Grazio Simeon, Grubisić Frane, Jajić Zrinka
Klinika za reumatologiju, Referentni centar za upalne reumatske bolesti Ministarstva zdravstva RH Klinicka bolnica Sestre milosrdnice, Vinogradska 29, 10000 Zagreb.
Reumatizam. 2003;50(1):18-22.
The comparison of standard high frequency (ST-TENS) and acupuncture-like TENS (AL-TENS) in patients with rheumatoid arthritis is presented. Thirty-three patients (26 women and 7 men) with rheumatoid arthritis (according to modified ACR criteria), and with the duration of the disease 10.7 +/- 8.8 years are investigated. Each subject received ST-TENS (75 Hz) at the selected joint and AL-TENS (4 Hz) at the contralateral joint respectively. No significant difference between left and right side in pre-treatment pain was the main criterion for selecting the treated joint. Treatment was performed during 12 days. The initiation, duration, level of hypolgesia (according to Ritchie's pain assessment scale and VAS), patients' global assessment and possible reduction of dosage of analgetics/antirheumatics were measured. There was a significant reduction in pain level on ST-TENS site (48.6%), and on AL-TENS site (40.8%), measured on VAS. Results of Ritchie's index showed significant difference before and after application (for each type of TENS P < 0.05). There was no statistical difference between both types of TENS regarding the reduction of pain level, as well as the initiation of analgesic effect, whilst it was noted a slightly longer, although statistically not significant, hypoalgesic effect of AL-TENS. Patients' global assessment also did not differ relating to ST-TENS and AL-TENS, as well as their opinion on possible dosage reduction of analgetics/antirheumatics. Side effects for both types of TENS were negligible. The findings showed that ST-TENS and AL-TENS provided hypoalgesic effect in the similar degree in patients with long-standing rheumatoid arthritis.
本文介绍了标准高频经皮电刺激神经疗法(ST-TENS)与类针刺经皮电刺激神经疗法(AL-TENS)在类风湿性关节炎患者中的比较。研究对象为33例类风湿性关节炎患者(26名女性和7名男性,根据改良的美国风湿病学会标准诊断),病程为10.7±8.8年。每位受试者分别在选定关节接受ST-TENS(75Hz)治疗,在对侧关节接受AL-TENS(4Hz)治疗。治疗前疼痛在左右两侧无显著差异是选择治疗关节的主要标准。治疗持续12天。测量了镇痛作用的起始、持续时间、程度(根据里奇疼痛评估量表和视觉模拟评分法)、患者的整体评估以及镇痛药/抗风湿药可能的剂量减少情况。根据视觉模拟评分法测量,ST-TENS治疗部位的疼痛水平显著降低(48.6%),AL-TENS治疗部位的疼痛水平显著降低(40.8%)。里奇指数结果显示,两种经皮电刺激神经疗法应用前后均有显著差异(每种类型的经皮电刺激神经疗法P<0.05)。在疼痛水平降低以及镇痛效果起始方面,两种经皮电刺激神经疗法之间无统计学差异,不过注意到AL-TENS的镇痛作用持续时间略长,尽管无统计学意义。患者的整体评估在ST-TENS和AL-TENS之间也无差异,以及他们对镇痛药/抗风湿药可能的剂量减少的看法也无差异。两种经皮电刺激神经疗法的副作用均可忽略不计。研究结果表明,ST-TENS和AL-TENS在长期类风湿性关节炎患者中提供了相似程度的镇痛作用。