摘要
BACKGROUND： Iatrophysics can improve the velocity of local microcirculation at peripheral nerve injured sites and promote the recovery from injury. Research has shown that simultaneous application of two physical factors has synergistic effects on the recovery of peripheral nerve function. OBJECTIVE： To treat patients that received peripheral nerve entrapment surgery with comprehensive rehabilitation by decimeter wave therapy and electrical stimulation, and to observe the clinical effects of promoting nerve function recovery. DESIGN： Randomized controlled study. SETTINGS： Department of Orthopaedics, the Third Hospital of Baoding; Department of Hand Surgery, the Third Hospital of Hebei Medical University; Woman-Children Healthcare Center, Southern District, Baoding. PARTICIPANTS： A total of 124 patients, who received peripheral nerve entrapment surgery, were selected from the Department of Orthopaedics, the Third Hospital of Baoding between July 2001 and May 2007. All patients met the diagnostic standard of peripheral nerve entrapment syndrome defined by Doctor Chen in 1995. All subjects gave informed consent for treatments and conditions involved. The experiment was approved by a local ethics committee. All patients were randomly divided into four groups： electrical stimulation group, decimeter wave group, compound physical factor group, and control group, with 31 subjects in each group. METHODS： Patients received neurolysis at an appropriate interval after hospitalization. （1） Multi-form wave therapeutic equipment made in China was used to treat patients in the electrical stimulation group after neurolysis. Wave form, stimulus width, interval time, and stimulus intensity were regulated based on the grade of nerve injury. The details were as follows： mild nerve injury： 50-100-ms stimulus width and 1 500-2 000-ms intervals; moderate nerve injury： 100-200-ms stimulus width and 3 000-4 000-ms intervals; severe nerve injury： 200-300-ms stimulus width and 3 000--6 000-ms intervals. Current dosage was 20- 40 mA. The electrical stimulation was given 6 minutes/session, once a day, and 20 days were regarded as one treatment cycle. （2） A TMA-A double-frequent mild-hot therapeutic instrument was used on patients in the decimeter wave group after neurolysis. The therapeutic program was adapted to the early and middle-late phase. In the early phase, the decimeter wave was 10-15 W, 10 minutes/session, once a day; in the middle-late phase, the decimeter wave was 10-30 W, 20 minutes/session, once a day. Twenty days were regarded as one treatment cycle. （3） Patients in the compound physical factor group following neurolysis were treated the same as the decimeter wave group and electrical stimulation group, respectively. The treatment was performed once a day, and 20 days were regarded as one course. （4） Patients in the control group were not administered any physical treatment. MAIN OUTCOME MEASURES： Therapeutic efficacy was comprehensively evaluated based on motor and sensory evaluation criteria （set by Subassociation of Hand Surgery, Chinese Medical Association） at 1, 2, and 3 months after surgery, as well as changes in the electromyogram before and after operation. RESULTS： All 124 patients with peripheral nerve entrapment syndrome were included in the final analysis. One month after surgery, fineness rates in the electrical stimulation group, decimeter wave group, and compound physical factor group were not significantly different from those in the control group （P 〉 0.05）. There was also no significant difference between the electrical stimulation group, decimeter wave group, and compound physical factor group （P 〉 0.05）. Two months after surgery, fineness rates in the electrical stimulation group and decimeter wave group were not significantly different from the control group （P 〉 0.05）. However, fineness rates were higher in the compound physical factor group compared to the other three groups （P 〈 0.05）. There was no significant difference between the electrical stimulation group and the decimeter wave group （P 〉 0.05）. Three months after operation, fineness rates in the electrical stimulation group, decimeter wave group, and compound physical factor group were higher than the control group （P 〈 0.05）. However, there was no significant difference between the electrical stimulation group, decimeter wave group, and compound physical factor group （P 〉 0.05）. CONCLUSION： The combination of decimeter wave therapy and electrical stimulation can remarkably shorten the recovery time of peripheral nerve function. The synergistic effect is superior to that of electrical stimulation and decimeter wave alone. This suggests that those two physical factors have synergistic effects on the treatment of peripheral nerve entrapment syndrome.
