肘端针刺与腕端针刺治疗轻中度腕管综合征的临床研究

Clinical Study of Acupuncture at the Elbow End Versus Acupuncture at the Wrist End for Mild-to-moderate Carpal Tunnel Syndrome

目的观察肘端针刺与腕端针刺治疗轻中度腕管综合征的临床疗效。方法将120例轻中度腕管综合征患者用随机数字表法分为腕端针刺组和肘端针刺组,每组60例。腕端针刺组针刺大陵、内关、阳溪、偏历、阳池、外关、腕骨和养老穴进行治疗,肘端针刺组针刺郄门、曲泽、孔最、尺泽、曲池、手三里、四渎、天井、支正和小海穴进行治疗,两组均连接电针。比较两组临床疗效,观察治疗前后两组Levine腕管综合征问卷调查表和腕关节患者评估量表的评分变化。结果肘端针刺组总有效率为88.3%,高于腕端针刺组的68.3%,组间差异具有统计学意义(P<0.05)。治疗后,两组Levine腕管综合征问卷调查表和腕关节患者评估量表的评分均较同组治疗前降低(P<0.05);治疗2个疗程后和治疗后,肘端针刺组Levine腕管综合征问卷调查表和腕关节患者评估量表的评分低于腕端针刺组(P<0.05)。治疗过程中,两组均无明显不良反应。结论腕端针刺与肘端针刺治疗均可缓解轻中度腕管综合征患者的症状、改善功能障碍、减轻疼痛,肘端针刺的疗效优于腕端针刺。

Objective To observe the clinical efficacy of acupuncture at the elbow end versus acupuncture at the wrist end in treating mild-to-moderate carpal tunnel syndrome(CTS).Method A total of 120 patients with mild-to-moderate CTS were divided into a wrist-end acupuncture group and an elbow-end acupuncture group using the random number table method,with 60 cases in each group.In the wrist-end acupuncture group,Daling(PC7),Neiguan(PC6),Yangxi(LI5),Pianli(LI6),Yangchi(TE4),Waiguan(TE5),Wangu(SI4),and Yanglao(SI6)were selected for acupuncture treatment.In the elbow-end acupuncture group,Ximen(PC4),Quze(PC3),Kongzui(LU6),Chize(LU5),Quchi(LI11),Shousanli(LI10),Sidu(TE9),Tianjing(TE10),Zhizheng(SI7),and Xiaohai(SI8)were selected for acupuncture treatment.Electroacupuncture was applied in both groups.The clinical efficacy was compared between the two groups.The scores of Levine’s questionnaire for CTS and patient-related wrist evaluation scale were observed before and after treatment.Result The total effective rate was 88.3%in the elbow-end acupuncture group,higher than 68.3%in the wrist-end acupuncture group,showing a significant between-group difference(P<0.05).After treatment,the scores of Levine’s questionnaire and patient-related wrist evaluation scale dropped in both groups(P<0.05).After two treatment courses and after treatment,the scores of Levine’s questionnaire and patient-related wrist evaluation scale were lower in the elbow-end acupuncture group than in the wrist-end acupuncture group(P<0.05).During the treatment process,there were no noticeable adverse reactions in the two groups.Conclusion Acupuncture at either the wrist end or at the elbow end can alleviate the symptoms,improve the function,and reduce pain in treating patients with CTS,but acupuncture at the elbow end can produce more significant efficacy than that at the wrist end.