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脉冲电磁场(PEMF)作为间质性膀胱炎/膀胱疼痛综合征疼痛管理的辅助疗法。

Pulsed electromagnetic field (PEMF) as an adjunct therapy for pain management in interstitial cystitis/bladder pain syndrome.

作者信息

Ross Christina, Overholt Tyler, Xu Raymond, Badlani Gopal, Evans Robert J, Matthews Catherine A, Walker Stephen J

机构信息

Wake Forest Institute for Regenerative Medicine, Wake Forest Baptist Medical Center, 391 Technology Way, Winston Salem, NC, 27101, USA.

Department of Urology/Female Pelvic Health, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.

出版信息

Int Urogynecol J. 2022 Mar;33(3):487-491. doi: 10.1007/s00192-021-04862-3. Epub 2021 Jun 8.

Abstract

INTRODUCTION AND HYPOTHESIS

Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) often experience chronic pelvic and even systemic pain that can be difficult to clinically manage. Pulsed electromagnetic field (PEMF) therapy, a non-invasive strategy that has shown significant efficacy for pain reduction in other chronic pain conditions, may provide benefit for pain management in patients with IC/BPS.

METHODS

PEMF delivery to patients occurs via a bio-electromagnetic-energy device which consists of a flexible mat (180 × 50 cm) that the patient lies on for systemic, full-body delivery and/or a flexible pad (50 × 15 cm) for targeted delivery to a specific body region (e.g., pelvic area). The duration of individual sessions, number of sessions per day, total number of sessions, and follow-up observation period vary between previously published studies. Positive outcomes are typically reported as a significant reduction in visual analog scale (VAS) pain score and functional improvement assessed using validated questionnaires specific to the condition under study.

RESULTS AND CONCLUSIONS

The use of PEMF has been evaluated as a therapeutic strategy for pain management in several clinical scenarios. Randomized, double-blinded, placebo-controlled trials have reported positive efficacy and safety profiles when PEMF was used to treat non-specific low back pain, patellofemoral pain syndrome, chronic post-operative pain, osteoarthritis-related pain, rheumatoid arthritis-related pain, and fibromyalgia-related pain. Based on these positive outcomes in a variety of pain conditions, clinical trials to evaluate whether PEMF can provide a safe, non-invasive therapeutic approach to improve symptoms of chronic pain and fatigue in patients with IC/BPS are warranted.

摘要

引言与假设

间质性膀胱炎/膀胱疼痛综合征(IC/BPS)患者常经历慢性盆腔疼痛甚至全身性疼痛,临床管理颇具难度。脉冲电磁场(PEMF)疗法是一种非侵入性策略,已在其他慢性疼痛病症中显示出显著的止痛效果,可能对IC/BPS患者的疼痛管理有益。

方法

通过生物电磁能量设备向患者输送PEMF,该设备包括一块柔性垫(180×50厘米),患者躺在上面接受全身照射,和/或一块柔性垫(50×15厘米)用于靶向照射特定身体区域(如盆腔区域)。先前发表的研究中,单次治疗时长、每日治疗次数、总治疗次数以及随访观察期各不相同。阳性结果通常表现为视觉模拟量表(VAS)疼痛评分显著降低,以及使用针对所研究病症的有效问卷评估的功能改善。

结果与结论

在几种临床情况下,已对PEMF作为疼痛管理治疗策略进行了评估。随机、双盲、安慰剂对照试验报告称,当PEMF用于治疗非特异性腰痛、髌股疼痛综合征、慢性术后疼痛、骨关节炎相关疼痛、类风湿关节炎相关疼痛和纤维肌痛相关疼痛时,具有积极的疗效和安全性。基于这些在多种疼痛病症中的积极结果,有必要开展临床试验以评估PEMF是否能为改善IC/BPS患者的慢性疼痛和疲劳症状提供一种安全、非侵入性的治疗方法。

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