重复经颅磁刺激联合针刺治疗脊髓损伤后神经病理性疼痛的临床研究

目的：观察重复经颅磁刺激（rTMS）联合针刺治疗脊髓损伤（SCI）后神经病理性疼痛（NP）的临床疗效。方法：按随机数字表法将99例SCI后NP患者分成对照组、针刺组和联合组，各33例。对照组进行常规基础治疗，针刺组在对照组基础上进行针刺治疗，联合组在针刺组基础上进行rTMS治疗。分别于治疗前及治疗6周后对3组患者进行视觉模拟量表（VAS）、汉密顿抑郁量表（HAMD）、汉密顿焦虑量表(HAMA)及生活质量SF-36量表评估。结果：治疗6周后，3组患者VAS、HAMD和HAMA评分较治疗前均明显降低（P＜0.05），SF-36量表各项评分较治疗前均明显升高（P＜0.05）；针刺组VAS、HAMD和HAMA评分较对照组均有降低（P＜0.05），SF-36量表各项评分较对照组均有升高（P＜0.05）；联合组VAS、HAMD和HAMA评分较针刺组和对照组均有降低（P＜0.05），SF-36量表各项评分较针刺组和对照组均有升高（P＜0.05）。结论：rTMS联合针刺治疗SCI后NP患者，有助于改善患者临床疼痛现象，且在改善患者情绪和生活质量方面疗效显著。

Clinical study of repetitive transcranial magnetic stimulation combined with acupuncture in the treatment of neuropathic pain after spinal cord injury

Objective: To observe the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with acupuncture in the treatment of neuropathic pain (NP) after spinal cord injury (SCI). Methods: A total of 99 patients with NP after SCI were randomly divided into control group, acupuncture group and combined group, with 33 cases in each group. The control group received routine basic treatment, the acupuncture group received acupuncture treatment on the basis of the control group, and the combined group received rTMS treatment on the basis of the acupuncture group. The patients in the three groups were assessed with visual analogue scale (VAS), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and quality of life SF-36 before and 6 weeks after treatment. Results: After 6 weeks of treatment, the VAS score, HAMD score and HAMA score in the three groups were significantly lower (P<0.05), and the scores of SF-36 were significantly higher than those before treatment (P<0.05); The VAS score, HAMD score and HAMA score in the acupuncture group were lower (P<0.05), and the scores of SF-36 scale were higher than those in the control group (P<0.05); The VAS score, HAMD score and HAMA score in the combined group were lower (P<0.05), and the scores of SF-36 scale were higher than those in the acupuncture group and the control group (P<0.05). Conclusion: rTMS combined with acupuncture in the treatment of NP patients after SCI is helpful to alleviate the clinical pain, and has a significant effect in improving the mood and quality of life of patients.