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静磁场疗法:剂量学考量

Static magnetic field therapy: dosimetry considerations.

作者信息

Colbert Agatha P, Markov Marko S, Souder James S

机构信息

Helfgott Research Institute, National College of Natural Medicine, Portland, OR 97201, USA.

出版信息

J Altern Complement Med. 2008 Jun;14(5):577-82. doi: 10.1089/acm.2007.0827.

DOI:10.1089/acm.2007.0827
PMID:18532897
Abstract

The widespread use of static magnetic field (SMF) therapy as a self-care physical intervention has led to the conduct of numerous randomized controlled trials (RCTs). A recent systematic review of SMF trials for pain reduction concluded that the evidence does not support the use of permanent magnets for pain relief. We argue that this conclusion is unwarranted if the SMF dosage was inadequate or inappropriate for the clinical condition treated. The purpose of this communication is to (1) provide a rationale and an explanation for each of 10 essential SMF dosing parameters that should be considered when conducting trials of SMF therapy, and (2) advocate for the conduct of Phase I studies to optimize SMF dosimetry for each condition prior to implementing a large-scale RCT. A previous critical review of SMF dosimetry in 56 clinical studies found that reporting SMF dosages in a majority of those studies was of such poor quality that the magnetic field exposure at the target tissue could not be characterized. Without knowing what magnetic field actually reached the target, it is impossible to judge dosage adequacy. In order to quantify SMF exposure at the site of pathology (target tissue/s), that site must be clearly named; the distance of the permanent magnet surface from the target must be delineated; the physical parameters of the applied permanent magnet must be described; and the dosing regimen must be precisely reported. If the SMF dosimetry is inadequate, any inferences drawn from reported negative findings are questionable.

摘要

静磁场(SMF)疗法作为一种自我保健的物理干预手段被广泛应用,这促使了众多随机对照试验(RCT)的开展。最近一项关于SMF疗法减轻疼痛的系统评价得出结论,证据不支持使用永磁体缓解疼痛。我们认为,如果SMF剂量不足或不适用于所治疗的临床病症,这一结论是没有依据的。本交流的目的是:(1)为进行SMF疗法试验时应考虑的10个基本SMF剂量参数中的每一个提供原理和解释;(2)倡导在开展大规模RCT之前,针对每种病症进行I期研究以优化SMF剂量测定法。先前对56项临床研究中的SMF剂量测定法进行的批判性综述发现,这些研究中的大多数在报告SMF剂量时质量很差,以至于无法确定靶组织处的磁场暴露情况。在不知道实际到达靶标的是什么磁场的情况下,就无法判断剂量是否充足。为了量化病理部位(靶组织)处的SMF暴露,必须明确指出该部位;必须划定永磁体表面与靶标的距离;必须描述所应用永磁体的物理参数;并且必须精确报告给药方案。如果SMF剂量测定法不充分,那么从所报告的阴性结果得出的任何推论都是值得怀疑的。

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