Sato Karina Laurenti, Sanada Luciana Sayuri, Silva Morgana Duarte da, Okubo Rodrigo, Sluka Kathleen A
Department of Physical Therapy, Federal University of Sergipe, Sao Cristovao, Brazil.
Department of Physical Therapy, Physiotherapy Postgraduate Program, Santa Catarina State University, Florianopolis, Brazil.
Korean J Pain. 2020 Apr 1;33(2):121-130. doi: 10.3344/kjp.2020.33.2.121.
Transcutaneous electrical nerve stimulation (TENS), manual acupuncture (MA), and spinal cord stimulation (SCS) are used to treat a variety of pain conditions. These non-pharmacological treatments are often thought to work through similar mechanisms, and thus should have similar effects for different types of pain. However, it is unclear if each of these treatments work equally well on each type of pain condition. The purpose of this study was to compared the effects of TENS, MA, and SCS on neuropathic, inflammatory, and non-inflammatory pain models.
TENS 60 Hz, 200 μs, 90% motor threshold (MT), SCS was applied at 60 Hz, an intensity of 90% MT, and a 0.25 ms pulse width. MA was performed by inserting a stainless-steel needle to a depth of about 4-5 mm at the Sanyinjiao (SP6) and Zusanli (ST36) acupoints on a spared nerve injury (SNI), knee joint inflammation (3% carrageenan), and non-inflammatory muscle pain (intramuscular pH 4.0 injections) in rats. Mechanical withdrawal thresholds of the paw, muscle, and/or joint were assessed before and after induction of the pain model, and daily before and after treatment.
The reduced withdrawal thresholds were significantly reversed by application of either TENS or SCS ( < 0.05). MA, on the other hand, increased the withdrawal threshold in animals with SNI and joint inflammation, but not chronic muscle pain.
TENS and SCS produce similar effects in neuropathic, inflammatory and non-inflammatory muscle pain models while MA is only effective in inflammatory and neuropathic pain models.
经皮电刺激神经疗法（TENS）、手动针刺疗法（MA）和脊髓刺激疗法（SCS）被用于治疗多种疼痛病症。这些非药物治疗方法通常被认为是通过相似的机制起作用，因此对于不同类型的疼痛应具有相似的效果。然而，目前尚不清楚这些治疗方法中的每一种对每种疼痛病症的疗效是否相同。本研究的目的是比较TENS、MA和SCS对神经性、炎症性和非炎症性疼痛模型的影响。
TENS采用60Hz、200μs、90%运动阈值（MT），SCS采用60Hz、90%MT强度和0.25ms脉冲宽度。通过在大鼠的 spared nerve injury（SNI）、膝关节炎症（3%角叉菜胶）和非炎症性肌肉疼痛（肌肉内注射pH4.0）的三阴交（SP6）和足三里（ST36）穴位插入不锈钢针至约4-5mm深度来进行MA。在疼痛模型诱导前后以及治疗前后每日评估爪、肌肉和/或关节的机械性撤针阈值。
应用TENS或SCS后，降低的撤针阈值得到显著逆转（<0.05）。另一方面，MA提高了SNI和关节炎症动物的撤针阈值，但对慢性肌肉疼痛无效。
TENS和SCS在神经性、炎症性和非炎症性肌肉疼痛模型中产生相似的效果，而MA仅在炎症性和神经性疼痛模型中有效。
