行为、物理疗法联合药物对腕管综合征的疗效分析

Analysis of therapeutic effect for carpal tunnel syndrome treated with a combination of behavior therapy,physical therapy and pharmacotherapy

目的观察行为、物理疗法联合药物治疗对轻、中度腕管综合征患者手部功能的影响。方法采用行为、物理疗法联合药物治疗54例轻、中度腕管综合征患者。于治疗前及治疗后2个月应用症状严重程度评分(SSS)、功能状态评分(FSS)和电生理检查对患者进行评价。结果与治疗前比较,患者治疗后SSS评分及FSS评分均显著降低(均P<0.01)。治疗前正中神经感觉神经动作电位(SNAP)波幅及感觉传导速度(SCV)均低于治疗后(均P<0.05)。与治疗前比较,治疗后正中神经末端运动潜伏期(DML)显著缩短(P<0.01),复合肌肉动作电位(CMAP)波幅显著升高(P<0.01);运动传导速度(MCV)治疗前后差异无统计学意义(P>0.05)。治疗前后尺神经SNAP波幅、SCV、DML、CMAP波幅、MCV差异均无统计学意义(均P>0.05)。结论行为、物理疗法联合药物治疗能有效改善轻、中度腕管综合征患者的手部功能。

Objective To observe the effect on the function of the patients’fingers who suffer from mild to moderate carpal tunnel syndrome(CTS)treated with a combination of behavior therapy,physical therapy and pharmacotherapy.Methods Fifty-four patients with mild to moderate CTS were treated with a combination of behavior therapy,physical therapy and pharmacotherapy.Before treatment and at 2 months after treatment,the enrolled subjects were evaluated by symptom severity scale(SSS)and functional status scale(FSS)and electrophysiological examination.Results Compared with those before treatment,the scores of SSS and FSS were significantly lower after treatment(all P<0.01).The amplitude of sensory nerve action potential(SNAP)and sensory conduction velocity(SCV)in the median nerve before treatment were significantly lower than those after treatment(all P<0.05).Compared with those before treatment,the median motor nerve distal motor latency(DML)was significantly shorted(P<0.01),and the compound muscle action potential(CMAP)amplitude was significantly increased after treatment(P<0.01).And there was no statistical significance in median motor nerve motor conduction velocities(MCV)before and after treatment(P>0.05).There was no statistical significance of amplitude of SNAP,SCV,DML,the amplitude of CMAP,MCV in ulnar nerve before and after treatment(all P>0.05).Conclusion Combination of behavior therapy,physical therapy and pharmacotherapy have a positive effect on the function of the fingers with mild to moderate CTS.