Epidemiology and Data Analysis Laboratory, ABC Medical School (FMABC), Av. Lauro Gomes 2000, Vila Sacadura Cabral, Santo André, 09060-870 São Paulo, SP, Brazil.
Federal Institute of Education, Science and Technology of Ceara, Boa Viagem Campus, Rod. Pres. Juscelino Kubitschek, 63870-000 Boa Viagem, CE, Brazil.
Mediators Inflamm. 2018 Apr 2;2018:1094352. doi: 10.1155/2018/1094352. eCollection 2018.
The mechanism of pain reduction involves bidirectional processes of pain blocking (nociception) and reductions in the levels of proinflammatory cytokines in the blood. Does transcutaneous electrical nerve stimulation (TENS) reduce blood levels of proinflammatory cytokines? For this systematic review, we searched in six databases to identify randomized controlled trials with the criteria: humans older than 18 years (adults), use of TENS in the experimental group, and having at least one pre- and postintervention blood level of at least one proinflammatory cytokine. The risk of bias and the level of evidence were assessed. Five studies were included involving 240 participants. The heterogeneity of the studies was high (: 85%); therefore, we used a random-effects meta-analysis. It was observed through the meta-analysis synthesis measures that there were statistically significant differences following the use of TENS to reduce the general group of cytokines. When grouped by chronic disease, by postoperative settings, or by individual studies in the case of IL-6, it was observed that the significant reduction of cytokines related to the use of TENS was maintained. The use of TENS reduced the blood levels of proinflammatory cytokines (we observed a protective factor of TENS in relation to inflammation). The protocol of the systematic review was registered in PROSPERO, CRD42017060379.
镇痛机制涉及疼痛阻断（痛觉）和血液中促炎细胞因子水平降低的双向过程。经皮神经电刺激（TENS）是否能降低血液中促炎细胞因子的水平？在这项系统评价中，我们在六个数据库中进行了检索，以确定符合以下标准的随机对照试验：年龄大于 18 岁的人类（成年人）、实验组使用 TENS、至少有一次干预前后血液中至少一种促炎细胞因子的水平。我们评估了偏倚风险和证据水平。纳入了五项研究，涉及 240 名参与者。研究之间的异质性很高（I²=85%）；因此，我们使用了随机效应荟萃分析。荟萃分析综合测量结果表明，TENS 可显著降低一般细胞因子组。当按慢性疾病、术后环境或个别研究中 IL-6 进行分组时，观察到与 TENS 使用相关的细胞因子显著降低。TENS 的使用降低了促炎细胞因子的血液水平（我们观察到 TENS 与炎症相关的保护因素）。系统评价的方案已在 PROSPERO 中注册，CRD42017060379。
