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针刺样电刺激对慢性紧张型头痛的影响:一项随机、双盲、安慰剂对照试验

Effect of acupuncture-like electrical stimulation on chronic tension-type headache: a randomized, double-blinded, placebo-controlled trial.

作者信息

Wang Kelun, Svensson Peter, Arendt-Nielsen Lars

机构信息

Center for Sensory-Motor Interaction, Orofacial Pain Laboratory, Aalborg University, Aalborg, Denmark.

出版信息

Clin J Pain. 2007 May;23(4):316-22. doi: 10.1097/AJP.0b013e318030c904.

Abstract

OBJECTIVE

The aim of this study was to examine the effect of acupuncture-like electrical stimulation on chronic tension-type headache (TTH) in a randomized, double-blinded, placebo-controlled study.

METHODS

Thirty-six patients (18 men, 18 women) with chronic TTH in accordance with the criteria of International Headache Society were investigated. The patients were randomly assigned into 2 groups: a treatment group and a placebo group. Pain duration, pain intensity on a 0 to 10 cm visual analog scale, number of headache attacks, and use of medication were recorded in a diary for 2 weeks before treatment (baseline), early stage of treatment (Treat-1; 2 wk), late stage of treatment (Treat-2; 4 wk), and after the end of treatment (Post-1, Post-2, Post-3 corresponding to 2, 4, and 6-wk follow-up). The patients also provided an overall evaluation of the treatment effect at each stage. Patients were taught how to use either an acupuncture-like electrical stimulator or a sham stimulator (identical but incapable of delivering an electric current) and then instructed to use the device at home. Six acupoints, bilateral EX-HN5, GB 20, LI 4, were selected to be stimulated 3 minutes for each point, twice a day. Friedman repeated measure analysis of variance on rank was used to test the data.

RESULTS

The pain duration was shortened at Treat-1 and pain intensity was decreased at Treat-1 and Treat-2 compared with baseline. The overall evaluation of the 2 treatments indicated improvements in both the treatment and the placebo groups, but with no significant difference between the groups (P>0.061). Despite the apparent improvement in both the treatment and placebo groups, a decrease in analgesic use was only observed in the treatment group. There was also a significant positive correlation between the reported intensity of the stimulus-evoked sensation and the evaluation of the effect of either active or placebo treatments (P=0.039).

CONCLUSIONS

The use of acupuncture-like electrical stimulation was not associated with significant adverse effects. These results indicate that acupuncture-like electrical stimulation is a safe and potentially analgesic-sparing therapy that may be considered as an adjunctive treatment for patients with chronic TTH although the clinical effect on pain seems to be marginal in the present set-up.

摘要

目的

本研究旨在通过一项随机、双盲、安慰剂对照试验,探讨类针刺电刺激对慢性紧张型头痛(TTH)的影响。

方法

根据国际头痛协会标准,对36例慢性TTH患者(18例男性,18例女性)进行研究。患者被随机分为两组:治疗组和安慰剂组。在治疗前2周(基线期)、治疗早期(治疗1;2周)、治疗晚期(治疗2;4周)以及治疗结束后(分别对应2、4和6周随访的Post-1、Post-2、Post-3),通过日记记录疼痛持续时间、0至10厘米视觉模拟量表上的疼痛强度、头痛发作次数以及药物使用情况。患者还对各阶段的治疗效果进行总体评估。指导患者如何使用类针刺电刺激器或假刺激器(外观相同但无电流输出),然后让他们在家中使用该设备。选取双侧EX-HN5、GB 20、LI 4六个穴位,每个穴位刺激3分钟,每天2次。采用Friedman秩重复测量方差分析对数据进行检验。

结果

与基线期相比,治疗1时疼痛持续时间缩短,治疗1和治疗2时疼痛强度降低。两种治疗方法的总体评估显示,治疗组和安慰剂组均有改善,但两组间无显著差异(P>0.061)。尽管治疗组和安慰剂组均有明显改善,但仅在治疗组观察到镇痛药使用减少。刺激诱发感觉的报告强度与主动治疗或安慰剂治疗效果评估之间也存在显著正相关(P=0.039)。

结论

类针刺电刺激的使用未发现明显不良反应。这些结果表明,类针刺电刺激是一种安全且可能节省镇痛药的治疗方法,对于慢性TTH患者可考虑作为辅助治疗,尽管在当前设置下对疼痛的临床效果似乎有限。

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