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外周磁刺激治疗纤维肌痛:一项系统评价与荟萃分析

Peripheral magnetic stimulation for the treatment of fibromyalgia: a systematic review and meta-analysis.

作者信息

Leenus Alvin, Rahman Rayaan, Dana Elad, Tran Cody, Westwood Duncan, Osokin Evgeny E, Hoydonckx Yasmine, Moayedi Massieh, Hirani Salman, Khan James S

机构信息

Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.

Faculty of Medicine, McGill University, Montreal, QC, Canada.

出版信息

Pain Manag. 2025 Jan;15(1):45-53. doi: 10.1080/17581869.2025.2459594. Epub 2025 Jan 30.

Abstract

OBJECTIVES

To systematically review and conduct a meta-analysis of studies on peripheral magnetic stimulation (PMS) for fibromyalgia (FM) treatment.

METHODS

MEDLINE, EMBASE, CENTRAL, CINHAL, Web of Science, and ProQuest databases were searched from inception to July 2023 for studies in adult patients with FM treated with PMS. Studies using transcranial magnetic stimulation were excluded.

RESULTS

Six randomized controlled trials (RCTs) ( = 279 patients) were identified and included in the review. PMS regimens varied, ranging from 8 to 40 min per session over 3-84 days. All studies compared PMS to a visually and physically identical sham device without magnetic fields. Most of the included studies demonstrated positive findings for PMS on pain and functional outcomes. In our meta-analysis, PMS significantly reduced pain scores within 1-3 months (mean difference -1.86 on NRS, 95% confidence interval -2.85 to -0.87,  = 0.0002, I = 68%, 4 studies [154 participants], low quality of evidence), but not at ≥3 months (low quality of evidence). Minimal adverse effects were reported.

DISCUSSION

Evidence for PMS use in FM is encouraging for short-term benefit. However, heterogeneous patient populations, varied PMS regimens, and limited number of studies are important limitations. Large, high-quality RCTs are needed to confirm PMS benefits and to make definitive recommendations.

PROTOCOL REGISTRATION

PROSPERO Identifier is CRD42021235164.

摘要

目的

系统评价并对关于外周磁刺激(PMS)治疗纤维肌痛(FM)的研究进行荟萃分析。

方法

检索MEDLINE、EMBASE、CENTRAL、CINHAL、科学网和ProQuest数据库,纳入自数据库建库至2023年7月期间使用PMS治疗成年FM患者的研究。排除使用经颅磁刺激的研究。

结果

共识别出6项随机对照试验(RCT)(n = 279例患者)并纳入本综述。PMS方案各不相同,每次治疗时间为8至40分钟,疗程为3至84天。所有研究均将PMS与视觉和物理外观相同但无磁场的假装置进行比较。大多数纳入研究表明PMS在疼痛和功能结局方面有积极结果。在我们的荟萃分析中,PMS在1至3个月内显著降低疼痛评分(NRS平均差值为-1.86,95%置信区间为-2.85至-0.87,P = 0.0002,I² = 68%,4项研究[154名参与者],证据质量低),但在≥3个月时未降低(证据质量低)。报告的不良反应极少。

讨论

PMS用于FM的证据表明其在短期有益,这令人鼓舞。然而,患者群体异质性、PMS方案多样以及研究数量有限是重要局限性。需要开展大型、高质量的RCT来证实PMS的益处并给出明确建议。

方案注册

PROSPERO标识符为CRD42021235164。

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