穴位经皮电刺激的止痛作用

本文报告40例疼痛病人(其中腰腿痛24例、肩颈痛7例和其他疼痛9例)使用TENS的止痛效果。采用双相脉冲波形,频率3～15Hz,脉宽0.1～1.0ms。按经络学说选用4个治疗穴位,以耐受量刺激强度,治疗15分钟。目测类比评定(0～100分):治疗后平均降低36分(治疗前为67.6分),经t检验,P<0.0005,有非常显著性差异。百分对比评定(0/100%):治疗后平均疼痛减轻51.5%,4例疼痛完全消失,1例无效。治疗后疼痛减轻60%、50%和30%以上者,分别为35%、67.5%和90%。痛觉阈和感觉阈测定:治疗后痛觉阈和感觉阈分别增高2.1mA和1.3mA(N=22),两者均P<0.0005,有非常显著性差异,痛觉阈增高比感觉阈较为显著。止痛持续时间:治疗后24小时追踪14例,疼痛减轻持续2、5、10和24小时以上者,分别为93%、64%、57%和14%左右。结合文献简要地讨论了针刺、电针和神经电刺激的止痛机制。

The Analgesic Effects of Acupuncture Points by Transcutaneous Electrical Stimulation

This article reports the analgesic effect of TENS on 40 cases with pain (including 24 low back pain, 7 shoulder neck pain and 9 cases of other pain). The wave form of electric stimulation is irregular biphasic pulse with frequencies of 3-15Hz, pulse width of 0.1-1.0 ms. The points of treament were selected based on the Hypothesis of the Channels. 4 points were used with the tolerable intensity for 15 minutes. Evaluation of Visual Analogue Scale(0-100): It was reduced 36 after treatment (67.5 before treatment), Thet-test revealed a high statistical significance (P<0.0005). Evaluation of Percent Comparision Scale(0-100%): The pain was relieved by 51.5% after treatment on an average. 4 patients achieved complete relief, but one case showed no relief. The percentage of pain relief of 30%, 50% and 60% were 90, 67.5 and 35 respectively. Study of Pain Threshold and Sensory Thresholds Pain Threshold rised 2.1 mA and Sensory Threshold rised 1.3 mA after treatment. Both of them revealed statistical significance (N=22, P<0.0005). But the increase of pain threshold was more pronounced. Analgesic duration: 14 patients were followed up for 24 hours after treatment. The subjects with pain relief for 2, 5, 10 and 24 hours amounted to 93%, 64%, 57% and 14%, respectively. The mechanism of analgesic effects of acupuncture, electroacupuncture and nerve electrical stimulation is briefly discussed.