Percutaneous electrical nerve field stimulation compared to standard medical therapy in adolescents with functional abdominal pain disorders.

IF 2.5 Q2 CLINICAL NEUROLOGY Frontiers in pain research (Lausanne, Switzerland) Pub Date : 2023-09-19 eCollection Date: 2023-01-01 DOI:10.3389/fpain.2023.1251932

Neha R Santucci, Rashmi Sahay, Khalil I El-Chammas, Kahleb Graham, Mikaela Wheatley, Madeleine Vandenbrink, Jennifer Hardy, Lin Fei

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Abstract

Introduction: Standard medical therapy (SMT) in children with functional abdominal pain disorders (FAPD) includes cyproheptadine and amitriptyline. While percutaneous electrical nerve field stimulation (PENFS) has shown benefit, no study has compared outcomes of PENFS to SMT. We aimed to examine changes in abdominal pain, nausea and disability before and after treatment and compare outcomes between treatments.

Methods: The records of FAPD patients ages 11-21 years, treated with 4 weeks of PENFS, cyproheptadine or amitriptyline were reviewed. Outcomes were evaluated using validated questionnaires [Abdominal Pain Index (API), Nausea Severity Scale (NSS), and the Functional Disability Inventory (FDI)] at baseline and follow-up within 3 months (FU).

Result: Of 101 patients, 48% received PENFS, 31% cyproheptadine and 21% received amitriptyline. Median ages were 17 (15-19), 16 (15-18) and 15 (11-16) years respectively and the majority were females (75%, 90% and 52% respectively). In the PENFS group, API (p = 0.001), NSS (p = 0.059) and FDI (p = 0.048) were significantly lower at FU. API (p = 0.034) but not NSS and FDI (p > 0.05) decreased significantly at FU in the amitriptyline group. API, NSS and FDI did not change significantly with cyproheptadine at FU (p > 0.05). FU API scores were lower in PENFS vs. cyproheptadine (p = 0.04) but not vs. amitriptyline (p = 0.64). The FDI scores were significantly lower in the amitriptyline vs. cyproheptadine group (p = 0.03).

Conclusion: Therapy with PENFS showed improvements in abdominal pain, nausea and disability while amitriptyline showed improvements in abdominal pain within 3 months of treatment. PENFS was more effective than cyproheptadine in improving abdominal pain. Amitriptyline improved disability scores more than cyproheptadine and showed promise for treatment. PENFS may be a good non-pharmacologic alternative for FAPD.

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经皮神经电场刺激与标准药物治疗功能性腹痛障碍青少年的比较。

引言：儿童功能性腹痛障碍（FAPD）的标准药物治疗（SMT）包括赛庚啶和阿米替林。虽然经皮神经电场刺激（PENFS）已显示出益处，但没有研究将PENFS与SMT的结果进行比较。我们的目的是检查治疗前后腹痛、恶心和残疾的变化，并比较两种治疗的结果。方法：回顾11～21岁FAPD患者接受PENFS、赛庚啶或阿米替林治疗4周的记录。在基线和3个月内的随访（FU）中，使用经验证的问卷[腹痛指数（API）、恶心严重程度量表（NSS）和功能性残疾量表（FDI）]评估结果。结果：101例患者中，48%接受PENFS治疗，31%接受赛庚啶治疗，21%接受阿米替林治疗。中位年龄分别为17岁（15-19岁）、16岁（15-18岁）和15岁（11-16岁），大多数为女性（分别为75%、90%和52%）。在PENFS组中，API（p = 0.001）、NSS（p = 0.059）和外国直接投资（p = 0.048）在FU时显著降低。API（p = 0.034），但不包括NSS和FDI（p > 0.05）显著降低。API、NSS和FDI在FU时与赛庚啶无显著变化（p > 与赛庚啶相比，PENFS中FU API评分较低（p = 0.04），但与阿米替林相比没有（p = 0.64）。阿米替林组的FDI得分显著低于赛庚啶组（p = 0.03）。结论：PENFS治疗后3个月内，腹痛、恶心和残疾症状得到改善，阿米替林治疗后腹痛症状得到改善。PENFS在改善腹痛方面比赛庚啶更有效。阿米替林比赛庚啶更能改善残疾评分，并显示出治疗前景。PENFS可能是FAPD的一种很好的非药物替代品。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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