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新型痛点治疗与传统物理治疗对慢性颈肩痛的疗效比较:多中心随机对照试验

Novel Noxipoint Therapy versus Conventional Physical Therapy for Chronic Neck and Shoulder Pain: Multicentre Randomised Controlled Trials.

作者信息

Koo Charles C, Lin Ray S, Wang Tyng-Guey, Tsauo Jau-Yih, Yang Pan-Chyr, Yen Chen-Tung, Biswal Sandip

机构信息

Stanford University, Stanford, CA 94305, U.S.A.

College of Medicine, National Taiwan University, Taipei, Taiwan 100.

出版信息

Sci Rep. 2015 Nov 10;5:16342. doi: 10.1038/srep16342.

Abstract

As chronic pain affects 115 million people and costs $600B annually in the US alone, effective noninvasive nonpharmacological remedies are desirable. The purpose of this study was to determine the efficacy and the generalisability of Noxipoint therapy (NT), a novel electrotherapy characterised by site-specific stimulation, intensity-and-submodality-specific settings and a immobilization period, for chronic neck and shoulder pain. Ninety-seven heavily pretreated severe chronic neck/shoulder pain patients were recruited; 34 and 44 patients were randomly allocated to different treatment arms in two patient-and-assessor-blinded, randomised controlled studies. The participants received NT or conventional physical therapy including transcutaneous electrical nerve stimulation (PT-TENS) for three to six 90-minute sessions. In Study One, NT improved chronic pain (-89.6%, Brief Pain Inventory, p < 0.0001, 95% confidence interval), function (+77.4%, range of motion) and quality of life (+88.1%) at follow-up (from 4 weeks to 5 months), whereas PT-TENS resulted in no significant changes in these parameters. Study Two demonstrated similar advantages of NT over PT-TENS and the generalisability of NT. NT-like treatments in a randomised rat study showed a similar reduction in chronic hypersensitivity (-81%, p < 0.01) compared with sham treatments. NT substantially reduces chronic neck and shoulder pain, restores function, and improves quality of life in a sustained manner.

摘要

由于慢性疼痛影响着1.15亿人,仅在美国每年就花费6000亿美元,因此有效的非侵入性非药物疗法备受期待。本研究的目的是确定诺西点疗法(NT)对慢性颈肩痛的疗效和普遍性,NT是一种新型电疗法,其特点是特定部位刺激、强度和亚模式特定设置以及固定期。招募了97名经过大量预处理的重度慢性颈/肩痛患者;在两项患者和评估者双盲的随机对照研究中,34名和44名患者被随机分配到不同的治疗组。参与者接受NT或包括经皮电刺激神经疗法(PT-TENS)在内的传统物理治疗,为期三至六个90分钟疗程。在研究一中,随访(4周至5个月)时,NT改善了慢性疼痛(简短疼痛量表,-89.6%,p<0.0001,95%置信区间)、功能(+77.4%,活动范围)和生活质量(+88.1%),而PT-TENS在这些参数上没有显著变化。研究二证明了NT相对于PT-TENS的类似优势以及NT的普遍性。在一项随机大鼠研究中,与假治疗相比,类似NT的治疗显示慢性超敏反应有类似程度的降低(-81%,p<0.01)。NT能显著减轻慢性颈肩痛,持续恢复功能并改善生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e47/4639784/abf138e7baf7/srep16342-f1.jpg

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