重复经颅磁刺激治疗脊髓损伤后神经病理性疼痛的系统综述和荟萃分析  

Systematic review and Meta-analysis of repetitive transcranial magnetic stimulation in treatment of neuropathic pain after spinal cord injury

作　　者：文冰冰 代欣 王晓霞 张雪 WEN Bing-bing;DAI Xin;WANG Xiao-xia;ZHANG Xue(Outpatient Department,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院门诊部,北京100144

出　　处：《颈腰痛杂志》2024年第1期124-128,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的系统分析重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗脊髓损伤后神经病理性疼痛(neuropathic pain,NP)的临床效果。方法计算机检索中国知网、万方数据库、维普、PubMed、Embase、Corchrane Library、Web of science等中英文数据库,检索rTMS治疗脊髓损伤后NP的随机对照研究,采用Jadad量表进行质量评价后进行Meta分析。结果共纳入6篇文献。合并Meta分析显示,rTMS可显著降低脊髓损伤后NP患者的VAS/NRS水平(MD=-1.03,95%CI=-1.60~-0.46,P<0.01);rTMS可降低脊髓损伤后NP患者的HAMD评分(MD=-1.71,95%CI=-2.60~-0.82,P<0.01);rTMS对脊髓损伤后NP患者的HAMA评分影响不显著(MD=-0.84,95%CI=-5.48~3.81,P=0.72)。结论rTMS可缓解脊髓损伤后NP患者的疼痛程度,改善患者的抑郁状态。Objective To systematically analyze the clinical effect of repetitive transcranial magnetic stimulation(rTMS)in the treatment of neuropathic pain(NP)after spinal cord injury(SCI).Methods Chinese and English databases such as CNKI,Wanfang database,VIP,PubMed,EMBASE,Cochrane Library and web of science were searched by computer.The randomized controlled study of NP after SCI treated with rTMS was searched.The quality was evaluated by Jadad scale and Meta-analysis was carried out.Results A total of 6 literature articles were included.Combined Meta-analysis showed that rTMS could significantly reduce the level of VAS/NRS in NP patients after SCI(MD=-1.03,95%CI=-1.60~-0.46,P<0.01).rTMS could reduce the level of HAMD in NP patients after SCI(MD=-1.71,95%CI=-2.60~-0.82,P<0.01).rTMS had no significant effect on the level of HAMA in NP patients after SCI(MD=-0.84,95%CI=-5.48~3.81,P=0.72).Conclusion rTMS can alleviate the pain and depression of NP patients after SCI.

关 键 词：脊髓损伤 神经病理性疼痛 重复经颅磁刺激 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]