elderly individuals,primarily characterized by cartilage degradation,subchondral bone remodeling,and synovial inflammation.It often result in chronic joint pain,physical function impairment,and even disability in patients.As society continues to age rapidly,this condition places an enormous burden on social economics.Currently,clinical treatment mainly involves symptomatic relief in the early stages and joint replacement in the advanced stages,with no effective method to delay the progression of KOA.In recent years,photobiomodulation therapy(PBMT)has garnered significant attention from researchers due to its painless,non-invasive,and safe therapeutic effects.PBMT enhances cellular energy levels and optimizes their state by stimulating ATP synthesis;it also improves blood flow conditions by adjusting hemodynamic status;modulates the levels of related cytokines to alleviate cellular inflammatory responses;and regulates the secretion of related enzymes to reduce cartilage degradation.This article outlines how PBMT treats KOA through these mechanisms,as well as its therapeutic effects and potential mechanisms in promoting cartilage regeneration,reducing synovial inflammation,and allevitating pain.

关 键 词：膝骨关节炎 光生物调节疗法 软骨再生 滑膜炎症 疼痛 

分 类 号：R684.3[医药卫生—骨科学]