Sluka Kathleen A, Walsh Deirdre
Physical Therapy and Rehabilitation Sciences Graduate Program, Neuroscience Graduate Program, Pain Research Program, University of Iowa, Iowa City, IA 52242, USA.
J Pain. 2003 Apr;4(3):109-21. doi: 10.1054/jpai.2003.434.
Transcutaneous electrical nerve stimulation (TENS) is used clinically by a variety of health care professionals for the reduction of pain. Clinical effectiveness of TENS is controversial, with some studies supporting whereas others refute its clinical use. Although used by health professionals for decades, the mechanisms by which TENS produces analgesia or reduces pain are only recently being elucidated. This article describes the basic science mechanisms behind different frequencies of TENS stimulation. Specifically, we describe the literature that supports the use of different frequencies and intensities of TENS. We further describe theories that support the use of TENS such as the gate control theory and the release of endogenous opioids. The literature that supports or refutes each of these theories is described. We also review the clinical literature on TENS effectiveness and elucidate the problems with clinical research studies to date. In conclusion, TENS is a noninvasive modality that is easy to apply with relatively few contraindications. However, the clinical efficacy of TENS will remain equivocal until the publication of sufficient numbers of high quality, randomized, controlled clinical trials.
经皮电刺激神经疗法（TENS）被各类医疗保健专业人员用于临床以减轻疼痛。TENS的临床疗效存在争议，一些研究支持其临床应用，而另一些则予以反驳。尽管医疗专业人员使用TENS已有数十年，但TENS产生镇痛或减轻疼痛的机制直到最近才得以阐明。本文描述了不同频率TENS刺激背后的基础科学机制。具体而言，我们阐述了支持使用不同频率和强度TENS的文献。我们还进一步描述了支持使用TENS的理论，如闸门控制理论和内源性阿片类物质的释放。文中描述了支持或反驳这些理论的文献。我们还回顾了关于TENS疗效的临床文献，并阐明了迄今为止临床研究存在的问题。总之，TENS是一种非侵入性治疗方式，易于应用且相对禁忌证较少。然而，在发表足够数量的高质量、随机、对照临床试验之前，TENS的临床疗效仍将不明确。
