电针为主治疗腕管综合征疗效观察

Efficacy observation of carpal tunnel syndrome treated with electroacupuncture

目的:探讨电针为主对腕管综合征患者正中神经传导速度和形态的影响,评估电针为主治疗腕管综合征的疗效。方法:对30例腕管综合征患者采用电针患侧曲池、阳池、手三里、内关、合谷穴,配合半导体激光照射患侧神门、阳溪。观察治疗前后患者症状的改善、神经传导速度的变化及超声下形态学的改变。结果:临床治疗总有效率为96.7%(29/30)。治疗后正中神经感觉传导速度明显增快、波幅明显增高,差异有统计学意义(均P<0.001);运动末端潜伏期明显缩短(P<0.001),运动波幅无明显变化(P>0.05)。治疗后正中神经近端肿胀明显改善(P<0.05),有效率为36.7%(11/30);腕管纵横径之比治疗前后无明显差异(P>0.05)。结论:电针对腕管综合征患者正中神经有良性的修复作用,能够有效消减炎性反应,改善神经纤维的缺血、水肿,但短期内不会有形态学上的改变。

Objective To explore the impacts of electroacupuncture on median nerve conduction velocity and morphology in patients of carpal tunnel syndrome （CTS） and evaluate the efficacy of electroacupuncture on CTS. Methods Thirty cases of CTS were treated with eleetroaeupuncture at Quchi （LI 11）, Yangchi （TE 4）, Shousanli （LI 10）, Neiguan （PC 6） and Hegu （LI 4） on the affected side, combined with semiconductor laser irradiation at Shenmen （HT 7） and Yangxi （LI 5） on the affected side. The improvements in the symptoms and changes in nerve conduction velocity and ultrasound morphology were observed before and after treatment. Result The clinical total effective rate was 96.7% （29/30）. The median nerve conduction velocity was accelerated apparently and the am- plitude was increased after treatment as compared with those before treatment, indicating the statistically signifi- cant difference （all P〈0. 001）. The distal motor latency was shortened apparently （P〈0. 001） and the motor am- plitude had no apparent change （P〉0. 05）. The proximal median nerve swelling was relieved apparently after treatment （P〈0.05） and the effective rate was 36.7% （11/30）. There was no apparent difference in the ratio of the vertical and horizontal diameters of carpal tunnel after treatment as compared with that before treatment （P〉0.05）. Conclusion Electroacupuncture presents the positive repair function to the median nerve in the patients of CTS. It can effectively alleviate inflammatory reaction and relieve isehemia and swelling of nerve fibers. And it cannot induce the changes in morphology in a short term.