慢性関節リウマチに対する低出力YAGレーザー照射効果 第1報

Abstract

According to clinical experiences, the laser irradiation to rheumatoid arthritis (RA) is known to be effective. However there are many supposed ways to controll RA by the laser irradiation. The effects of laser irradiation to RA, are separated into two groups; one is an early effects, the other is a late of In the early effects, the most important supposed effect might be an increased blood flow in the tissue, the late effects could be considered as the immunosuppression.How the effects occur in RA by the YAG laser irradiation. Firstly, an animal study followed by a clinical study, are designed to know the mechanism of effects of YAG laser irradiation to rheumatoid arthritis. In the animal study using adjuvant arthritis of rats, the method of YAG laser irradiation to an adjuvant arthritis is as followings,the adjuvant is injected to right paw in all rats, and YAG laser irradiatinn is performed to right or left paw, 100mw in power, 15 minutes per day in duration, 6 times in a week. The histological change of H-E stain is severe in no laser irradiated paw. In the group that laser irradiation starts in the next day of injection, small infiltration of inflammatory cells and mild proliferation of stroma cell can be seen. By the irradiation to no adjuvant injected paw, remarkable edema in stroma may be shown an increased permeability of capillaly. In the immunohistologic examination using Ia antigen, T4 and T8, the expression of T4 and T8 is very small, however there is strong expression of Ia antigen in no laser irradiated paw. By the YAG laser irradiation, the expression of Ia antigen is decreased. In clinical study, 25 patients with RA participated. The YAG laser irradiation is once or twice in a week, 500mw in power, 10 minutes in duration. By the laser irradiation, there is no significant change in the systemic activity of RA. Concerning about subjective improvement, there is no aggravation, 37.5% in improved and 29.2% in remarkably improved. Concerning about objective improvement, there is no aggravation, 64.6% in improved and 16.7% remarkably improved.YAG laser irradiation is effective in treatment of RA, it may mainly depend on the increase of circulation.