半导体激光治疗SD大鼠创伤性口腔溃疡的实验研究

doi:10.13701/j.cnki.kqyxyj.2020.08.016

摘要/Abstract

摘要： 目的: 探究不同功率的半导体激光照射对SD大鼠实验性口腔溃疡β-内啡肽(β-endorpin, β-EP)、5-羟色胺(5-hydroxytryptamine,5-HT)含量的影响及愈合情况观察。方法: SD大鼠60只,随机选取9只设为正常对照组,剩余51只建造口腔溃疡模型,随机取3只行病理学观察,以确定模型建造成功。剩余48只随机分为溃疡对照组和激光照射3组共4组。激光3组连续3 d分别按照1.0 W、20 Hz,1.5 W、20 Hz,2.0 W、20 Hz的照射剂量给与溃疡激光治疗。检测建模前后及激光处理后各组溃疡组织中β-EP、5-HT的含量。肉眼动态观察并用愈合指数评价溃疡愈合情况,并于建模第2天,第5天和第9天在显微镜下观察各组溃疡组织的病理表现。结果: 造模导致的溃疡损伤可使溃疡周围组织β-EP含量增高(P＜0.01)。激光3组溃疡周围组织β-EP含量与溃疡对照组差异无统计学意义,各组溃疡周围组织5-HT含量差异均无统计学意义(P＞0.05)。建模第5天各激光组溃疡周围组织充血明显减轻,假膜变薄,且愈合指数显著优于对照组。各激光组镜下均见新生肉芽组织周围存在大量的新生血管和胶原纤维。建模第9天,各激光组溃疡多数愈合,但2 W组的新生组织周围充血水肿较1 W及1.5 W组明显。1 W及1.5 W组愈合指数显著优于对照组。镜下观察激光1.0 W及1.5 W组原溃疡组织新生上皮几乎完全覆盖,但1.5 W组上皮结构较1.0W组更加成熟,且表面出现较完整的角化层。2 W组新生上皮覆盖溃疡表面约90%。结论: 激光照射治疗并未显著增加溃疡组织β-内啡肽的释放,对5-HT的含量无明显影响,关于激光止痛的机制需进一步研究。激光照射能明显促进口腔溃疡的愈合,其中1.5 W组愈合效果更佳,提示1.5 W,20 Hz可能是临床应用半导体激光治疗口腔溃疡的较佳参数。

关键词: 半导体激光, 口腔溃疡, 疼痛, 愈合

Abstract: Objective: To investigate the effect of semiconductor laser with different parameters on levels of β-endorpin (β-EP), 5-hydroxytryptamine (5-HT), and healing of oral ulcers in SD rats. Methods: Nine rats were randomly selected from 60 SD rats and set as the normal control group. The remaining 51 rats were constructed oral ulcer models and the modeling day was set as day 0. 3 rats were selected for pathological observation to determine the success of model construction. The remaining 48 ones were randomly divided into four groups: ulcer control group and three laser irradiation groups. The three laser groups were given laser therapy at 1.0W/20Hz, 1.5W/20Hz, and 2.0W/20Hz (once per day, 3 consecutive days). The levels of β-EP and 5-HT were detected at 24 h after the last treatment. The healing of the ulcers was observed and evaluated by healing index following by microscope observation on day 2, 5, and 9. Results: The level of β-EP was increased in ulcer tissues (P<0.01). There was no statistically significant difference in the β-EP level between the laser groups and the ulcer control group. No statistically significant difference was found in the content of 5-HT between all groups (P>0.05). The healing index was better in laser groups on day 5, and the hyperemia in laser groups was significantly reduced. Besides, the pseudomembrane was thinner, and there was a large number of neovascularization and collagenous fibers observed by microscope. On day 9, most ulcers were healed in the laser groups. However, congestion and edema was more obvious in the 2W group than the other two groups. Healing index was better in 1W and 1.5W groups than other groups, however, more keratinization showed in 1.5W. Epithelium covered about 90% of the ulcer surface in 2W group. Conclusion: Laser therapy can not increase the release of β-EP in ulcer tissues, and has no effect on 5-HT content. Laser irradiation can significantly promote the healing of oral ulcer, and the healing is better in the 1.5W group, suggesting that 1.5W/20Hz may be a proper parameter for clinical application of semiconductor laser in the treatment of oral ulcer.

Key words: semiconductor laser, oral ulcer, pain, healing

霍晓, 韩宁, 刘莉. 半导体激光治疗SD大鼠创伤性口腔溃疡的实验研究[J]. 口腔医学研究, 2020, 36(8): 770-775.

HUO Xiao, HAN Ning, LIU Li. Effect of Semiconductor Laser Irradiation on Oral Ulcer Model of SD Mice[J]. Journal of Oral Science Research, 2020, 36(8): 770-775.

