Research progress on analgesic mechanism and application of transcutaneous electrical acupoint stimulation
LI Yingsi1 FANG Juan1▲ CHEN Caiyi2 JIANG Jinguang3 WANG Meng3
1.Department of Acupuncture and Moxibustion, Suqian Traditional Chinese Medicine Hospital, Jiangsu Province, Suqian 223800, China;
2.College of Acupuncture and Moxibustion, Fujian University of Traditional Chinese Medicine, Fujian Province, Fuzhou 350122, China;
3.Department of Proctology, Suqian Traditional Chinese Medicine Hospital, Jiangsu Province, Suqian 223800, China
Abstract:Pain is a kind of unpleasant feeling and emotional experience, which seriously harms the physical and mental health of patients. The effectiveness and scientific nature of acupuncture analgesia have been proved by many studies. As a means of acupuncture analgesia, transcutaneous electrical acupoint stimulation (TEAS) has become a hot spot in the field of acupuncture in recent years. TEAS can reduce pain sensitivity by activating the pain inhibition mechanism and promote the release of endogenous opioid peptides to exert analgesic effect, which can significantly improve pain and associated symptoms in patients. TEAS are widely used for a variety of acute and chronic pain, such as postoperative acute pain, chronic pain, cancer pain, etc. In this paper, the analgesic mechanism and clinical application of TEAS are reviewed in recent years, in order to provide reference for clinical analgesia of TEAS.
[1] 韩济生.针麻镇痛研究[J].针刺研究,2016,41(5):377- 387.
[2] 何孟霖,胡澄,田伟千.经皮穴位电刺激在围手术期的应用[J].针刺研究,2021,46(9):800-803.
[3] Melzack R,Wall PD. Pain mechanisms:a new theory [J]. Science,1965,150(3699):971-979.
[4] 褚华清,郑晖.经皮神经电刺激在疼痛诊疗中的应用及研究进展[J].中国疼痛医学杂志,2021,27(9):693-697.
[5] Sprenger C,May A,Buchel C. Pain contra pain:the concept of DNIC [J]. Schmerz,2010,24(6):569-574.
[6] 端木程琳,张晓宁,何伟,等.电针/经皮电刺激激活不同传入神经纤维对肌肉炎性痛大鼠的镇痛效应研究[J].针刺研究,2021,46(5):404-410.
[7] 陈李圳,王晓宇,何伟,等.不同针灸刺激的镇痛作用与神经传入特征[J].中华中医药杂志,2022,37(5):2622- 2626.
[8] Sluka KA,Bjordal JM,Marchand S,et al. What makes transcutaneous electrical nerve stimulation work?Making sense of the mixed results in the clinical literature [J]. Phys Ther,2013,93(10):1397-1402.
[9] 周鹏,宋雨桐,张阔,等.经皮穴位电刺激对大脑神经功能活动影响研究进展[J].航天医学与医学工程,2019,32(5):463-470.
[10] Kara M,Ozcakar L,Gokcay D,et al. Quantification of the effects of transcutaneous electrical nerve stimulation with functional magnetic resonance imaging:a double-blind randomized placebo-controlled study [J]. Arch Phys Med Rehabil,2010,91(8):1160-1165.
[11] Vance CG,Dailey DL,Rakel BA,et al. Using TENS for pain control:the state of the evidence [J]. Pain Manag,2014, 4(3):197-209.
[12] 刘天红,宋召军,裘晟晨.经皮穴位电刺激对类风湿关节炎大鼠外周阿片肽表达水平的影响[J].上海针灸杂志,2021,40(6):769-776.
[13] 时艳杰,王铁东,曹鑫蔚,等.经皮穴位电刺激辅助麻醉对胸科手术患者血浆β-EP、5-HT、PGE2水平及疼痛的影响[J].辽宁中医药大学学报,2021,23(9):190-193.
[14] De Santana JM,Da SL,De Resende MA,et al. Transcutaneous electrical nerve stimulation at both high and low frequencies activates ventrolateral periaqueductal grey to decrease mechanical hyperalgesia in arthritic rats [J]. Neuroscience,2009,163(4):1233-1241.
[15] 宋康,金孝岠.经皮穴位电刺激辅助椎管内麻醉的研究进展[J].赣南医学院学报,2021,41(6):639-643.
[16] 冯吉杰,王珂,张雪慧,等.不同强度经皮穴位电刺激对胸腔镜手术患者术后免疫功能的影响[J].上海针灸杂志,2020,39(5):584-588.
[17] 果君媛,袁芬,刘翔,等.经皮穴位电刺激复合全身麻醉对输尿管软镜碎石术后疼痛、应激反应及免疫功能的影响[J].中国医刊,2022,57(2):194-198.
[18] 朱兵.论穴位与穴位特异性[J].中国针灸,2021,41(9):943-950.
