Moharić Metka, Burger Helena
Department of Physical and Rehabilitation Medicine, Linhartova 51, SI-1000 Ljubljana, Slovenia.
Int J Rehabil Res. 2010 Sep;33(3):211-7. doi: 10.1097/MRR.0b013e3283352151.
Transcutaneous electrical nerve stimulation (TENS) is one of the therapies for painful neuropathy. Its analgesic mechanisms probably involve the gate control theory, the physiological block and the endogenous pain inhibitory system. The aim of the study was to determine whether TENS improves small fibre function diminished because of painful diabetic neuropathy. Forty-six patients with painful diabetic neuropathy were treated with TENS three consecutive hours a day for 3 weeks. Treatment effect was evaluated with cold, warm, cold pain and heat pain thresholds, vibration perception thresholds and touch perception thresholds. In all patients, thermal-specific and thermal pain sensitivity determination showed quantitative and qualitative abnormalities in all the measured spots. After the TENS therapy, no statistically significant changes in cold, warm, cold pain, heat pain, vibratory perception and touch perception thresholds were observed in the stimulated area. TENS did not alter C, Aδ nor Aβ fibre-mediated perception thresholds. The observed changes at thenar are probably because of central mechanisms. In general, analgesic mechanisms of TENS are likely to be complex.
经皮电神经刺激（TENS）是治疗疼痛性神经病变的方法之一。其镇痛机制可能涉及闸门控制理论、生理阻滞和内源性疼痛抑制系统。本研究的目的是确定TENS是否能改善因疼痛性糖尿病神经病变而受损的小纤维功能。46例疼痛性糖尿病神经病变患者接受TENS治疗，每天连续3小时，共3周。用冷、温、冷痛和热痛阈值、振动觉阈值和触觉阈值评估治疗效果。在所有患者中，热特异性和热痛敏感性测定显示，在所有测量部位均存在定量和定性异常。TENS治疗后，在刺激区域未观察到冷、温、冷痛、热痛、振动觉和触觉阈值有统计学意义的变化。TENS未改变C纤维、Aδ纤维和Aβ纤维介导的感觉阈值。在鱼际观察到的变化可能是由于中枢机制。一般来说，TENS的镇痛机制可能很复杂。
