经皮神经电刺激治疗腓肠肌激痛点注射治疗疼痛的疗效：一项随机对照试验。
Efficacy of Topical Vibratory Stimulation for Reducing Pain During Trigger Point Injection to the Gastrocnemius: A Randomized Controlled Trial.
机构信息
Department of Anesthesiology and Pain Medicine, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, South Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Soonchunhyang University Hospital, Bucheon, South Korea.
出版信息
Arch Phys Med Rehabil. 2019 Sep;100(9):1607-1613. doi: 10.1016/j.apmr.2019.02.010. Epub 2019 Mar 27.
OBJECTIVE
To evaluate the efficacy of topical vibratory stimulation for reducing pain during trigger point injection (TPI).
DESIGN
Double-blind randomized placebo-controlled clinical trial.
SETTING
Tertiary care university hospital.
PARTICIPANTS
A total of 136 participants were randomly recruited from among patients with myofascial pain syndrome who were scheduled for TPI. Of these, 65 were excluded because they met the exclusion criteria, and 11 because they refused to participate. Finally, 60 participants were enrolled. No participants dropped out of the study.
INTERVENTION
Participants were randomly assigned to the vibration group or control group. TPI was performed with 0.5% lidocaine using a 25-gauge needle. A vibrator was applied to the popliteal fossa for 3 to 5 seconds prior to and during TPI to the gastrocnemius; 100-Hz vibration was turned on for the vibration group and turned off for the control group.
MAIN OUTCOME MEASURES
Pain intensity during TPI was assessed using a 100-mm visual analog scale (VAS) as a primary outcome, and participant satisfaction and preference for repeated use were measured using 5-point Likert scales as a secondary outcome. These parameters were evaluated immediately after TPI. The primary outcome was evaluated using analysis of covariance and secondary outcome using the Mann-Whitney U test.
RESULTS
VAS scores for pain during TPI were significantly lower in the vibration group (30.30; 95% confidence interval [CI], 22.65-39.26) compared with the control group (47.58; 95% CI, 38.80-56.52; F=7.74; P< .01). The mean difference in VAS scores between the 2 groups was 17.27 (95% CI, 5.24-29.30). Participant satisfaction and preference for repeated use were significantly higher in the vibration group than in the control group (P<.05). No participant showed any side effects.
CONCLUSION
Topical vibratory stimulation significantly decreased pain during TPI of the gastrocnemius.
目的
评估经皮穴位电刺激（TENS）缓解扳机点注射（TPI）疼痛的疗效。
设计
双盲随机安慰剂对照临床试验。
地点
三级护理大学医院。
参与者
共招募了 136 名计划接受 TPI 的肌筋膜疼痛综合征患者，他们被随机分为振动组或对照组。其中 65 人因不符合纳入标准而被排除，11 人因拒绝参与而被排除。最终有 60 名参与者入组。没有参与者退出研究。
干预措施
参与者被随机分配到振动组或对照组。使用 25 号针和 0.5%利多卡因进行 TPI。在 TPI 前和期间，将振动器应用于腘窝 3 至 5 秒，100Hz 振动开启用于振动组，关闭用于对照组。
主要观察指标
TPI 期间疼痛强度采用 100mm 视觉模拟量表（VAS）评估，作为主要结局，采用 5 分 Likert 量表评估参与者对重复使用的满意度和偏好，作为次要结局。这些参数在 TPI 后立即进行评估。主要结局采用协方差分析评估，次要结局采用 Mann-Whitney U 检验评估。
结果
与对照组（47.58；95%置信区间[CI]，38.80-56.52；F=7.74；P<.01）相比，振动组 TPI 时疼痛的 VAS 评分（30.30；95%CI，22.65-39.26）明显更低。两组间 VAS 评分的平均差异为 17.27（95%CI，5.24-29.30）。振动组的参与者满意度和对重复使用的偏好明显高于对照组（P<.05）。没有参与者出现任何副作用。
结论
经皮穴位电刺激可显著减轻比目鱼肌 TPI 时的疼痛。
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