基于肌电图观察针刀结合神经松动术治疗腕管综合征的疗效

Observation of the therapeutic effect of needle knife combined with neurolysis on carpal tunnel syndrome based on electromyography

目的 探讨针刀结合神经松动术治疗腕管综合征(carpal tunnel syndrome,CTS)的疗效,并采用肌电图观察治疗效果。方法 选取2021年9月至2022年11月陕西省中医医院康复科就诊的62例轻中度CTS患者,随机分为研究组和对照组,每组31例。对照组采用针刀治疗,研究组在针刀治疗的基础上结合神经松动术治疗。采用视觉疼痛评分(visual analogue scale,VAS)法评估疼痛,采用Levine腕管综合征问卷评分(Levine carpal tunnel syndrome questionnaire,LCTSQ)评估患者腕管综合征的程度和症状,比较两组治疗前后的肌电图检测结果。治疗前、治疗1周、治疗2周后的VAS、LCTSQ评分,以及治疗1周、治疗2周后的临床总有效率。结果 治疗后,两组正中神经远端潜伏期(distal motor latency,DML)较治疗前均降低,波幅(amplitude,AMP)、感觉传导速度(sensory conduction velocity,SCV)较治疗前均升高,且研究组DML明显低于对照组(P<0.05),AMP、SCV明显高于对照组(P<0.05)。治疗1周、2周后两组VAS、LCTSQ评分较治疗前均降低(P<0.05),治疗2周后两组VAS、LCTSQ评分较治疗1周均降低(P<0.05),且研究组明显低于对照组(P<0.05)。治疗1周后研究组治疗总有效率为64.52%,与对照组的61.29%比较,差异无统计学意义(P>0.05),治疗2周后研究组总有效率为96.77%,对照组为80.65%,差异有统计学意义(P<0.05)。结论 针刀结合神经松动术治疗CTS,可有效地修复受损神经,减轻疼痛,改善腕管功能和症状,提高临床治疗效果。

Objective Explore the therapeutic effect of needle knife combined with neurolysis on carpal tunnel syndrome(CTS),and observe the effect using electromyography.Methods 62 mild to moderate CTS patients who visited the Rehabilitation Department of Shaanxi Provincial Hospital of Chinese Medicine from September 2021 to November 2022 were randomly divided into a study group and a control group,with 31 patients in each group.The control group received needle knife treatment,while the study group received neurolysis on the basis of needle knife treatment.The visual analogue scale(VAS)was used to evaluate pain,and the Levine carpal tunnel syndrome questionnaire(LCTSQ)was used to evaluate the degree and symptoms of carpal tunnel syndrome.The electromyographic examination results before and after treatments were compared between the two groups.The VAS and LCTSQ scores were also compared before treatment,1 week of treatment,and 2 weeks of treatment,as well as the clinical treatment efficacy after 1 week and 2 weeks of treatment.Results After treatment,the distal motor latency(DML)of the median nerve in both groups was lower than that before treatment,and the amplitude(AMP)and sensory conduction velocity(SCV)were higher than those before treatment.The DML in the study group was significantly lower than that in the control group(P<0.05),while the AMP and SCV were significantly higher than those in the control group(P<0.05).After 1 and 2 weeks of treatment,the VAS and LCTSQ scores of both groups decreased compared to before treatment(P<0.05).After 2 weeks of treatment,the VAS and LCTSQ scores of both groups decreased compared to 1 week of treatment(P<0.05),and the study group was significantly lower than the control group(P<0.05).The total effective rate of the study group after one week of treatment was 64.52%,which was not statistically significant compared to 61.29%in the control group(P>0.05).The total effective rate of the study group after two weeks of treatment was 96.77%,while in the control group it was 80.65%,with a statistically significant difference(P<0.05).Conclusion The combination of needle knife and neurolysis for the treatment of CTS can effectively promote the repair of damaged nerves,reduce pain,improve carpal tunnel function and symptoms,and improve clinical treatment efficacy.