基于神经电生理探讨重复外周磁刺激治疗腰椎间盘突出症

doi:10.3969/j.issn.1006-5725.2024.12.009

Abstract

Abstract:

Objective To explore the efficacy of repetitive peripheral magnetic stimulation （rPMS） in patients with lumbar disc herniation （LDH）. Methods From March 2023 to March 2024，60 LDH patients were recruited in the inpatient or outpatient department of the rehabilitation department of a tertiary hospital. All patients were randomly assigned to the rPMS group or the conventional group， 30 cases in each group. Both groups received routine physical therapy， and the rPMS group was treated with rPMS on this basis.VAS， JOA， and neurophysiological tests were performed before intervention and 2 weeks after intervention. Results The VAS and JOA scores of the two groups were significantly lower than those before treatment （P < 0.05）. Compared with the conventional group， the VAS and JOA scores of the rPMS group were significantly lower （P < 0.05）. Compared before and after treatment， the neuroelectrophysiological examination of the rPMS group was significantly improved （P < 0.05）. After 2 weeks of treatment， the tibial nerve motor conduction velocity， H reflex latency and IP peak in the conventional group were significantly faster than those before treatment（P < 0.05）. After 2 weeks of treatment， compared with the conventional group， there were significant differences in tibial nerve motor conduction velocity， peroneal nerve motor conduction velocity， superficial peroneal nerve sensory conduction velocity， sural nerve sensory conduction velocity， H reflex latency and IP peak （P < 0.05）. Conclusion rPMS can significantly improve and restore pain and nerve injury in patients with LDH. rPMS can be used as an effective adjuvant therapy.

Key words: repeat peripheral magnetic stimulation, lumbar disc herniation, neuropathic pain

CLC Number:

R493

Jia YUAN,Wenfeng FENG,Yunxiang DOU,Xuanjun CHEN,Zhihong ZHANG. Effective of repeated peripheral magnetic stimulation treatment over patients with lumbar disc herniation was observed based on neuroelectrophysiological examination[J]. The Journal of Practical Medicine, 2024, 40(12): 1665-1670.

