臺灣博碩士論文加值系統

近年來，發光二極體（LED）光療經由幾種機制在於減輕疼痛和促進組織修復，已引起注意。LED已經有了很久的發展，與雷射光比較，更具經濟效益且更為有效。除了日益增加的基礎與臨床的研究來了解病理的機轉，適當的術後止痛治療仍然是醫學的一大挑戰。LED在術後傷口的止痛效果，尚未好好檢視。促發炎性和抗炎性細胞激素，環氧合酶-2，前列腺素E2的疼痛作用在先前的研究已經顯示出來。因此，在本實驗，我們要檢視LED的止痛效果，藉著比較促發炎性和抗炎性細胞激素，環氧合酶-2，前列腺素E2在切割傷口前或後，與是否接受LED治療有相關性。觀察她們之間的數值改變來驗證有、無LED光照治療對傷口的切割後有、無止痛效果。
本研究探討波長940nm的發光二極體(Light Emitting Diode，LED)作為光源來進行止痛機制的觀察，以實驗大鼠做為對象，在老鼠的左腳腳底切割傷口。實驗鼠被分別為4組：不照光只切傷口組(I組)、先照光再切傷口(L-I組)、先切傷口再照光(I-L組)、切傷口前後都照(L-I-L組)。
我們用熱過度痛感的行為檢驗法，在實驗之前與之後各做一次，來做比較。行為檢驗法之後，我們取傷口皮膚組織，藉著西方墨點法將IL-1β、IL-10， COX-2和PGE2做蛋白質表現分析(每組5隻)。
熱退縮延遲時間在I組有明顯的減少(P<0.05)，但有LED照過的三組卻沒有減少。止痛效果與減少IL-1β、 COX-2和PGE2減少和IL-10增加是相關的。IL-1β、COX-2和PGE2的數值在LED照光組也有明顯的下降(P<0.05)，而IL-10的數值也明顯的增加(P<0.05)，因此，熱退縮延遲時間增長顯示LED的止痛效果而止痛效果與IL-1β、IL-10 COX-2和PGE2減少和IL-10增加是相關的，證實LED光照對切割後疼痛是具有止痛效果的。

Recently, light emitting diode (LED) phototherapy has attracted attention for reducing pain and inducing tissue repair through several mechanisms. The LED has a longer life, is more economically accessible and can be efficient as laser light. Despite increased basic and clinical researches and improved understanding of pathologic mechanisms, optimal post-surgical pain therapy remains a challenge for physicians. The analgesic effect of LED on incisional wound has not been examined. The effect of pro- and anti-inflammatory cytokine, COX-2 and PGE2 in pain treatment has been demonstrated by previous report. Thus, in this study, we will examine the analgesic effect of LED therapy and the role of pro- and anti-inflammatory cytokine, COX-2 and PGE2 in incisional skin after LED therapy or not. The rats were randomly divided into four groups. Rats received 940nm LED therapy 6 days before incision over left hind planta (group L-I) or 6 days after incision (group I-L) or from 3 days before incision to 3 days after incision (group L-I-L), skin incision only (group I). Thermal withdrawal latency was tested before and after treatment, skin tissues were collected for IL-1β, IL-10, COX-2 and PGE2 protein analysis (n=5 each group) by western blot after behavior test. Thermal withdrawal latency was significant decreased in incision wound but not in incision wound treated with LED. The IL-1β, COX-2 and PGE2 were significant decreased after LED treatment compared with incision wound with no LED treatment group (P<0.05). The IL-10 was significant increased after LED treatment compared with incision wound with no LED treatment group (P<0.05). Thus, the analgesic effect of LED was associated with the decrease of IL-1β, COX-2 and PGE2 and the increase of IL-10, and confirmed that the LED therapy on cut pain relief has a positive effect.