参考文献

[1] 杨相笛,陈悦,李丹,等.半导体激光在口腔临床医疗中的应用和研究进展[J].激光生物学报,2015,24(3):226-231.
[2] Tsai SR, Hamblin MR. Biological effects and medical applications of infrared radiation [J]. J Photochem Photobiol B, 2017, 5(170): 197-207.
[3] Boras VV, Juras DV, željko Verzak, et al. Applications of Low Level Laser Therapy [M]. in:A Textbook of Advanced Oral & Maxillofacial Surgery, 2013:327-339.
[4] Mohammed N , Allam H , Elghoroury E , et al. Evaluation of serum beta-endorphin and substance P in knee osteoarthritis patients treated by laser acupuncture [J]. J Complement Integr Med, 2018, 15(2):223-210.
[5] Basford JR. Low intensity laser therapy: Still not an established clinical tool [J]. Lasers Surg Med, 1995, 16:331-342.
[6] Bardin L. The complex role of serotonin and 5-HT receptors in chronic pain [J]. Behav Pharmacol, 2011, 22(5-6):390-404.
[7] Tomaz de Magalhães M, Núñez SC, Kato IT, et al. Light therapy modulates serotonin levels and blood flow in women with headache. A preliminary study [J]. Exp Biol Med (Maywood), 2016, 241(1):40-45.
[8] Perese Serra A, Ashmawi HA. Influence of naloxone and methysergide on the analgesic effects of low-level laser in an experimental pain model[J]. Rev Bras Anestesiol, 2010, 60(3):302-310.
[9] 彭玉梅.口腔溃疡动物实验模型的建立[J].北京口腔医学,2008,16(2):85-86.
[10] 陈吉莉,袁盛梦,陈芳园,等.化学灼烧法大鼠口腔溃疡动物模型对照优化的研究[J].中国实验动物学报,2018,26(5):17-23.
[11] Yilmaz HG, Albaba MR, Caygur A, et al. Treatment of recurrent aphthous stomatitis with Er,Cr:YSGG laser irradiation: A randomized controlled split mouth clinical study [J]. J Photochem Photobiol B,2017,170:1-5.
[12] 李娟,刘宗响,段宁,等.Nd:YAG激光、CO₂激光局部治疗轻型复发性阿弗他溃疡短期疗效比较研究[J].口腔医学研究,2017,33(9):63-66.
[13] Valerie GA, Sjölund S, Bornstein MM. Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review [J]. Lasers Med Sci, 2017, 32(4):953-963.
[14] Kato IT, Pellegrini VD, Prates RA, et al. Low-level laser therapy in burning mouth syndrome patients: a pilot study [J]. Photomed Laser Surg, 2010, 28 :835-839.
[16] Chow RT, David MA, Armati PJ. 830nm laser irradiation induces varicosity formation, reduces mitochondrial membrane potential and blocks fast axonal flow in small and medium diameter rat dorsal root ganglion neurons: implications for the analgesic effects of 830nm laser [J]. J Peripher Nerv Syst, 2007, 12:28-39.
[17] Carroll JD, Milward MR, Cooper PR, et al. Developments in low level light therapy (LLLT) for dentistry [J]. Dent Mater, 2017, 30(5):465-475.
[18] 丁新民,王永武. 半导体激光治疗复发性阿弗它溃疡[J].中国激光医学杂志,2004,13(2):123.
[19] 沃春新,徐正涛,秦乐,等. 体外冲击波治疗大鼠肌筋膜疼痛及其机制初探[J].中国疼痛医学杂志,2018,24(8):586-592.
[20] Hagiwara S, Iwasaka H, Hasegawa A, et al. Pre-irradiation of blood by gallium aluminum arsenide (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats [J]. Anesth Analg, 2008, 107(3):1058-1063.
[21] Rittner HL,Machelska H,Stein C. Leukocytes in the regulation of pain and analgesia [J]. J Leukoc Biol,2005,78(6):1215-1222.
[22] 李凤丽,林松杉,刘世森,等. 低功率半导体激光对口腔溃疡局部β-EP的影响[J].军医进修学院学报, 2012,33(3):280-281.
[23] Enwemeka CS, Parker JC, Dowdy DS. The efficacy of low-power lasers in tissue repair and pain control: a meta-analysis study [J]. Photomed Laser Surg, 2004, 22:323-329.
[24] de Freitas LF, Hamblin MR. Proposed mechanisms of photobiomodulation or low-level light therapy [J]. IEEE J Sel Top Quantum Electron, 2016, 22:348-364.
[25] Tezel A, Kara C, Balkaya V, et al. An evaluation of different treatment for recurrent aphthous stomatitis and patient perceptions: Nd:YAG laser versus medication [J]. Photomed Laser Surg, 2009, 27: 101-106.
[26] Hamblin MR, Huang YY, Sharma SK, et al. Biphasic dose response in low level light therapy-an update [J]. Dose Response, 2011, 9(4): 602-618.
[27] Aggarwal H, Singh MP, Nahar P, et al. Efficacy of low-level laser therapy in treatment of recurrent aphthous ulcers-a sham controlled, split mouth follow up study [J]. J Clin Diagn Res, 2014, 8(2):218-221.

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