经皮穴位电刺激治疗带状疱疹后神经痛的频率特异性

FREQUENCY SPECIFICITY OF TRANSCUTANEOUS ELECTRICAL ACUPOINT STIMULATION FOR THE TREATMENT OF POST-HERPETIC NEURALGIA

目的:观察经皮穴位电刺激(Transcutaneous electrical acupoint stimulation,TEAS)治疗带状疱疹后神经痛(post-herpetic neuralgia,PHN)疗效的频率特异性。方法:60例临床诊断PHN的患者,随机均分为3组,每组各20例。对照组采用常规药物治疗,2 Hz组和100 Hz组在常规药物治疗的基础上,分别加用频率为2 Hz或100 Hz的TEAS,每天半小时,疗程2周。结果:本课题实际完成58例,其中对照组脱落2例,成为18例。治疗2周后,三组疼痛程度[采用数字评分(Numerical Rating Scale,NRS)与视觉模拟评分(Visual Analogue Scale,VAS)]均有显著下降。以治疗前每组的VAS值为100%,治疗两周后,单纯药物对照组下降到68.2%;100 Hz组下降到65.4%(与对照组无显著差异);而2 Hz组下降到40.8%,疗效显著优于其余两组(P<0.01)。三组患者治疗后焦虑、抑郁状态评分均有显著下降,各组之间差异无统计意义。结论:频率为2 Hz的TEAS对带状疱疹后神经痛的药物镇痛治疗有显著加强作用,100 Hz无效。

Objective：To observe the specific frequency of transcutaneous electrical acupoint stimulation（TEAS） for the treatment of post-herpetic neuralgia（PHN）. Methods： A total of 60 patients with clinical diagnosis of PHN were randomly and equally divided into 3 groups and 58 completed the trial. The control group（n=18） only received routine medical treatment（Vitamin B1, Mecobalamin Tablets, Gabapentin and Tramadol）. The 2 Hz group（n=20） and 100 Hz group（n=20） received TEAS with a frequency of 2 Hz or 100 Hz, respectively, combined with routine medicine. TEAS was administered by using a Han＇s acupoint nerve stimulator（HANS, model 200A） with two output channels connected with 4 skin pads placed on 4 acupoints, 30 minutes per day for 14 days. The Numerical Rating Scale（NRS） and Visual Analogue Scale（VAS） for pain assessment were taken as clinical outcomes. Results： All 3 groups showed significant reduction of pain scores over the period of 2 weeks. Taking the VAS value of each group as 100%,the value after 2 weeks of treatment was 68.2% in the control group, 65.4% in the 100 Hz group, and 40.8% in the 2 Hz group（P 〈0.01, compared to the other two groups）. There was no significant difference among three groups in terms of the degree of anxiety and depression. Conclusions： The TEAS with a frequency of 2 Hz, but not 100 Hz, significantly strengthened the curative effect of pharmacological intervention on pain in patients with post-herpetic neuralgia.