摘要…………………………………………………………………………………………….I
Abstract……………………………………………………………………………………….IV
致謝.....................................................................VI
目錄
圖目錄
第一章　緒 論.……………………………………………………………………………..…1
　1-1　研究動機……………………………………………………………………………...1
　1-2　研究背景……………………………………………………………………………...2
　1-3　研究目的……………………………………………………………………………...4
第二章　文獻回顧…………………………………………………………………………….6
　2-1　光學理論……………………………………………………………………………...6
2-1-1 光度量參數簡介………………………………………………………………….6
2-1-2 光通量…………………………………………………………………………….6
2-1-3 發光強度………………………………………………………………………….7
2-1-4 亮度……………………………………………………………………………….7
2-1-5 發光效率………………………………………………………………………….7
2-1-6 光照度…………………………………………………………………………….8
2-1-7 LED 其他相關光度參數…………………………………………………………9
　2-2　光療的歷史……………………………………………………………………….…11
　2-3　光療的發展……………………………………………………………………….…13
　2-4　各種顏色光波應用……………………………………………………………….…16
2-4-1 紅外線……..................………………..…………………………………..…16
2-4-2 紅光………………………………..…………………......................16
2-4-3 黃光………….……………………………………...............................16
2-4-4 藍光………………………………..………………..............................17
2-4-5 紫外線……………………… …………………………………………………...17
2-5 光質與光強對皮膚的生理影響…….….…….……………………………………...18
2-6 熱過度痛感( Hyperalgesia)……………………………………………..…………...20
2-7 細胞激素(cytokine)、環氧合酶(COX-2)和前列腺素E2(PGE2)….….……………21
2-7-1 細胞激素(cytokine) ……………………………………………………………...22
2-7-2細胞激素的作用特點........................................................24
2-7-3 IL-1β，Interleukin-1β(介白質，白細胞介素) ............................ 24
2-7-4 IL-10，Interleukin-10：..................................................24
2-7-5環氧合酶-2(COX-2) ........................................................25
2-7-6前列腺素與前列腺素E2......................................................27
2-8 西方墨點法(Western Blot Method) ………….………………………...………......28
第三章　實驗計畫..........……………...........................................30
　3-1 實驗計畫簡介……………………………......................................30
3-2　設備儀器……………………………………...…………... .....................31
3-3 實施方法……………………………………………….............................................35
　3-4　進行步驟……………...………………………………………………………..……...36
　3-5　數據分析……………….……….............................................48
第四章　實驗結果…………………………....………………………………………………...48
　4-1　LED對熱過度痛感的影響.…......………………………………………………………48
　4-2　LED對細胞激素IL-1β、IL-10、COX-2和PGE2的影響……..……………………50
第五章　討論………………………………………………………………………………...54
第六章　結論與未來展望…………………………………………………………………...58
參考文獻…………………………………………………………………………………...... 59
圖目錄　
圖2-1 小功率 LED 空間光強分布圖……………………………………………………….8
圖2-2 LED 空間光強分布示意圖……………………………………………………………9
圖2-3 LED 相關光度參數定義示意圖……………………………………………………..10
圖2-4利用LED光療和冷水浸泡來比較肌肉酸痛的治療…………………..……………19
圖2-5. 環氧化酵素在合成前列腺素的路徑………………………………………………..27
圖3-1 UGO BASILE plantar test，用來測熱刺激抗過度痛感…………………………….31
圖3-2分光度計(TECAN Sunrise Microplate Reader) ……………………………………...32
圖3-3 Bio-Rad Mini-PROTEAN II Electrophoresis Cell和Mini Trans-Blot Electrophoretic Transfer Cell…………………………………………………………………………………..33
圖3-4 UVP BioSpectrum 500 Imaging System…………………………………………….34
圖3-5使用 Ugo Basile plantar test過程照………………………………………………….36
圖3-6. 940nm LED光源排列方式……….………………………………………………….37
圖3-7. 照光方式(測面照)……. …….………………………………………………………38
圖3-8. 照光方式(正面照)……………………………………………………………...……38
圖3-9.以躺臥方式直接照光………………………………………………..………………..39
圖3-10.剪下皮膚組織………………………………………………………………………..41
圖3-11.用均質機絞碎皮膚組織……………………………………………………………..42
圖4-1.各組實驗前後熱退縮延遲時間的比較…...………………………………………….49
圖4-2.各組的IL-1β蛋白質表現的比較……………………………………………..……..51
圖4-3.各組的IL-10蛋白質表現的比較…………………………………………………….52
圖4-4.各組的COX-2蛋白質表現的比較………………………………………………..…53
圖4-4.各組的COX-2蛋白質表現的比較…………………………………………………. 54

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