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重复经颅磁刺激(rPMS)缓解上斜方肌肌筋膜疼痛综合征患者针刺后疼痛的有效性:一项双盲、随机临床试验。

Effectiveness of Repetitive Peripheral Magnetic Stimulation (rPMS) in Relieving Post-Needling Soreness in Patient with Upper Trapezius Myofascial Pain Syndrome: A Double-Blind, Randomized Clinical Trial.

作者信息

Vearasilp Anja, Sukareechai Chomkajee

机构信息

Department of Rehabilitation Medicine, Panyananthaphikkhu Chonprathan Medical Center Srinakharinwirot University, Nonthaburi, Thailand.

出版信息

J Pain Res. 2025 May 20;18:2541-2548. doi: 10.2147/JPR.S519318. eCollection 2025.

Abstract

OBJECTIVE

To study the effectiveness of relieving post-needling soreness with repetitive peripheral magnetic stimulation (rPMS) compared with sham.

METHODS

This double-blind, randomized clinical trial evaluated the effects of repetitive peripheral magnetic stimulation (rPMS) on post-needling soreness following dry-needling treatment. Participants who had active myofascial pain trigger points (MTrPs), in the upper trapezius muscle and received dry needling at the upper trapezius muscle were randomly assigned to either an rPMS group, which received targeted magnetic stimulation at the site of post-needling soreness, or a sham group, which receiving a placebo intervention simulating the rPMS procedure. The rPMS parameters were set to standard mode with normal current direction and a biphasic waveform. Specific settings included an inter-pulse interval of 10, burst pulse of 2, pulse B/A ratio of 1.0, a repetitive rate of 20 pulses per second, and a total of 20 pulse trains over a 10-minute session. Results were assessed using a standardized pain scale to quantify soreness levels at various intervals post-treatment, ultimately aiming to determine if rPMS significantly enhances recovery compared to sham stimulation of magnetic stimulation sessions at the sore area or a sham group undergoing a placebo intervention mimicking the rPMS procedure. The primary outcome was the pressure pain threshold (PPT) change, measured immediately after dry needling and post-intervention. Secondary outcomes included changes in pain intensity, assessed using the Numeric Rating Scale (NRS) immediately post-dry needling, post-intervention, and at 24- and 48-hours post-intervention, as well as neck range of motion, measured at the same intervals. This methodology provided a robust framework to compare the therapeutic effects of rPMS with a placebo intervention in managing post-needling soreness.

RESULTS

The rPMS group demonstrated a significant increase in PPT compared to the sham group (P=0.002). The Numeric Rating Scale (NRS) also significantly improved in the rPMS group compared to the sham group (P < 0.05). No serious adverse events were reported.

CONCLUSION

Repetitive peripheral magnetic stimulation (rPMS) is an effective method for relieving post-needling soreness compared to sham treatment. This non-invasive modality may benefit clinical practice by enhancing patient comfort and recovery after needling interventions.

摘要

目的

研究重复外周磁刺激(rPMS)与假刺激相比缓解针刺后疼痛的效果。

方法

这项双盲、随机临床试验评估了重复外周磁刺激(rPMS)对干针治疗后针刺后疼痛的影响。在上斜方肌有活跃肌筋膜疼痛触发点(MTrP)且接受过上斜方肌干针治疗的参与者被随机分配到rPMS组,该组在针刺后疼痛部位接受靶向磁刺激,或假刺激组,该组接受模拟rPMS程序的安慰剂干预。rPMS参数设置为标准模式,电流方向正常,波形为双相。具体设置包括脉冲间期10、爆发脉冲数2、脉冲B/A比1.0、重复频率每秒20个脉冲,在10分钟疗程内共20个脉冲序列。使用标准化疼痛量表评估结果,以量化治疗后不同时间间隔的疼痛程度,最终目的是确定与在疼痛区域进行假磁刺激或接受模拟rPMS程序的安慰剂干预的假刺激组相比,rPMS是否能显著促进恢复。主要结局是干针治疗后及干预后立即测量的压力疼痛阈值(PPT)变化。次要结局包括使用数字评分量表(NRS)在干针治疗后、干预后以及干预后24小时和48小时评估的疼痛强度变化,以及在相同时间间隔测量的颈部活动范围。该方法提供了一个强大的框架,用于比较rPMS与安慰剂干预在管理针刺后疼痛方面的治疗效果。

结果

与假刺激组相比,rPMS组的PPT显著增加(P = 0.002)。与假刺激组相比,rPMS组的数字评分量表(NRS)也显著改善(P < 0.05)。未报告严重不良事件。

结论

与假治疗相比,重复外周磁刺激(rPMS)是缓解针刺后疼痛的有效方法。这种非侵入性方式可能通过提高患者在针刺干预后的舒适度和恢复情况而有益于临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ea/12103201/ce0c2bb3815b/JPR-18-2541-g0001.jpg

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