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膝骨关节炎患者的经皮电神经刺激:来自随机对照试验的证据。

Transcutaneous Electrical Nerve Stimulation in Patients With Knee Osteoarthritis: Evidence From Randomized-controlled Trials.

作者信息

Chen Ling-Xiao, Zhou Zhi-Rui, Li Yu-Lin, Ning Guang-Zhi, Li Yan, Wang Xiao-Bo, Feng Shi-Qing

机构信息

*Department of Orthopaedics, Tianjin Medical University General Hospital, Heping District, Tianjin †Department of Radiation Oncology, Fudan University Shanghai Cancer Center ‡Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

出版信息

Clin J Pain. 2016 Feb;32(2):146-54. doi: 10.1097/AJP.0000000000000233.

Abstract

OBJECTIVES

Transcutaneous electrical nerve stimulation (TENS) has been reported to relieve pain and improve function in patients with knee osteoarthritis. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of TENS for the management of knee osteoarthritis.

METHODS

We searched Embase, PubMed, CENTRAL, SIGLE, PEDro, and clinicaltrials.gov, up to June 2014 for literature related to TENS used for the treatment of knee osteoarthritis. Two authors independently screened the searched records based on the title and abstract. Information including the authors, study design, mean age, sex, study population, stimulation frequency (of TENS), outcome measures, and follow-up periods were extracted by the 2 authors.

RESULTS

Eighteen trials were included in the qualitative systematic review, and 14 were included in the meta-analysis. TENS significantly decreased pain (standard mean difference, -0.79; 95% confidence interval [CI], -1.31 to -0.27; P<0.00001) compared with control groups. There was no significant difference in the Western Ontario and McMaster Universities Osteoarthritis Index (standard mean differences, -0.13; 95% CI, -0.35 to 0.1; P=0.09) or the rate of all-cause discontinuation (risk ratio, 0.77; 95% CI, 0.48 to 1.22; P=0.94) between the TENS and control groups.

DISCUSSION

TENS might relieve pain due to knee osteoarthritis. Further randomized-controlled trials should focus on large-scale studies and a longer duration of follow-up.

摘要

目的

据报道,经皮电刺激神经疗法(TENS)可缓解膝关节骨关节炎患者的疼痛并改善其功能。本系统评价和荟萃分析的目的是评估TENS治疗膝关节骨关节炎的疗效。

方法

我们检索了截至2014年6月的Embase、PubMed、CENTRAL、SIGLE、PEDro和clinicaltrials.gov,以查找与TENS用于治疗膝关节骨关节炎相关的文献。两位作者根据标题和摘要独立筛选检索到的记录。两位作者提取了包括作者、研究设计、平均年龄、性别、研究人群、(TENS的)刺激频率、结局指标和随访期等信息。

结果

定性系统评价纳入了18项试验,荟萃分析纳入了14项试验。与对照组相比,TENS显著减轻了疼痛(标准均差,-0.79;95%置信区间[CI],-1.31至-0.27;P<0.00001)。在西安大略和麦克马斯特大学骨关节炎指数方面(标准均差,-0.13;95%CI,-0.35至0.1;P=0.09),或在TENS组与对照组之间的全因停药率方面(风险比,0.77;95%CI,0.48至1.22;P=0.94),均无显著差异。

讨论

TENS可能缓解膝关节骨关节炎所致的疼痛。进一步的随机对照试验应侧重于大规模研究和更长的随访期。

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