电针治疗坐骨神经痛刺激参数的文献研究

【作者】 刘璇；

【导师】 刘志顺；

【作者基本信息】 北京中医药大学 ， 中医内科学， 2008， 硕士

【摘要】 背景:虽然经皮电刺激及电针治疗坐骨神经痛的疗效已得到肯定,但是最佳的电针刺激参数仍不明了。作为中医疗法的重要组成部分,电针在世界范围内已被广泛运用于坐骨神经痛的治疗。国内外关于这方面的研究也很多,但是目前研究电针刺激参数的高质量文献很少。目的:拟在总结目前临床及实验治疗坐骨神经痛的电针参数,探索治疗坐骨神经痛的最佳电针刺激参数。方法:计算机检索中国生物医学光盘数据库CBM (1979~2007),中文科技期刊全文数据库(VIP) (1989～2007),中国知网(1979~2007), MEDLINE (1966~2007),从文献所研究的电针频率、波形、电流、电极、频次等几方面对入选文献进行总结,制定数据提取表格,分析不同电针刺激参数的不同的电针效应。　结果:1电子检索出相关文献138篇,包括中文文献135篇,英文文献3篇。19篇被排除。排除后共剩余文献119篇。其中12篇文献为研究不同电针刺激参数与针效关系的研究,为动物实验文献。107篇文献为使用电针为干预措施治疗坐骨神经痛,并对所使用的电针参数加以描述,但并非专门研究电针刺激参数的文献,其中包括76篇临床研究文献,31篇动物实验文献。2临床所使用的电针治疗坐骨神经痛的参数范围为:频率1~20Hz,集中在低频率,电流0.2~0.8mA,强度大多为以患者耐受为刺激强度,波形多选用疏密波、连续波为主,频次为1次/d。3动物实验所使用的电针频率多集中在2~20Hz,其中专门研究电针参数与针效关系的实验结果表明,2Hz、5Hz的低频电针治疗坐骨神经痛疗效好,动物实验所使用的电流范围为0.4~10mA,强度均采用穴位周围组织轻微颤抖或肌肉出现轻微抽动,波形断续波为主,频次为每日或隔日一次,阴极电刺激对促进周围神经再生有效,损伤初期刺激对侧肢体较同侧肢体效果更佳。结论:不同电针参数治疗坐骨神经痛的疗效不同。尚需采用高质的临床研究对电针治疗坐骨神经痛的最佳参数进行探索。更多还原

【Abstract】 BackgroundAlthough transcutaneous electrical nerve stimulation (TENS) and electroacupuncture relieve the pain of sciatic, the stimulation parameters that would best prevent the development of the condition are not known. As an important content of Chinese medicine, electroacupuncture is widely applied for the treatment of sciatica in the world . Lots of research works were done both in China and in western countries,but quality of electroacupuncture stimulation parameter trials is not optimistic. This kind of high quality trial is rare in the world now.ObjectivesThe purpose of this study was to summarize main electroacupuncture stimulation parameters used in clinical treatments and animal experiments. Compared the ability of several different stimulation parameters used in clinical strategies to reduce the development of sciatica.MethodsTrials were searched in computerized general and specialized databases (MEDLINE, CBM, www.cnki.net).Summerized different kinds of stimulation parameters,such as frequency, wave, electric current, electrodes. Data was extracted from each included study with a data extraction. Analyze different effects of different stimulation parameters.Results135 trials from China, Japan and U.S.A were included. Clinical research suggested:daily electroacupuncture with freauency of 1~20Hz,electric current of 0.2~0.8mA, continuous and dilatational waveform , might be a useful treatment. Intensity of stimulation was to be able to bear by patient. Animal research suggested electroacupuncture with freauency of 2Hz and 5Hz,electric current of0.4~10mA, waveform of intermittent, might be a useful treatment. The intensity of stimulation was that needed to produce a visible muscle contraction. Peripheral nerve regeneration was accelerated by distal cathode DC application.conclusionsDifferent kinds of electroacupuncture stimulation parameters have different effects on treating sciatica. More evidence on validity of sciatic with different kinds of electroacupuncture stimulation parameters is still needed.There is a need for further well designed clinical trials.更多还原