高频脊髓电刺激和低频脊髓电刺激治疗慢性疼痛有效性和安全性比较的meta分析

A meta-analysis of the effectiveness and safety of high-frequency spinal cord stimulation and low-frequency spinal cord stimulation in the treatment of chronic pain

摘要:

目的：系统性评价高频脊髓电刺激（High-frequency spinal cord stimulation, HFSCS)和低频脊髓电刺激(low-frequency spinal cord stimulation, LFSCS) 治疗慢性疼痛的有效性及安全性。方法：计算机检索PubMed、Web of Science、Cochrane Library、embase等数据库，搜索有关高频脊髓电刺激和低频脊髓电刺激治疗慢性疼痛的疗效对比的随机对照试验，检索时间为从2010年1月至2021年10月。由另外2名研究者独立提取数据，采用 Revman 5.3 软件进行 Meta 分析。结果：与低频脊髓电刺激相比，高频SCS获得了更高的有效率、患者满意度及更好的临床总体效果（P<0.05）。两者在降低疼痛评分和降低Oswestry功能障碍指数方面无统计学差异（P>0.05）。高频SCS具有更高的安全性。结论：高频脊髓电刺激与传统脊髓电刺激相比，具有良好的有效性和安全性，且不会出现感觉异常，在治疗慢性疼痛方面具有巨大的潜力。但是相关研究较少，仍需要更多的高质量临床研究来提供循证依据。

Abstract:

Objective: To systematically evaluate the effectiveness and safety of high-frequency spinal cord stimulation (HFSCS) and low-frequency spinal cord stimulation (LFSCS) in the treatment of chronic pain. Methods: PubMed, Web of Science, Cochrane Library, and embase were searched electronically from January 2010 to October 2021 to collect randomized controlled trials on the efficacy of high-frequency SCS and low-frequency SCS in the treatment of chronic pain. Two other researchers independently extracted data. Meta-analysis was performed by Revman 5.3 software. Result: Meta-analysis results show that compared with low-frequency SCS, high-frequency SCS has more advantages in efficiency and improving sleep, achieving higher patient satisfaction and better overall clinical effects (P<0.05). There was no significant difference in reducing the pain score and the Oswestry dysfunction index (P>0.05). High-frequency SCS has higher security. Conclusion: Compared with traditional SCS, high-frequency SCS has good effectiveness and safety without paresthesia, and it has great potential in the treatment of chronic pain. However, there are fewer valuable studies, and more high-quality clinical studies are needed to provide evidence-based basis. Key words High-frequency spinal cord stimulation Low-frequency spinal cord stimulation Chronic pain Randomized controlled trials Efficiency safety mata-analysis