[19] Noba L,Rodgers S,Chandler C,et al. Enhanced Recovery After Surgery(ERAS)Reduces Hospital Costs and Improve Clinical Outcomes in Liver Surgery:a Systematic Review and Meta-Analysis [J]. J Gastrointest Surg,2020,24(4):918-932.
[20] Song B,Chang Y,Li Y,et al. Effects of Transcutaneous Electrical Acupoint Stimulation on the Postoperative Sleep Quality and Pain of Patients After Video-Assisted Thoracoscopic Surgery:A Prospective,Randomized Controlled Trial [J]. Nat Sci Sleep,2020(12):809-819.
[21] Meng D,Mao Y,Song QM,et al. Efficacy and Safety of Transcutaneous Electrical Acupoint Stimulation(TEAS)for Postoperative Pain in Laparoscopy:A Systematic Review and Meta-Analysis of Randomized Controlled Trials [J]. Evid Based Complement Alternat Med,2022,2022:9922879.
[22] Ao L,Shi J,Bai Y,et al. Effects of transcutaneous electrical acupoint stimulation on perioperative immune function and postoperative analgesia in patients undergoing radical mastectomy:A randomized controlled trial [J]. Exp Ther Med,2021,21(3):184.
[23] 胡小雪,李建松,金忆,等.经皮穴位电刺激在老年骨关节炎初次全膝关节置换术麻醉中超前镇痛效果的临床研究[J].山东中医杂志,2021,40(7):724-728.
[24] Chi YL,Zhang WL,Yang F,et al. Transcutaneous Electrical Acupoint Stimulation for Improving Postoperative Recovery,Reducing Stress and Inflammatory Responses in Elderly Patient Undergoing Knee Surgery [J]. Am J Chin Med,2019,47(7):1445-1458.
[25] Qi WH,Miao WJ,Ji YZ,et al. The Analgesic Effect of Transcutaneous Electrical Acupoint Stimulation on Labor: A Randomized Control Study [J]. Int J Gen Med,2021,14:559-569.
[26] 吕红梅,袁士涛,代玉圣,等.经皮穴位电刺激对丙泊酚闭环麻醉输注系统麻醉手术患儿血流动力学、应激反应和炎症反应的影响[J].河南中医,2019,39(3):399- 402.
[27] 王福涌,李仲文,代文杰,等.全身麻醉联合经皮穴位电刺激在小儿腹腔镜疝修补术中的应用效果[J].临床医学,2020,40(12):9-12.
[28] Ozen S,Saracgil CS,Cabioglu MT,et al. A Comparison of Physical Therapy Modalities Versus Acupuncture in the Treatment of Fibromyalgia Syndrome:A Pilot Study [J]. J Altern Complement Med,2019,25(3):296-304.
[29] Chiou YF,Yeh ML,Wang YJ. Transcutaneous Electrical Nerve Stimulation on Acupuncture Points Improves Myofascial Pain,Moods,and Sleep Quality [J]. Rehabil Nurs,2020,45(4):225-233.
[30] He DP,Zhang J,Bai ZF. Percutaneous Electrical Nerve Stimulation for Chronic Knee Pain:A Randomized,Sham-controlled Trial [J]. Altern Ther Health Med,2019, 25(2):30-34.
[31] Miao Q,Qiang JH,Jin YL. Effectiveness of percutaneous neuromuscular electrical stimulation for neck pain relief in patients with cervical spondylosis [J]. Medicine(Baltimore),2018,97(26):e11080.
[32] 刘小华,李崖雪,吴民民,等.深刺下关穴配合经皮穴位电刺激治疗三叉神经痛临床疗效及对睡眠质量影响[J].辽宁中医药大学学报,2022,24(4):196-200.
[33] Lu Z,Wang Q,Sun X,et al. Transcutaneous electrical acupoint stimulation before surgery reduces chronic pain after mastectomy:A randomized clinical trial [J]. J Clin Anesth,2021,74:110453.
[34] 陈雨,林青,刘传波,等.癌性疼痛的中医治疗进展[J].医学综述,2020,26(20):4112-4116.
[35] Tai JB,Hong L,Ma ME,et al. Evaluation of therapeutic effect of transcutaneous electrical acupoint stimulation on bone metastasis pain and its influence on immune function of patients [J]. Ann Palliat Med,2020,9(5):2538-2544.
[36] Siemens W,Boehlke C,Bennett MI,et al. Transcutaneous electrical nerve stimulation for advanced cancer pain inpatients in specialist palliative care-a blinded,randomized,sham-controlled pilot cross-over trial [J]. Support Care Cancer,2020,28(11):5323-5333.
[37] Nakano J,Ishii K,Fukushima T,et al. Effects of transcutaneous electrical nerve stimulation on physical symptoms in advanced cancer patients receiving palliative care [J]. Int J Rehabil Res,2020,43(1):62-68.