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非药物止痛治疗:经皮电神经刺激和针灸。

Non-pharmacological treatments for pain relief: TENS and acupuncture.

机构信息

Consultation d'évaluation et de traitement de la douleur, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.

出版信息

Joint Bone Spine. 2017 Dec;84(6):657-661. doi: 10.1016/j.jbspin.2017.02.005. Epub 2017 Feb 20.

Abstract

Acupuncture and transcutaneous electrical nerve stimulation (TENS) are non-pharmacological methods that have been used for millennia to relieve pain. As with all complementary treatments, efficacy evaluations face two hurdles: the non-feasibility of double-blinding and the difficulty in identifying the optimal control population or treatment. Nevertheless, recent studies of good methodological quality have demonstrated benefits in many types of pain compared to conventional treatment. The mechanisms of action of acupuncture and TENS, which are increasingly well understood, involve endogenous pain control systems, cerebral plasticity, and nonspecific effects (e.g., expectations and placebo effect). No serious adverse effects have been reported. These data support the more widespread use of non-pharmacological pain management, most notably in patients with chronic pain inadequately relieved by medications alone.

摘要

针灸和经皮电神经刺激(TENS)是两种非药物方法,已经有几千年的历史用于缓解疼痛。与所有补充治疗方法一样,疗效评估面临两个障碍:双盲法的不可行性和确定最佳对照人群或治疗方法的困难。然而,最近一些方法学质量较高的研究表明,与传统治疗相比,针灸和 TENS 在许多类型的疼痛中都有疗效。针灸和 TENS 的作用机制越来越被理解,包括内源性疼痛控制系统、大脑可塑性和非特异性效应(例如,期望和安慰剂效应)。没有报告严重的不良反应。这些数据支持更广泛地使用非药物性疼痛管理,特别是在单独使用药物治疗无法充分缓解慢性疼痛的患者中。

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