CAJ | 학술논문

背景：以往的研究表明经皮神经电刺激对缓解多种疾病引起的疼痛症状有效，但其对缓解膝骨关节炎患者疼痛的确切疗效仍存在争议。且经皮神经电刺激可分为高频和低频两种模式，目前关于其分别针对膝骨关节炎疼痛的疗效尚不明确。目的：荟萃分析高频经皮神经电刺激与低频经皮神经电刺激缓解膝骨关节炎疼痛的作用。方法：计算机检索PubMed，Embase和Cochrane数据库以及手工检索国内外公开发表的有关经皮神经电刺激缓解膝骨关节炎疼痛的随机对照试验，所有检索截止至2014年2月。严格评价纳入研究的方法学质量并提取数据，2名研究人员独立运用RevMan 5.2软件对数据进行统计分析。结果与结论：共纳入10项随机对照试验，累计519例研究对象。荟萃分析结果显示，与对照组相比，高频经皮神经电刺激可显著缓解膝骨关节炎患者的疼痛[MD=-0.56，95%CI(-0.98，-0.15)，P=0.008]；与对照组相比，低频经皮神经电刺激并未缓解膝骨关节炎患者的疼痛[MD=-0.13，95%CI(-1.63，1.38)， P=0.87]；与低频经皮神经电刺激相比，高频经皮神经电刺激可显著缓解膝骨关节炎患者的疼痛[MD=-0.85，95%CI(-1.32，-0.37)，P=0.0005]。提示高频经皮神经电刺激可一定程度缓解膝骨关节炎患者的疼痛症状，而对比高频经皮神经电刺激，低频经皮神经电刺激对缓解膝骨关节炎患者的疼痛症状无明显作用。但由于样本量较小，纳入各研究在参数选择存在差异，存在一定局限性，此结论未来尚需更多高质量的随机对照试验进一步证实。
배경：이왕적연구표명경피신경전자격대완해다충질병인기적동통증상유효，단기대완해슬골관절염환자동통적학절료효잉존재쟁의。차경피신경전자격가분위고빈화저빈량충모식，목전관우기분별침대슬골관절염동통적료효상불명학。목적：회췌분석고빈경피신경전자격여저빈경피신경전자격완해슬골관절염동통적작용。방법：계산궤검색PubMed，Embase화Cochrane수거고이급수공검색국내외공개발표적유관경피신경전자격완해슬골관절염동통적수궤대조시험，소유검색절지지2014년2월。엄격평개납입연구적방법학질량병제취수거，2명연구인원독립운용RevMan 5.2연건대수거진행통계분석。결과여결론：공납입10항수궤대조시험，루계519례연구대상。회췌분석결과현시，여대조조상비，고빈경피신경전자격가현저완해슬골관절염환자적동통[MD=-0.56，95%CI(-0.98，-0.15)，P=0.008]；여대조조상비，저빈경피신경전자격병미완해슬골관절염환자적동통[MD=-0.13，95%CI(-1.63，1.38)， P=0.87]；여저빈경피신경전자격상비，고빈경피신경전자격가현저완해슬골관절염환자적동통[MD=-0.85，95%CI(-1.32，-0.37)，P=0.0005]。제시고빈경피신경전자격가일정정도완해슬골관절염환자적동통증상，이대비고빈경피신경전자격，저빈경피신경전자격대완해슬골관절염환자적동통증상무명현작용。단유우양본량교소，납입각연구재삼수선택존재차이，존재일정국한성，차결론미래상수경다고질량적수궤대조시험진일보증실。
BACKGROUND:Extensive studies have shown that transcutaneous electrical nerve stimulation (TENS) plays a positive role in relieving the pain caused by a variety of diseases. However, its exact effect to manage pain in patients with knee osteoarthritis is stil controversial. TENS is classified into h-TENS and l-TENS, but currently its respective role in relieving the pain caused by knee osteoarthritis is not clear yet. OBJECTIVE: To compare the efficacy of h-TENS and l-TENS on pain relieving among patients with knee osteoarthritis. METHODS: A computer-based search was performed on PubMed, Embase and Cochrane database for randomized controled trials on TENS for the treatment of knee pain in patients with knee osteoarthritis which were reported before February 2014. Methodology quality of the trials was criticaly assessed and relative data were extracted. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software. RESULTS AND CONCLUSION:A total of 10 randomized controled trials involving 519 cases were included. The results of meta-analysis showed that the h-TENS group had significant effects on pain relief in knee osteoarthritis patients in comparison to the control group [MD=-0.56, 95%CI(-0.98,-0.15),P=0.008]; the l-TENS group had no significant effect on pain relief in knee osteoarthritis patients in comparison to the control group [MD=-0.13, 95%CI(-1.63, 1.38),P=0.87]; the h-TENS group had significant effect on pain relief in knee osteoarthritis patients in comparison to the l-TENS group [MD=-0.85, 95%CI(-1.32, -0.37), P=0.000 5]. These findings indicate that h-TENS performs something positive to reduce pain in knee osteoarthritis patients that l-TENS cannot do. Owing to the limitations of this study, further work is needed to determine the role of TENS in pain management among patients with knee osteoarthritis.