夹脊电针疗法联合重复经颅磁刺激对不完全性脊髓损伤后神经病理性疼痛患者心理状态、血清炎性因子和疼痛介质的影响  

Effects of Clip Spinal Electroacupuncture Therapy Combined with Repeated Transcranial Magnetic Stimulation on Psychological Status,Serum Inflammatory Factors and Pain Mediator in Patients with Neuropathic Pain after Incomplete Spinal Cord Injury

作　　者：侯轶[1] 李婧 刘洋[1] 刘浩[1] 刘立宏[1] HOU Yi;LI Jing;LIU Yang;LIU Hao;LIU Li-hong(Department of Rehabilitation Medicine,Xiangya Second Hospital of Central South University,Changsha,Hunan,410011,China)

机构地区：[1]中南大学湘雅二医院康复医学科,湖南长沙410011

出　　处：《现代生物医学进展》2022年第19期3724-3728,共5页Progress in Modern Biomedicine

基　　金：湖南省自然科学基金项目(2019JJ40432);中南大学本科生教育教学改革项目(2020jy168-2);中南大学研究生教育教学改革项目(2022JGB063)。

摘　　要：目的:观察夹脊电针疗法联合重复经颅磁刺激(r TMS)对不完全性脊髓损伤(ISCI)后神经病理性疼痛(NP)患者心理状态、血清炎性因子和疼痛介质的影响。方法:选择ISCI后并发NP患者113例,根据随机数字表法分为对照组(n=56,r TMS治疗)和研究组(n=57,对照组基础上结合夹脊电针疗法),连续治疗4周后观察两组疼痛改善、心理状态、血清炎性因子和疼痛介质水平的变化。结果:研究组的临床总有效率高于对照组(P<0.05)。研究组治疗4周后的疼痛评级指数(PRI)、现实疼痛指数(PPI)、视觉模拟评分(VAS)评分低于对照组(P<0.05)。研究组治疗4周后的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组(P<0.05)。研究组治疗4周后的肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)低于对照组,白细胞介素-10(IL-10)则高于对照组(P<0.05)。研究组治疗4周后的前列腺素E_(2)(PGE_(2))、5-羟色胺(5-HT)低于对照组,β-内啡肽(β-EP)则高于对照组(P<0.05)。结论:夹脊电针疗法联合r TMS治疗ISCI后NP患者,可有效减轻疼痛症状,改善其心理状态、血清炎性因子和疼痛介质水平。Objective:To observe the effects of clip spinal electroacupuncture therapy combined with repeated transcranial magnetic stimulation(r TMS)on psychological status,serum inflammatory factors and pain mediator in patients with neuropathic pain(NP)after incomplete spinal cord injury(ISCI).Methods:113 patients with NP after ISCI were selected,and they were randomly divided into control group(n=56,r TMS treatment)and study group(n=57,clip spinal electroacupuncture therapy on the basis of the control group)according to random number table method.4 weeks after continuous treatment,the changes of pain improvement,psychological status,serum inflammatory factors and pain mediator were observed in the two groups.Results:The total clinical effective rate of the study group was higher than that of the control group(P<0.05).4 weeks after treatment,the pain rating index(PRI),present pain index(PPI)and visual analog scale(VAS)score of the study group were lower than those of the control group(P<0.05).The scores of self-rating Anxiety Scale(SAS)and self-rating depression Scale(SDS)of the study group at 4 weeks after treatment were lower than those in the control group(P<0.05).4 weeks after treatment,the levels of tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)of the study group were lower than those of the control group,while the level of interleukin-10(IL-10)was higher than that of the control group(P<0.05).The levels of prostaglandin E_(2)(PGE_(2))and 5-hydroxytryptamine(5-HT)of the study group at 4 weeks after treatment were lower than those of the control group,while the level ofβ-endorphin(β-EP)was higher than that of the control group(P<0.05).Conclusion:The clip spinal electroacupuncture therapy combined with r TMS in the treatment of patients with NP after ISCI can effectively reduce pain symptoms and improve their psychological status,serum inflammatory factors and pain mediators.

关 键 词：不完全性脊髓损伤 神经病理性疼痛 重复经颅磁刺激 夹脊电针疗法 心理状态 炎性因子 疼痛介质 

分 类 号：R681.5[医药卫生—骨科学] R454[医药卫生—外科学] R245[医药卫生—临床医学]