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

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摘要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。

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	区子昌
	姜业勤
	岑结容

关键词 ：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, 临床效果

Abstract：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 type Ⅰ (CRPS Ⅰ). Methods A total of 150 elderly patients diagnosed as CRPS Ⅰin 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 Ⅰwas more significant than rTMS, and the duration was longer, which was worthy of clinical promotion and application.

Key words： Repetitive transcranial magnetic stimulation Repetitive peripheral magnetic stimulation Combined treatment Elderly patients Complex regional pain syndrome Clinical effect

作者简介: 区子昌（1975-），男，广东江门人，副主任医师，主要从事内科疾病治疗工作

引用本文:

区子昌;姜业勤;岑结容. 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[J]. 中国当代医药, 2022, 29(2): 15-19.
OU Zichang; JIANG Yeqin;CEN Jierong. 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. 中国当代医药, 2022, 29(2): 15-19.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2022/V29/I2/15

[1]	Harden RN，Bruehl S，Stanton Hicks M，et al.Proposed new diagnostic criteria for complex regional pain syndrome[J].PainMed，2007，8（4）：326-331.
[2]	Polycarpou N，Ng YL，Canavan D，et al.Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing[J].Int Endod J，2005，38（3）：169-178.
[3]	Sathorn C，Parashos P，Messer H.The prevalence of postoperative pain and flare-up in single and multiple-visit endodontic treatment：a systematic review[J].Int Endod J，2008，41（2）：91-99.
[4]	李娜，何亮亮，王小平，等.重复经颅磁刺激治疗原发性三叉神经痛的疗效及安全性分析[J].中国全科医学，2016，19（12）：1387-1391.
[5]	陈富勇，陶蔚，孙伟，等.重复经颅磁刺激治疗慢性神经病理性疼痛[J].中国微侵袭神经外科杂志，2013，18（2）：57-59.
[6]	Shim H，Rose J，Halle S，et al.Complex regional pain syndrome：a narrative review for the practising clinician[J].Br J Anaesth，2019，123（2）：e424-e433.
[7]	Jo YH，Kim K，Lee BG，et al.Incidence of and Risk Factors for Complex Regional Pain Syndrome Type 1 after Surgery for Distal Radius Fractures：A Population-based Study[J].Sci Rep，2019，9（1）：4871.
[8]	Borchers AT，Gershwin ME.Complex regional pain syndrome：a comprehensive and critical review[J].Autoimmun Rev，2014，13（3）：242-265.
[9]	Shirani P，Jawaid A，Moretti P，et al.Familial occurrence of complex regional pain syndrome[J].Can J Neurol Sci，2010，37（3）：389-394.
[10]	Gaspar AT，Antunes F.Síndrome doloroso regional complexo tipo Ⅰ[Type Ⅰcomplex regional pain syndrome][J].Acta Med Port，2011，24（6）：1031-1040.
[11]	冯思宁，张立新.磁刺激在脊髓损伤康复治疗中的应用进展[J].中国医学物理学杂志，2020，37（12）：1566-1572.
[12]	Leszczyńska K，Wincek A，Fortuna W，et al.Treatment of patients with cervical and upper thoracic incomplete spinal cord injury using repetitive transcranial magnetic stimulation[J].Int J Artif Organs，2020，43（5）：323-331.
[13]	高天昊，陆蓉蓉，姜从玉，等.神经病理性疼痛重复经颅磁刺激治疗研究进展[J].上海医药，2017，38（13）：22-26.
[14]	王毅，程诚，沈红艳，等.经颅磁刺激对阿尔茨海默病患者认知功能及伴痴呆的行为精神症状疗效的meta 分析[J].上海交通大学学报（医学版），2021，41（7）：932-941.
[15]	李鑫，王楚怀.重复磁刺激技术应用于腰痛的研究进展[J].中国康复医学杂志，2021，36（5）：626-630.
[16]	Xiang HF，Sun J，Tang X，et al.The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients：a systematic review and meta-analysis of randomized controlled trials[J].Clin Rehabil，2019，33（5）：847-864.
[17]	Chokroverty S，Sachdeo R，Dilullo J，et al.Magnetic stimulation in the diagnosis of lumbosacral radiculopathy[J].J Neurol Neurosurg Psychiatry，1989，52（6）：767-772.
[18]	刘威，曲福玲，徐琳，等.重复外周磁刺激治疗疼痛的研究进展[J].华西医学，2020，35（1）：93-97.
[19]	Makarov S，Bogdanov G，Noetscher G，et al.Design and Analysis of a Whole-Body Noncontact Electromagnetic Subthreshold Stimulation Device with Field Modulation Targeting Nonspecific Neuropathic Pain[M].//Makarov S，Horner M，Noetscher G，et al.Brain and Human Body Modeling：Computational Human Modeling at EMBC 2018.Cham（CH）：Springer，2019：Chapter 5.
[20]	Cavaleri R，Chipchase LS，Summers SJ，et al.Repetitive transcranial magnetic stimulation of the primary motor cortex expedites recovery in the transition from acute to sustained experimental pain：a randomised，controlled study[J].Pain，2019，160（11）：2624-2633.
[21]	Qian Y，Cheng Y，Cai J，et al.Advances in electrical and magnetic stimulation on nerve regeneration[J].Regen Med，2019，14（10）：969-979.
[22]	Fitzgibbon BM，Hoy KE，Knox LA，et al.Evidence for the improvement of fatigue in fibromyalgia：A 4-week left dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation randomized-controlled trial[J].Eur J Pain，2018，22（7）：1255-1267.
[23]	Sato A，Torii T，Iwahashi M，et al.Alterations in motorcortical excitability induced by peripheral stimulation with magnetic stimulation[J].IEEE Trans Magn，2018，54（11）：1-4.
[24]	Asao A，Ikeda H，Nomura T，et al.Short-term session of repetitive peripheral magnetic stimulation combined with motor imagery facilitates corticospinal excitability in healthy human participants[J].Neuroreport，2019，30（8）：562-566.
[25]	Picarelli H，Teixeira MJ，de Andrade DC，et al.Repetitive transcranial magnetic stimulation is efficacious as an addon to pharmacological therapy in complex regional pain syndrome （CRPS）type Ⅰ[J].J Pain，2010，11（11）：1203-1210.
[26]	Gaertner M，Kong JT，Scherrer KH，et al.Advancing Transcranial Magnetic Stimulation Methods for Complex Regional Pain Syndrome：An Open-Label Study of Paired Theta Burst and High-Frequency Stimulation[J].Neuromod-ulation，2018，21（4）：409-416.
[27]	Deogaonkar M，Sharma M，Oluigbo C，et al.Spinal Cord Stimulation （SCS） and Functional Magnetic Resonance Imaging （fMRI）：Modulation of Cortical Connectivity With Therapeutic SCS[J].Neuromodulation，2016，19（2）：142-153.
[28]	Krause P，Foerderreuther S，Straube A.Effects of conditioning peripheral repetitive magnetic stimulation in patients with complex regional pain syndrome[J].Neurol Res，2005，27（4）：412-417.