摘要
目的:观察超声引导针刀联合局部运动训练治疗腕管综合征(CTS)的临床疗效。方法:选取符合纳入标准的60例CTS患者,根据Excel随机表格法分为观察组和对照组,每组各30例。观察组采用超声引导针刀联合运动训练的治疗方案,对照组采用局部封闭联合运动训练的治疗方案,共治疗3周。比较两组患者治疗前后的超声结果、波士顿腕管综合征调查问卷(BCTQ)评分、正中神经感觉神经传导速度(SCV)、运动电位潜伏期(DML)及临床疗效和复发率。结果:治疗后,两组患者钩骨水平正中神经前后径较治疗前均明显变长,豌豆骨水平正中神经横截面积与腕横韧带厚度较治疗前均明显变小(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。两组患者BCTQ评分较治疗前均明显降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者SCV较治疗前明显升高(P<0.05),且观察组高于对照组(P<0.05)。两组患者DML较治疗前明显降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,观察组的优良率(96.67%,29/30)明显优于对照组(83.33%,25/30)(P<0.05)。治疗8周后进行随访,观察组复发1例,对照组复发6例,复发率比较差异有统计学意义。结论:超声引导针刀联合局部运动训练治疗腕管综合征疗效显著,可有效改善CTS的临床症状且更能保障其安全性,值得临床推广与应用。
Objective:To observe the clinical efficacy of ultrasound-guided needle-knife combined with local exercise training in the treatment of carpal tunnel syndrome(CTS).Method:Sixty patients with CTS who met the inclusion criteria were selected and divided into observation group and control group according to Excel random table,with 30 cases in each group.The observation group was treated with ultrasound-guided needle-knife combined with exercise training,while the control group was treated with local blocking combined with exercise training,and both groups were treated for 3 weeks.The ultrasonic results,Boston carpal tunnel questionnaire(BCTQ)score,median nerve sensory nerve conduction velocity(SCV),motor potential latency(DML)and clinical effects,and recurrence rate of the two groups were compared before and after treatment.Results:After the treatment,the anteroposterior diameter of the median nerve at the level of the uncinate bone in both groups was significantly longer than that before the treatment,and the cross-sectional area of the median nerve at the level of the pisiform bone and the thickness of the transverse carpal ligament were significantly smaller than those before treatment(P<0.05).However,there was no statistical significance between the two groups(P>0.05).The BCTQ score in both groups was significantly lower than that before the treatment(P<0.05),and the observation group was lower than the control group(P<0.05).The SCV of the two groups was significantly increased compared to before the treatment(P<0.05),and the observation group was higher than the control group(P<0.05).The DML of the two groups decreased significantly compared to before the treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After the treatment,the clinical effect of the observation group was significantly better than that of the control group(P<0.05).Conclusion:Ultrasound guided needle-knife combined with local exercise training has a significant therapeutic effect on carpal tunnel syndrome,can effectively improve the clinical symptoms of CTS and ensure its safety.It is worthy of clinical application and promotion.
作者
宋寒冰
陈启鹏
王飞
梁仕博
SONG Hanbing;CHEN Qipeng;WANG Fei;LIANG Shibo(The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)
出处
《中医药信息》
2023年第12期53-57,64,共6页
Information on Traditional Chinese Medicine
基金
黑龙江省自然科学基金优秀青年项目(YQ2020H028)
黑龙江省中医药科研项目(ZHY2020-98,ZHY19-033)
黑龙江中医药大学“优秀创新人才支持计划”科研项目(2018RCQ07)。
关键词
腕管综合征
超声引导
针刀
运动训练
Carpal tunnel syndrome
Ultrasound guidance
Needle-knife
Exercise training
作者简介
第一作者:宋寒冰(1983-),男,博士,副主任医师,副教授,主要研究方向:中医骨伤科学。
