Melzack R, Jeans M E, Stratford J G, Monks R C
Department of Psychology, McGill University, Montreal, Que., Canada Pain Center, Montreal General Hospital, Montreal, Que. Canada.
Pain. 1980 Oct;9(2):209-217. doi: 10.1016/0304-3959(80)90008-1.
It has recently been shown that ice massage of the web between the thumb and index finger produces significantly greater relief of dental pain than a placebo control procedure. These results indicate that ice massage may be comparable to transcutaneous electrical stimulation (TES) and acupuncture, and may be mediated by similar neural mechanisms. The purpose of this study was to examine the relative effectiveness of ice massage and TES for the relief of low-back pain. Patients suffering chronic low-back pain were treated with both ice massage and TES. The order of treatments was balanced, and changes in the intensity of pain were measured with the McGill Pain Questionnaire (MPQ). The results show that both methods are equally effective: based on the Pain Rating Index of the MPQ, 67-69% of patients obtained pain relief greater than 33% with each method. The results indicate that ice massage is an effective therapeutic tool, and appears to be more effective than TES for some patients. It may also serve as an additional sensory-modulation method to alternate with TES to overcome adaptation effects. Evidence that cold signals are transmitted to the spinal cord exclusively by A-delta fibers and not by C fibers suggests that ice massage provides a potential method for differentiating among the multiple feedback systems that mediate analgesia produced by different forms of intense sensory input.
最近研究表明，对拇指与食指之间的指蹼进行冰敷按摩，相较于安慰剂对照程序，能显著减轻牙痛。这些结果表明，冰敷按摩可能与经皮电刺激（TES）及针灸效果相当，且可能由相似的神经机制介导。本研究的目的是检验冰敷按摩和TES缓解腰痛的相对有效性。患有慢性腰痛的患者接受了冰敷按摩和TES两种治疗。治疗顺序是平衡的，疼痛强度的变化通过麦吉尔疼痛问卷（MPQ）进行测量。结果显示，两种方法同样有效：基于MPQ的疼痛评分指数，每种方法都有67% - 69%的患者疼痛缓解超过33%。结果表明，冰敷按摩是一种有效的治疗手段，而且对某些患者而言似乎比TES更有效。它还可作为一种额外的感觉调制方法，与TES交替使用以克服适应性效应。有证据表明冷信号仅通过A - δ纤维而非C纤维传递至脊髓，这表明冰敷按摩为区分介导不同形式强烈感觉输入所产生镇痛作用的多种反馈系统提供了一种潜在方法。
