电刺激电流与保守治疗相结合对雷诺现象患者血管舒张的补充作用：一项随机试验。

The complementary effects of galvanic current electrical stimulation associated with conservative treatment to increase vasodilation in patients with Raynaud's phenomenon: a randomized trial.

机构信息

Instituto de Investigación Biosanitaria ibs.GRANADA and Department of Physical Therapy, Faculty of Health Sciences, University of Granada (UGR), Granada, Spain.

Department of Nursing, Physical Therapy and Medicine, University of Almeria, Almeria, Spain.

出版信息

Clin Rehabil. 2020 May;34(5):595-606. doi: 10.1177/0269215520907652. Epub 2020 Mar 6.

DOI:10.1177/0269215520907652

PMID:32141306

Abstract

OBJECTIVE

To analyze the effectiveness of an electrotherapy intervention with galvanic current on symptoms associated with Raynaud's phenomenon.

DESIGN

Single-blind randomized controlled trial, parallel design (1:1 ratio) and intention-to-treat analysis.

SETTING

Virgen de las Nieves Hospital, Granada, Spain.

SUBJECTS

Thirty-four participants with Raynaud's phenomenon, with a mean (SD) age of 43.43 (17.62) years.

INTERVENTIONS

The patients were randomly assigned to a control group with conservative treatment (anti-inflammatory, vasodilatory and analgesic drugs) or an intervention group that received conservative treatment and vasodilatory electrical stimulation during seven weeks, three times/week for a total of 20 sessions.

MAIN MEASURES

The primary outcome was the number of attacks. Secondary outcomes were pain, peripheral blow flow, oxygen saturation, upper limb disability, central sensitization, pain catastrophizing and temperature recovery. All outcomes were assessed at baseline, posttreatment and at two months of follow-up.

RESULTS

The galvanic current electrotherapy group showed significantly greater improvements in the number of attacks (mean difference = 26.3, 95% confidence interval (CI) = 14.4 to 38.3), pre-cold stress pain (95% CI = 0.6 to 2.4), radial artery blood flow (95% CI = -7.8 ⩾ ⩽ 1.3), ulnar artery blood flow (95% CI = -8.63 to 0.60), oxygen saturation (95% CI = -1.7 ⩾ ⩽ -0.29), upper limb disability (95% CI = 1.1 to 22.3), central sensitization (95% CI = 6.7 to 18.2) and temperature recovery (95% CI = -5.7 ⩾ ⩽ -0.32) than the conservative treatment group.

CONCLUSION

This study suggests that a complementary treatment with galvanic current in combination to conservative approach is superior to conservative applied as isolate, in reducing the clinical manifestations and disability in Raynaud's phenomenon.

摘要

目的

分析电疗干预对雷诺现象相关症状的疗效。

设计

单盲随机对照试验，平行设计（1:1 比例）和意向治疗分析。

地点

西班牙格拉纳达的 Virgen de las Nieves 医院。

对象

34 名患有雷诺现象的参与者，平均（标准差）年龄为 43.43（17.62）岁。

干预

患者被随机分配到对照组（接受抗炎、血管扩张和镇痛药物治疗）或干预组（在七周内接受保守治疗和血管扩张电刺激治疗，每周三次，共 20 次）。

主要措施

主要结局是发作次数。次要结局是疼痛、外周血流、氧饱和度、上肢残疾、中枢敏化、疼痛灾难化和温度恢复。所有结局均在基线、治疗后和随访两个月时进行评估。

结果

电流电疗组在发作次数（平均差异=26.3，95%置信区间（CI）=14.4 至 38.3）、冷应激前疼痛（95% CI=0.6 至 2.4）、桡动脉血流（95% CI=-7.8 ⩾ ⁇ ⩽ ⁇ 1.3）、尺动脉血流（95% CI=-8.63 至 0.60）、氧饱和度（95% CI=-1.7 ⩾ ⁇ ⩽ ⁇ -0.29）、上肢残疾（95% CI=1.1 至 22.3）、中枢敏化（95% CI=6.7 至 18.2）和温度恢复（95% CI=-5.7 ⩾ ⁇ ⩽ ⁇ -0.32）方面的改善明显优于保守治疗组。