黄芪桂枝五物汤联合腕部制动治疗气虚血瘀型腕管综合征49例

49 Cases of Carpal Tunnel Syndrome of Qi Deficiency and Blood Stasis Treated with Huangqi Guizhi Wuwu Decoction and Wrist Immobilization

目的:观察黄芪桂枝五物汤联合腕部制动疗法治疗腕管综合征的临床疗效。方法:纳入49例腕管综合征患者,所有患者均口服黄芪桂枝五物汤,1剂/d,早晚分服,疗程4周。同时腕关节支具固定2周,每周门诊复诊并记录症状改善情况。比较治疗前后波士顿腕管综合征问卷(Boston Carpal Tunnel Questionnaire,BCTQ)评分、疼痛视觉模拟量表(VAS)评分及神经电生理等相关检查结果。结果:治疗4周后BCTQ评分在症状严重程度量表(Sympton Severity Scale,SSS)和功能状态量表(Functional Status Scale,FSS)两方面均明显降低,差异有统计学意义(P<0.05);治疗后VAS评分显著降低,差异有统计学意义(P<0.05);在神经电生理检测方面,治疗后中指-腕感觉神经动作电位波幅(SNAP)、中指-腕感觉神经传导速度(SNCV)、示指-腕感觉神经动作电位波幅(SNAP)、示指-腕感觉神经传导速度(SNCV)、正中神经末端运动潜伏期(DML)明显改善,差异有统计学意义(P<0.05)。结论:黄芪桂枝五物汤联合腕部制动的治疗方式可以明显改善气虚血瘀型腕管综合征(轻中度)患者的症状及腕关节功能,疗效良好。

Objective:To observe the clinical efficacy of Huangqi Guizhi Wuwu decoction combined with wrist immobilization therapy on carpal tunnel syndrome.Methods:49 patients with carpal tunnel syndrome were recruited.Huangqi Guizhi Wuwu decoction was given separately in morning and evening.One dose per day for 4 weeks.At the same time,the wrist was fixed by orthosis for 2 weeks.Patients were notified for clinic every week for the follow-up visits and improvement of symptoms.The Boston Carpal Tunnel Syndrome Questionnaire(BCTQ)score,visual analogue scale(VAS)score,and neuroelectrophysiological results were compared before and after treatment.Results:After 4 weeks of treatment,the BCTQ score was significantly reduced in both symptoms(Sympton Severity Scale,SSS)and function(Functional Status Scale,FSS),and those differences were statistically significant(P<0.05);after treatment,the VAS score was significantly decreased,and the difference was statistically significant(P<0.05);in terms of neuroelectrophysiological testing,after treatment,middle finger-wrist SNAP,middle finger-wrist SNCV,index finger-wrist SNAP,index finger-wrist SNCV value were increased significantly,DML value lowered significantly,and the difference was statistically significant(P<0.05).Conclusion:Huangqi Guizhi Wuwu decoction combined with wrist immobilization can significantly improve the symptoms and wrist joint function of patients with Qi deficiency and blood stasis carpal tunnel syndrome(mild to moderate).