文章摘要
唐颖,王春梅,陈兴月,陈翰,谭明亮,周怡,陆松梅,陈文,李咏生.重复经颅磁刺激对癌痛患者的镇痛效果研究[J].中国康复,2022,37(5):259-262
重复经颅磁刺激对癌痛患者的镇痛效果研究
Analgesic effect of repetitive transcranial magnetic stimulation on cancer pain patients
  
DOI:
中文关键词: 癌痛  重复经颅磁刺激  背外侧前额叶  镇痛作用  生活质量
英文关键词: cancer pain  repetitive transcranial magnetic stimulation  dorsolateral prefrontal cortex  analgesic effect  quality of life
基金项目:国家自然科学基金项目 (81902302);重庆市自然科学基金项目(cstc2018jcyjAX0772)
作者单位
唐颖 重庆大学附属肿瘤医院肿瘤转移与个体化诊治转化研究重庆市重点实验室重庆 400038 
王春梅 重庆大学附属肿瘤医院肿瘤转移与个体化诊治转化研究重庆市重点实验室重庆 400038 
陈兴月 重庆大学附属肿瘤医院肿瘤转移与个体化诊治转化研究重庆市重点实验室重庆 400038 
陈翰 重庆市西南医院康复科重庆 400038 
谭明亮 重庆市西南医院康复科重庆 400038 
周怡 重庆市西南医院康复科重庆 400038 
陆松梅 重庆大学附属肿瘤医院肿瘤转移与个体化诊治转化研究重庆市重点实验室重庆 400038 
陈文 重庆大学附属肿瘤医院肿瘤转移与个体化诊治转化研究重庆市重点实验室重庆 400038 
李咏生 重庆大学附属肿瘤医院肿瘤转移与个体化诊治转化研究重庆市重点实验室重庆 400038 
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中文摘要:
  目的:探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation, rTMS)对癌痛患者的镇痛疗效。方法:本研究采用前瞻性随机对照试验,将50例癌痛患者随机分为rTMS组和对照组各25例。在常规药物治疗的基础上,rTMS组给予高频10Hz、左侧背外侧前额叶(DLPFC)刺激治疗,对照组采用假刺激治疗。采用数字评价量表疼痛评分、口服吗啡等效剂量(OME)、WHO生存质量测定量表简表(WHOQOL-BREF)评定患者的治疗效果。结果:经2周治疗后,rTMS组患者的NRS评分均较治疗前及对照组治疗后明显降低(P<0.05),对照组治疗前后比较差异无统计学意义。治疗后,2组患者的OME均较治疗前有所增加(P<0.05),但rTMS组的增加剂量要明显低于对照组(P<0.05)。治疗后,2组患者WHOQL-BREF总分均较治疗前明显提高(P<0.05),但rTMS组更高于对照组(P<0.05)。 治疗后,rTMS组的治疗有效率及显效率均明显高于对照组(P<0.05)。结论:rTMS可明显缓解癌痛患者的疼痛程度,降低止痛药物使用剂量,改善癌痛患者的生活质量,是一种有效的癌痛康复治疗工具。
英文摘要:
  Objective: To investigate the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) on patients with cancer pain. Methods: In this prospective randomized controlled trial, 50 patients with cancer pain were randomly divided into rTMS group and control group. On the basis of routine drug therapy, the rTMS group was treated with high frequency 10 Hz and left dorsolateral prefrontal cotex stimulation, while the control group was treated with sham stimulation. The therapeutic effect was evaluated by NRS digital score, oral equivalent dose of morphine (OME) and WHO quality of life scale (WHOQOL-BREF). Results: After 2 weeks of treatment, the NRS scores in the rTMS group were significantly lower than those before treatment and the control group after treatment (P<0.05), but there was no significant difference in the control group before and after treatment. After treatment, the OME of both groups increased as compared with that before treatment, but the increased dose of rTMS group was significantly lower than that of the control group (P<0.05). After treatment, the total scores of WHOQL-BREF in the two groups were significantly higher than those before treatment, but the total score in the rTMS group was higher than that in the control group (P<0.05). After treatment, the effective rate (NRS improvement ≥30% or 50%) in the rTMS group was significantly higher than that in the control group (P<0.05). Conclusion: rTMS can significantly relieve the pain degree of patients with cancer pain, reduce the dosage of analgesics, and improve the quality of life of patients with cancer pain. It may be an effective tool for rehabilitation treatment of cancer pain.
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