重复经颅磁刺激在慢性盆腔疼痛综合征治疗中的临床应用：一项范围综述
Clinical application of repetitive transcranial magnetic stimulation in the treatment of chronic pelvic pain syndrome: a scoping review.
作者信息
Luo Chunmei, Zhang Baocheng, Zhou Jing, Yu Keqiang, Chang Degui
机构信息
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Anorectal Department, Chengdu Anorectal Hospital, Chengdu, China.
出版信息
Front Neurol. 2025 Feb 26;16:1499133. doi: 10.3389/fneur.2025.1499133. eCollection 2025.
INTRODUCTION
Chronic pelvic pain syndrome is a common condition characterized by persistent symptoms that are difficult to treat. Repetitive transcranial magnetic stimulation (rTMS) is considered a safe treatment option for alleviating chronic pelvic pain, but different stimulation protocols can affect pain relief outcomes. Establishing an optimal stimulation protocol can enhance the uniformity and consistency of rTMS to provide a potentially effective therapeutic intervention. This review sought to systematically review and assess the existing literature on transcranial magnetic stimulation in patients experiencing chronic pelvic pain syndrome, evaluate the therapeutic efficacy, and determine the most effective stimulation protocol.
METHODS
A comprehensive search was conducted across three databases, supplemented by manual searches. Two researchers independently reviewed and extracted relevant studies and subsequently performed a thorough analysis of all available clinical data.
RESULTS
A total of eight studies were ultimately incorporated into the analysis. These comprised two randomized controlled trials, one self-controlled trial, two case reports, and three prospective studies. All studies demonstrated a notable reduction in pain scores post-treatment.
CONCLUSION
rTMS has demonstrated efficacy in alleviating pain in individuals suffering from chronic pelvic pain syndrome. It is regarded as a safe intervention with minimal adverse effects. Nonetheless, the variability observed across studies hindered our ability to conclusively determine the most effective stimulation sites and parameters. Additional research is essential to reduce bias, enhance methodological rigor, and ascertain the optimal conditions and indications for brain stimulation to optimize the therapeutic effectiveness of rTMS.
SYSTEMATIC REVIEW REGISTRATION
https://inplasy.com/projects/, identifier INPLASY2023120112.
引言
慢性盆腔疼痛综合征是一种常见病症，其特征为症状持续且难以治疗。重复经颅磁刺激（rTMS）被认为是缓解慢性盆腔疼痛的一种安全治疗选择，但不同的刺激方案可能会影响疼痛缓解效果。建立最佳刺激方案可提高rTMS的一致性和连贯性，从而提供一种潜在有效的治疗干预措施。本综述旨在系统回顾和评估有关慢性盆腔疼痛综合征患者经颅磁刺激的现有文献，评估其治疗效果，并确定最有效的刺激方案。
方法
在三个数据库中进行了全面检索，并辅以手工检索。两名研究人员独立审查并提取相关研究，随后对所有可用的临床数据进行了深入分析。
结果
最终共有八项研究纳入分析。其中包括两项随机对照试验、一项自身对照试验、两份病例报告和三项前瞻性研究。所有研究均表明治疗后疼痛评分显著降低。
结论
rTMS已证明对缓解慢性盆腔疼痛综合征患者的疼痛有效。它被视为一种安全的干预措施，副作用最小。然而，研究中观察到的变异性阻碍了我们最终确定最有效的刺激部位和参数的能力。有必要进行更多研究以减少偏倚、提高方法学严谨性，并确定脑刺激的最佳条件和适应症，以优化rTMS的治疗效果。
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