重复经颅磁刺激-重复外周磁刺激联合治疗老年患者复杂性区域疼痛综合征Ⅰ型的临床效果

Clinical effect of repetitive transcranial magnetic stimulation combined with repetitive peripheral magnetic stimulation in treatment of elderly patients with complex regional pain syndrome type Ⅰ

目的探讨重复经颅磁刺激-重复外周磁刺激(rTMS-rPMS)联合治疗老年患者复杂性区域疼痛综合征Ⅰ型(CRPSⅠ)的临床效果。方法选取2020年1月至2021年4月江门市第三人民医院收治的150例老年CRPSⅠ患者作为研究对象,按照随机数字表法将其分为治疗组与对照组,每组各75例。治疗组患者给予rTMS-rPMS联合治疗,对照组患者采用rTMS+rPMS 0 Hz(假刺激)治疗。比较两组患者治疗前后的疼痛视觉模拟评分法(VAS)评分及治疗效果满意率。结果第1次治疗前,两组患者的VAS评分比较,差异无统计学意义(P>0.05);第2次治疗前,治疗组患者的VAS评分低于对照组,差异有统计学意义(P<0.05)。两组患者两次治疗后各时间点的VAS评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗组患者第2次治疗前、治疗后各时间点的VAS评分均低于第1次治疗,差异有统计学意义(P<0.05)。对照组患者两次治疗前、治疗后24 h的VAS评分比较,差异无统计学意义(P>0.05);第2次治疗后即刻、72 h的VAS评分低于第1次治疗,治疗后10 d的VAS评分高于第1次治疗,差异有统计学意义(P<0.05)。治疗组患者的治疗效果满意率高于对照组,差异有统计学意义(P<0.05)。结论对CRPSⅠ老年患者采用rTMS-rPMS联合治疗相较于rTMS治疗的效果更显著,疗效持续时间更长,值得临床推广应用。

Objective To investigate the clinical effect of repetitive transcranial magnetic stimulation combined with repetitive peripheral magnetic stimulation(rTMS-rPMS)in the treatment of elderly patients with complex regional pain syndrome typeⅠ(CRPSⅠ).Methods A total of 150 elderly patients diagnosed as CRPSⅠin the Third People′s Hospital of Jiangmen City from January 2020 to April 2021 were selected as the research objects,and they were divided into the treatment group and the control group by random number table method,with 75 cases in each group.The treatment group was treated by rTMS combined with rPMS,and the control group was treated with rTMS plus rPMS 0 Hz(false stimulation).The visual analogue scale(VAS)score and clinical treatment effect were compared between the two groups before and after treatment.Results Before the first treatment,there was no statistical significant difference in VAS score between the two groups(P>0.05).Before the second treatment,VAS score of the treatment group was lower than that of the control group,and the difference was statistically significant(P<0.05).VAS scores at each time point after two treatments were lower than those before treatment,and the treatment group was lower than that of the control group,the differences were statistically significant(P<0.05).VAS scores of patients in the treatment group at each time point before and after the second treatment were lower than those of the first treatment, and the differences were statistically significant (P<0.05). There was no statistically significant difference in VAS score of control group before and 24 h after treatment (P>0.05). VAS scores at immediately and 72 h after the second treatment were lower than those of the first treatment, and VAS score at 10 d after the second treatment was higher than that of the first treatment, and the differences were statistically significant (P<0.05). The satisfaction rate of treatment effect in the treatment group was higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion The curative effect of rTMS combined with rPMS in the elderly patients with CRPS Ⅰ was more significant than rTMS, and the duration was longer, which was worthy of clinical promotion and application.