Figures/Tables 4

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References 33

1	中华医学会疼痛学分会脊柱源性疼痛学组. 腰椎间盘突出症诊疗中国疼痛专家共识［J］. 中国疼痛医学杂志， 2020， 26（1）： 2-6. doi:10.3969/j.issn.1006-9852.2020.01.002 doi: 10.3969/j.issn.1006-9852.2020.01.002
2	ZHANG A S， XU A， ANSARI K， et al. Lumbar Disc Herniation： Diagnosis and Management ［J］. Am J Med， 2023， 136（7）： 645-651. doi:10.1016/j.amjmed.2023.03.024 doi: 10.1016/j.amjmed.2023.03.024
3	DEYO R A， MIRZA S K. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk ［J］. N Engl J Med， 2016， 374（18）： 1763-1772.
4	康思敏，赵秦，曲玉娟，等. 骶裂孔注射治疗对腰椎间盘突出症患者步态的影响［J］. 中国康复医学杂志， 2023， 38（1）： 28-34. doi:10.3969/j.issn.1001-1242.2023.01.005 doi: 10.3969/j.issn.1001-1242.2023.01.005
5	TAŞPıNAR G， ANGıN E， OKSÜZ S. The effects of Pilates on pain， functionality， quality of life， flexibility and endurance in lumbar disc herniation ［J］. J Comp Eff Res， 2023， 12（1）： e220144.
6	VIALLE L R， VIALLE E N， SUáREZ HENAO J E， et al. LUMBAR DISC HERNIATION ［J］. Rev Bras Ortop， 2010， 45（1）： 17-22.
7	祁修权，王唯，裘小康，等. 腰椎间盘突出症患者术后发生隐性失血的列线图预测模型构建［J］. 实用医学杂志， 2023， 39（18）： 2300-2305. doi:10.3969/j.issn.1006-5725.2023.18.003 doi: 10.3969/j.issn.1006-5725.2023.18.003
8	中华医学会骨科学分会脊柱外科学组，中华医学会骨科学分会骨科康复学组. 腰椎间盘突出症诊疗指南［J］. 中华骨科杂志， 2020， 40（8）： 477-487. doi:10.3760/cma.j.cn121113-20200402-00213 doi: 10.3760/cma.j.cn121113-20200402-00213
9	AWADALLA A M， ALJULAYFI A S， ALROWAILI A R， et al. Management of Lumbar Disc Herniation： A Systematic Review ［J］. Cureus， 2023， 15（10）： e47908.
10	KLOMJAI W， KATZ R， LACKMY-VALLÉE A. Basic principles of transcranial magnetic stimulation （TMS） and repetitive TMS （rTMS）［J］. Ann Phys Rehabil Med， 2015， 58（4）： 208-213.
11	PANATHOOP A， SAENGSUWAN J， VICHIANSIRI R. Effects of repetitive peripheral magnetic stimulation vs. conventional therapy in the management of carpal tunnel syndrome： a pilot randomized controlled trial ［J］. Peer J， 2023， 11： e15398.
12	SCHNEIDER C， ZANGRANDI A， SOLLMANN N， et al. Checklist on the Quality of the Repetitive Peripheral Magnetic Stimulation （rPMS） Methods in Research： An International Delphi Study ［J］. Front Neurol， 2022， 13： 852848.
13	KANJANAPANANG N， CHANG K V. Peripheral Magnetic Stimulation ［M］. StatPearls［Internet］， 2023.
14	DANA E， TRAN C， OSOKIN E， et al. Peripheral magnetic stimulation for chronic peripheral neuropathic pain： A systematic review and meta-analysis ［J］. Pain Pract， 2024，24（4）：647-658.
15	BEDDER M， PARKER L. Magnetic Peripheral Nerve Stimulation （mPNS） for Chronic Pain ［J］. J Pain Res， 2023， 16： 2365-2373.
16	HAWKER G A， MIAN S， KENDZERSKA T， et al. Measures of adult pain： Visual Analog Scale for Pain （VAS Pain）， Numeric Rating Scale for Pain （NRS Pain）， McGill Pain Questionnaire （MPQ）， Short-Form McGill Pain Questionnaire （SF-MPQ）， Chronic Pain Grade Scale （CPGS）， Short Form-36 Bodily Pain Scale （SF-36 BPS）， and Measure of Intermittent and Constant Osteoarthritis Pain （ICOAP）［J］. Arthritis Care Res （Hoboken）， 2011， 63 ： S240-S252.
17	JUNG Y S， SUH J H， KIM H Y， et al. The Prognostic Value of Enhanced-MRI and Fluoroscopic Factors for Predicting the Effects of Transforaminal Steroid Injections on Lumbosacral Radiating Pain ［J］. Ann Rehabil Med， 2016， 40（6）： 1071-1081.
18	RUBIN D I. Needle electromyography： Basic concepts ［J］. Handb Clin Neurol， 2019， 160： 243-256.
19	JITPAKDEE K， LIU Y， KOTHEERANURAK V， et al. Transforaminal Versus Interlaminar Endoscopic Lumbar Discectomy for Lumbar Disc Herniation： A Systematic Review and Meta-Analysis ［J］. Global Spine J， 2023， 13（2）： 575-587. doi:10.1177/21925682221120530 doi: 10.1177/21925682221120530
20	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］. Brain and Human Body Modeling： Computational Human Modeling at EMBC 2018， 2019： 85-123.
21	LIM Y H， SONG J M， CHOI E H， et al. Effects of Repetitive Peripheral Magnetic Stimulation on Patients With Acute Low Back Pain： A Pilot Study ［J］. Ann Rehabil Med， 2018， 42（2）： 229-238.
22	NELSON F R， ZVIRBULIS R， PILLA A A. Non-invasive electromagnetic field therapy produces rapid and substantial pain reduction in early knee osteoarthritis： a randomized double-blind pilot study ［J］. Rheumatol Int， 2013， 33（8）： 2169-2173.
23	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.
24	刘浩，贾延兵，魏静，等. 重复外周磁刺激在康复治疗中的应用及研究进展［J］. 中国康复医学杂志， 2021， 36（5）： 631-637. doi:10.3969/j.issn.1001-1242.2021.05.024 doi: 10.3969/j.issn.1001-1242.2021.05.024
25	ZSCHORLICH V R， HILLEBRECHT M， TANJOUR T， et al. Repetitive Peripheral Magnetic Nerve Stimulation （rPMS） as Adjuvant Therapy Reduces Skeletal Muscle Reflex Activity ［J］. Front Neurol， 2019， 10： 930.
26	LIU L， LIU Z， HUANG L， et al. Pulsed magnetic field promotes proliferation and neurotrophic genes expression in Schwann cells in vitro ［J］. Int J Clin Exp Pathol， 2015， 8（3）： 2343-2353.
27	MASSé-ALARIE H， BEAULIEU L D， PREUSS R， et al. Repetitive peripheral magnetic neurostimulation of multifidus muscles combined with motor training influences spine motor control and chronic low back pain ［J］. Clin Neurophysiol， 2017， 128（3）： 442-453.
28	MASSé-ALARIE H， SCHNEIDER C. Revisiting the Corticomotor Plasticity in Low Back Pain： Challenges and Perspectives ［J］. Healthcare （Basel）， 2016， 4（3）：67.
29	DZIELSKA-OLCZAK M， OLCZAK S. Clinical application of cyclooxygenase-2 inhibitors［J］. Pol Merkur Lekarski， 2001， 10（60）： 480-482.
30	杜燕京，刘治军，傅得兴，等. 尼美舒利有效性和安全性文献综述和评价［J］. 药品评价， 2011， 8（6）： 19-23. doi:10.3969/j.issn.1672-2809.2011.06.005 doi: 10.3969/j.issn.1672-2809.2011.06.005
31	WHITTAKER R G. The fundamentals of electromyography ［J］. Pract Neurol， 2012， 12（3）： 187-194.
32	黄慜，苻晓慧. 腰椎间盘突出症患者远期疗效的神经肌电图分析［J］. 医药前沿， 2014，4（9）： 222-223.
33	SABBAHI M A， OVAK-BITTAR F. Electrodiagnosis-based management of patients with radiculopathy： The concept and application involving a patient with a large lumbosacral disc herniation ［J］. Clin Neurophysiol Pract， 2018， 3： 141-147.

