Katz J, Melzack R
J Pain Symptom Manage. 1991 Feb;6(2):73-83. doi: 10.1016/0885-3924(91)90521-5.
The present paper evaluates the efficacy of low frequency, high intensity auricular transcutaneous electrical nerve stimulation (TENS) for the relief of phantom limb pain. Auricular TENS was compared with a no-stimulation placebo condition using a controlled crossover design in a group of amputees with (1) phantom limb pain (Group PLP), (2) nonpainful phantom limb sensations (Group PLS), and (3) no phantom limb at all (Group No PL). Small, but significant, reductions in the intensity of nonpainful phantom limb sensations were found for Group PLS during the TENS but not the placebo condition. In addition, 10 min after receiving auricular TENS, Group PLP demonstrated a modest, yet statistically significant decrease in pain as measured by the McGill Pain Questionnaire. Ratings of mood, sleepiness, and anxiety remained virtually unchanged across test occasions and sessions, indicating that the decrease in pain was not mediated by emotional factors. Further placebo-controlled trials of auricular TENS in patients with phantom limb pain are recommended in order to evaluate the importance of electrical stimulation parameters such as pulse width and rate, and to establish the duration of pain relief.
本文评估了低频、高强度耳穴经皮电刺激神经疗法(TENS)缓解幻肢痛的疗效。在一组截肢患者中,采用对照交叉设计,将耳穴TENS与无刺激的安慰剂条件进行比较,这些患者分为:(1)幻肢痛组(PLP组),(2)无痛性幻肢感觉组(PLS组),以及(3)根本没有幻肢的组(无PL组)。在TENS治疗期间,PLS组无痛性幻肢感觉的强度有小幅但显著的降低,而在安慰剂条件下则没有。此外,接受耳穴TENS治疗10分钟后,PLP组通过麦吉尔疼痛问卷测量显示疼痛有适度但具有统计学意义的减轻。在不同的测试场合和疗程中,情绪、嗜睡和焦虑评分几乎没有变化,这表明疼痛的减轻不是由情绪因素介导的。建议对幻肢痛患者进行进一步的耳穴TENS安慰剂对照试验,以评估诸如脉冲宽度和频率等电刺激参数的重要性,并确定疼痛缓解的持续时间。