Systematic review and Meta-analysis of repetitive transcranial magnetic stimulation in treatment of neuropathic pain after spi-nal cord injury
文冰冰 1代欣 1王晓霞 1张雪1
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作者信息
1. 首都医科大学附属北京康复医院门诊部,北京 100144
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摘要
目的 系统分析重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗脊髓损伤后神经病理性疼痛(neuropathic pain,NP)的临床效果.方法 计算机检索中国知网、万方数据库、维普、PubMed、Embase、Corchrane Library、Web of science等中英文数据库,检索rTMS治疗脊髓损伤后NP的随机对照研究,采用Jadad量表进行质量评价后进行Meta分析.结果 共纳入6 篇文献.合并Meta分析显示,rTMS可显著降低脊髓损伤后NP患者的VAS/NRS水平(MD =-1.03,95%CI=-1.60～-0.46,P＜0.01);rTMS 可降低脊髓损伤后NP患者的HAMD评分(MD =-1.71,95%CI=-2.60～-0.82,P＜0.01);rTMS对脊髓损伤后NP患者的HAMA评分影响不显著(MD=-0.84,95%CI=-5.48～3.81,P=0.72).结论 rTMS可缓解脊髓损伤后NP患者的疼痛程度,改善患者的抑郁状态.
Abstract
Objective To systematically analyze the clinical effect of repetitive transcranial magnetic stimulation(rTMS)in the treatment of neuropathic pain(NP)after spinal cord injury(SCI).Methods Chinese and English databases such as CNKI,Wanfang database,VIP,PubMed,EMBASE,Cochrane Library and web of science were searched by computer.The randomized controlled stud-y of NP after SCI treated with rTMS was searched.The quality was evaluated by Jadad scale and Meta-analysis was carried out.Results A total of 6 literature articles were included.Combined Meta-analysis showed that rTMS could significantly reduce the level of VAS/NRS in NP patients after SCI(MD=-1.03,95%CI=-1.60～-0.46,P＜0.01).rTMS could reduce the level of HAMD in NP patients after SCI(MD=-1.71,95%CI=-2.60～-0.82,P＜0.01).rTMS had no significant effect on the level of HAMA in NP patients after SCI(MD=-0.84,95%CI =-5.48～3.81,P=0.72).Conclusion rTMS can alleviate the pain and depres-sion of NP patients after SCI.
关键词
脊髓损伤/神经病理性疼痛/重复经颅磁刺激
Key words
spinal cord injury/neuropathic pain/repetitive transcranial magnetic stimulation
维普
万方数据