组别	例数	性别（例）		年龄（x ± s，岁）	病程（x ± s，个月）	疼痛部位［例（%）］
组别	例数	男	女	年龄（x ± s，岁）	病程（x ± s，个月）	左侧	右侧
rPMS组	30	11	19	46.77 ± 2.45	5.4 ± 1.7	16（53.3）	14（46.7）
常规组	30	10	20	54.00 ± 1.48	5.2 ± 2.2	14（46.7）	16（53.3）
χ²/t值		0.073		0.059	0.173	0.267
P值		0.787		0.953	0.864	0.606

组别	例数	VAS评分
组别	例数	治疗前	治疗2周后	t值	P值
rPMS组	30	6.35 ± 0.97	2.99 ± 1.15	16.422	0.001
常规组	30	6.14 ± 0.82	3.47 ± 0.97	16.218	0.001
t值		-0.763	-3.034
P值		0.445	0.002

组别	例数	JOA评分
组别	例数	治疗前	治疗2周后	t值	P值
rPMS组	30	6.35 ± 0.97	24.23 ± 1.83	-16.927	0.001
常规组	30	17.87 ± 1.68	22.67 ± 2.51	-9.798	0.001
t值		-0.022	-2.927
P值		0.372	0.003

组别	例数	胫神经传导速度（运动）（m/s）
组别	例数	治疗前	治疗2周后	t值	P值
rPMS组	30	45.79 ± 6.07	51.03 ± 5.03	-7.369	0.001
常规组	30	46.04 ± 5.51	48.17 ± 4.07	-3.217	0.003
t值		-0.022	-3.542
P值		0.982	0.001
组别	例数	腓神经传导速度（运动）（m/s）
组别	例数	治疗前	治疗2周后	t值	P值
rPMS组	30	50.79 ± 1.05	55.85 ± 2.37	-5.657	0.001
常规组	30	45.74 ± 10.09	46.39 ± 5.65	-0.475	0.638
t值		-1.806	-2.205
P值		0.071	0.027
组别	例数	腓浅神经（感觉）（m/s）
组别	例数	治疗前	治疗2周后	t值	P值
rPMS组	30	43.21 ± 6.11	45.95 ± 5.03	-4.863	0.001
常规组	30	42.83 ± 5.52	42.26 ± 5.03	0.818	0.420
t值		-0.149	-3.453
P值		0.882	0.001
组别	例数	腓肠神经（感觉）（m/s）
组别	例数	治疗前	治疗2周后	t值	P值
rPMS组	30	46.96 ± 10.06	52.38 ± 7.52	-5.600	0.001
常规组	30	45.74 ± 10.09	46.39 ± 5.65	-0.475	0.638
t值		-0.379	-2.393
P值		0.705	0.017
组别	例数	H反射潜伏期（ms）
组别	例数	治疗前	治疗2周后	t/Z值	P值
rPMS组	30	34.89 ± 3.39	28.80 ± 1.92	10.124	0.001
常规组	30	34.00（32.60，37.30）	32.40（30.45，32.78）	2.615	0.014
t值		-0.074	-3.360
P值		0.941	0.001
组别	例数	IP峰值（μv）
组别	例数	治疗前	治疗2周后	t值	P值
rPMS组	30	2 500.47 ± 1647.43	3 616.07 ± 1521.92	-7.296	0.001
常规组	30	2 223.83 ± 1242.85	2 660.93 ± 1386.78	-2.904	0.007
t值		-0.312	-4.024
P值		0.755	0.001

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Effective of repeated peripheral magnetic stimulation treatment over patients with lumbar disc herniation was observed based on neuroelectrophysiological examination

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