经皮神经电刺激治疗膝骨关节炎性疼痛的荟萃分析  

Transcutaneous electrical nerve stimulation for pain relief in knee osteoarthritis: a Meta-analysis

作　　者：丁翔[1] 张屹[1] 邓桢翰[1] 杨烨[1] 杨拓[1] 李辉[1] 雷光华[1] 

机构地区：[1]中南大学湘雅医院骨科,湖南省长沙市410008

出　　处：《中国组织工程研究》2015年第11期1798-1804,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金项目(81272034);湖南省发改委项目([2013]1199);湖南省科技厅科研项目(2013SK2018);教育部博士点基金(20120162110036)~~

摘　　要：背景:以往的研究表明经皮神经电刺激对缓解多种疾病引起的疼痛症状有效,但其对缓解膝骨关节炎患者疼痛的确切疗效仍存在争议。且经皮神经电刺激可分为高频和低频两种模式,目前关于其分别针对膝骨关节炎疼痛的疗效尚不明确。目的:荟萃分析高频经皮神经电刺激与低频经皮神经电刺激缓解膝骨关节炎疼痛的作用。方法:计算机检索Pub Med,Embase和Cochrane数据库以及手工检索国内外公开发表的有关经皮神经电刺激缓解膝骨关节炎疼痛的随机对照试验,所有检索截止至2014年2月。严格评价纳入研究的方法学质量并提取数据,2名研究人员独立运用Rev Man 5.2软件对数据进行统计分析。结果与结论:共纳入10项随机对照试验,累计519例研究对象。荟萃分析结果显示,与对照组相比,高频经皮神经电刺激可显著缓解膝骨关节炎患者的疼痛[MD=-0.56,95%CI(-0.98,-0.15),P=0.008];与对照组相比,低频经皮神经电刺激并未缓解膝骨关节炎患者的疼痛[MD=-0.13,95%CI(-1.63,1.38),P=0.87];与低频经皮神经电刺激相比,高频经皮神经电刺激可显著缓解膝骨关节炎患者的疼痛[MD=-0.85,95%CI(-1.32,-0.37),P=0.000 5]。提示高频经皮神经电刺激可一定程度缓解膝骨关节炎患者的疼痛症状,而对比高频经皮神经电刺激,低频经皮神经电刺激对缓解膝骨关节炎患者的疼痛症状无明显作用。但由于样本量较小,纳入各研究在参数选择存在差异,存在一定局限性,此结论未来尚需更多高质量的随机对照试验进一步证实。BACKGROUND：Extensive studies have shown that transcutaneous electrical nerve stimulation （TENS） plays a positive role in relieving the pain caused by a variety of diseases. However, its exact effect to manage pain in patients with knee osteoarthritis is stil controversial. TENS is classified into h-TENS and l-TENS, but currently its respective role in relieving the pain caused by knee osteoarthritis is not clear yet. OBJECTIVE： To compare the efficacy of h-TENS and l-TENS on pain relieving among patients with knee osteoarthritis. METHODS： A computer-based search was performed on PubMed, Embase and Cochrane database for randomized controled trials on TENS for the treatment of knee pain in patients with knee osteoarthritis which were reported before February 2014. Methodology quality of the trials was criticaly assessed and relative data were extracted. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software. RESULTS AND CONCLUSION：A total of 10 randomized controled trials involving 519 cases were included. The results of meta-analysis showed that the h-TENS group had significant effects on pain relief in knee osteoarthritis patients in comparison to the control group [MD=-0.56, 95%CI（-0.98,-0.15）,P=0.008]; the l-TENS group had no significant effect on pain relief in knee osteoarthritis patients in comparison to the control group [MD=-0.13, 95%CI（-1.63, 1.38）,P=0.87]; the h-TENS group had significant effect on pain relief in knee osteoarthritis patients in comparison to the l-TENS group [MD=-0.85, 95%CI（-1.32, -0.37）, P=0.000 5]. These findings indicate that h-TENS performs something positive to reduce pain in knee osteoarthritis patients that l-TENS cannot do. Owing to the limitations of this study, further work is needed to determine the role of TENS in pain management among patients with knee osteoarthritis.

关 键 词：组织构建 骨组织工程 膝骨关节炎 关节疾病 关节痛 疼痛 经皮神经电刺激 物理疗法 镇痛 荟萃分析 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]