BACKGROUND： Iatrophysics can improve the velocity of local microcirculation at peripheral nerve injured sites and promote the recovery from injury. Research has shown that simultaneous application of two physical factors has synergistic effects on the recovery of peripheral nerve function. OBJECTIVE： To treat patients that received peripheral nerve entrapment surgery with comprehensive rehabilitation by decimeter wave therapy and electrical stimulation, and to observe the clinical effects of promoting nerve function recovery. DESIGN： Randomized controlled study. SETTINGS： Department of Orthopaedics, the Third Hospital of Baoding; Department of Hand Surgery, the Third Hospital of Hebei Medical University; Woman-Children Healthcare Center, Southern District, Baoding. PARTICIPANTS： A total of 124 patients, who received peripheral nerve entrapment surgery, were selected from the Department of Orthopaedics, the Third Hospital of Baoding between July 2001 and May 2007. All patients met the diagnostic standard of peripheral nerve entrapment syndrome defined by Doctor Chen in 1995. All subjects gave informed consent for treatments and conditions involved. The experiment was approved by a local ethics committee. All patients were randomly divided into four groups： electrical stimulation group, decimeter wave group, compound physical factor group, and control group, with 31 subjects in each group. METHODS： Patients received neurolysis at an appropriate interval after hospitalization. （1） Multi-form wave therapeutic equipment made in China was used to treat patients in the electrical stimulation group after neurolysis. Wave form, stimulus width, interval time, and stimulus intensity were regulated based on the grade of nerve injury. The details were as follows： mild nerve injury： 50-100-ms stimulus width and 1 500-2 000-ms intervals; moderate nerve injury： 100-200-ms stimulus width and 3 000-4 000-ms intervals; severe nerve injury： 200-300-ms stimulus width and 3 000--6 000-ms intervals. Current dosage was 20- 40 mA. The electrical stimulation was given 6 minutes/session, once a day, and 20 days were regarded as one treatment cycle. （2） A TMA-A double-frequent mild-hot therapeutic instrument was used on patients in the decimeter wave group after neurolysis. The therapeutic program was adapted to the early and middle-late phase. In the early phase, the decimeter wave was 10-15 W, 10 minutes/session, once a day; in the middle-late phase, the decimeter wave was 10-30 W, 20 minutes/session, once a day. Twenty days were regarded as one treatment cycle. （3） Patients in the compound physical factor group following neurolysis were treated the same as the decimeter wave group and electrical stimulation group, respectively. The treatment was performed once a day, and 20 days were regarded as one course. （4） Patients in the control group were not administered any physical treatment. MAIN OUTCOME MEASURES： Therapeutic efficacy was comprehensively evaluated based on motor and sensory evaluation criteria （set by Subassociation of Hand Surgery, Chinese Medical Association） at 1, 2, and 3 months after surgery, as well as changes in the electromyogram before and after operation. RESULTS： All 124 patients with peripheral nerve entrapment syndrome were included in the final analysis. One month after surgery, fineness rates in the electrical stimulation group, decimeter wave group, and compound physical factor group were not significantly different from those in the control group （P 〉 0.05）. There was also no significant difference between the electrical stimulation group, decimeter wave group, and compound physical factor group （P 〉 0.05）. Two months after surgery, fineness rates in the electrical stimulation group and decimeter wave group were not significantly different from the control group （P 〉 0.05）. However, fineness rates were higher in the compound physical factor group compared to the other three groups （P 〈 0.05）. There was no significant difference between the electrical stimulation group and the decimeter wave group （P 〉 0.05）. Three months after operation, fineness rates in the electrical stimulation group, decimeter wave group, and compound physical factor group were higher than the control group （P 〈 0.05）. However, there was no significant difference between the electrical stimulation group, decimeter wave group, and compound physical factor group （P 〉 0.05）. CONCLUSION： The combination of decimeter wave therapy and electrical stimulation can remarkably shorten the recovery time of peripheral nerve function. The synergistic effect is superior to that of electrical stimulation and decimeter wave alone. This suggests that those two physical factors have synergistic effects on the treatment of peripheral nerve entrapment syndrome.
