未调制的5千赫兹交流电与经皮电刺激神经疗法对机械性和热性疼痛、触觉阈值及周围神经传导的影响：一项双盲、安慰剂对照的交叉试验

Effect of Unmodulated 5-kHz Alternating Currents Versus Transcutaneous Electrical Nerve Stimulation on Mechanical and Thermal Pain, Tactile Threshold, and Peripheral Nerve Conduction: A Double-Blind, Placebo-Controlled Crossover Trial.

作者信息

Avendaño-Coy Juan, Gómez-Soriano Julio, Goicoechea-García Carlos, Basco-López Julian Angel, Taylor Julian

机构信息

Toledo Physiotherapy Research Group (GIFTO), Department of Nursing, Physical Therapy and Occupational Therapy, Castilla-La Mancha University, Toledo, Spain.

出版信息

Arch Phys Med Rehabil. 2017 May;98(5):888-895. doi: 10.1016/j.apmr.2016.11.020. Epub 2016 Dec 23.

DOI:10.1016/j.apmr.2016.11.020

PMID:28017706

Abstract

OBJECTIVE

To investigate the effect of unmodulated 5-kHz alternating current on mechanical pain threshold (MPT), heat pain threshold (HPT), tactile threshold (TT), and peripheral nerve conduction (PNC) compared with transcutaneous electrical nerve stimulation (TENS) and sham stimulation.

SETTING

National referral center.

DESIGN

Randomized, double-blind, placebo-controlled crossover trial.

PARTICIPANTS

Healthy volunteers (N=38). No dropouts or adverse events were reported.

INTERVENTION

TENS, unmodulated 5-kHz currents, and sham stimulation were applied on the radial nerve for 20 minutes with a 24-hour washout period between them and concealed intervention allocation.

MAIN OUTCOME MEASURES

Four measures were taken: before, during, and 2 after the interventions. Algometry was used to assess MPT, a Peltier thermode for HPT using the method of limits, Von Frey filaments for TT, and radial nerve compound action potential.

RESULTS

No differences were observed on MPT, HPT, and PNC when 5-kHz current and TENS were compared. However, TT increased 56.2mN (95% confidence interval [CI], 28.8-83.6) in the TENS group compared with the 5-kHz current group during intervention. Compared with sham stimulation during intervention, MPT increased 4.7N (95% CI, 0.3-9.2) using 5-kHz current and 10.4N (95% CI, 3.5-17.3) with TENS. TT increased 17.2mN (95% CI, 4.7-29.7) with 5-kHz current and 73.4mN (95% CI, 47.5-99.2) with TENS. However, HPT increased 1.0°C (95% CI, 0.2-2.0) only with TENS. For the PNC, no differences were found among the 3 groups.

CONCLUSIONS

Unmodulated 5-kHz current produced an increase in somatosensory thresholds that was greater than placebo but not when compared with TENS; however, participants perceived 5-kHz currents to be more comfortable and showed more habituation to them.

摘要

目的

与经皮电刺激神经疗法（TENS）和假刺激相比，研究未调制的5千赫交流电对机械痛阈（MPT）、热痛阈（HPT）、触觉阈（TT）和周围神经传导（PNC）的影响。

设置

国家转诊中心。

设计

随机、双盲、安慰剂对照交叉试验。

参与者

健康志愿者（N = 38）。未报告有退出者或不良事件。

干预措施

将TENS、未调制的5千赫电流和假刺激施加于桡神经20分钟，每次干预之间有24小时的洗脱期，并采用隐蔽的干预分配方式。

主要观察指标

在干预前、干预期间和干预后2次进行四项测量。使用压力测痛法评估MPT，使用极限法通过珀尔帖热刺激器评估HPT，使用冯·弗雷细丝评估TT，并测量桡神经复合动作电位。

结果

比较5千赫电流和TENS时，MPT、HPT和PNC未观察到差异。然而，在干预期间，与5千赫电流组相比，TENS组的TT增加了56.2毫牛顿（95%置信区间[CI]，28.8 - 83.6）。与干预期间的假刺激相比，使用5千赫电流时MPT增加了4.7牛顿（95% CI，0.3 - 9.2），使用TENS时增加了10.4牛顿（95% CI，3.5 - 17.3）。使用5千赫电流时TT增加了17.2毫牛顿（95% CI，4.7 - 29.7），使用TENS时增加了73.4毫牛顿（95% CI，47.5 - 99.2）。然而，仅TENS使HPT增加了1.0°C（95% CI，0.2 - 2.0）。对于PNC，三组之间未发现差异。