超声可视化针刀技术治疗腕管综合征的临床安全及疗效观察

Clinical Safety and Efficacy of Ultrasound-Visualized Acupotomy in the Treatment of Carpal Tunnel Syndrome

摘要: 目的：评价超声可视化针刀技术治疗腕管综合征(CTS)的安全性及临床疗效。方法：40例轻中度腕管综合征患者，按就诊顺序编号随机分为观察组和对照组各20例。对照组选用传统针刀(盲刺)治疗，观察组采用超声引导下针刀治疗，治疗时间为3周1疗程。1个疗程后，比较两组治疗前后的Levine腕管综合征问卷评分及末端运动潜伏期(Distal Motor Latency, DML)、感觉传导速度(Sensory Conduction Velocity, SCV)、感觉神经电位波幅(Sensory Nerve Action Potential, SNAP)等电生理参数，并进行Kelly疗效评定，最后对所得数据进行统计分析得出结论。结果：两组患者治疗前后Levine腕管综合征问卷评分，DML、SCV、SNAP等电生理参数经组内比较，差异有统计学意义(P < 0.05)。治疗后两组Levine腕管综合征问卷评分、DML及SCV等电生理参数经组间比较，差异有统计学意义(P < 0.05)，SNAP经组间比较，差异无统计学意义(P > 0.05)。两组治疗后经Kelly疗效评定，观察组治愈3例，显效11例，有效5例，无效1例；对照组治愈2例，显效7例，有效9例，无效2例，两组比较差异有统计学意义(P < 0.05)。结论：针刀治疗CTS疗效确切，超声可视化针刀治疗CTS疗效更优，安全性更高。

Abstract: Objective: evaluate the safety and clinical efficacy of ultrasound-visualized needle-knife technique in the treatment of carpal tunnel syndrome (CTS). Methods: 40 patients with mild to moderate carpal tunnel syndrome were randomly divided into observation groups (N = 20) and control groups (N = 20). The control group was treated with traditional acupotomy (blind acupuncture), and the observation group was treated with acupotomy under the guidance of ultrasound. The treatment period was 3 weeks and 1 course. After one course of treatment, the scores of Levine carpal tunnel syndrome questionnaire and the electrophysiological parameters, such as terminal motor latency (Distal Motor Latency, DML), sensory conduction velocity (Sensory Conduction Velocity, SCV) and sensory nerve potential amplitude (Sensory Nerve Action Potential, SNAP), were compared between the two groups before and after treatment, Kelly curative effect was evaluated, and the data were analyzed statistically to reach a conclusion. Results: there were significant differences in the scores of Levine Carpal Tunnel Syndrome questionnaire, DML, SCV and SNAP between the two groups before and after treatment (P < 0.05). After treatment, there were significant differences in the scores of Levine Carpal Tunnel Syndrome questionnaire, DML and SCV between the two groups (P < 0.05), but there was no significant difference in SNAP between the two groups (P > 0.05). After treatment, 3 cases were cured, 11 cases were markedly effective, 5 cases were effective and 1 case was ineffective in the Observation Group, 2 cases were cured, 7 cases were markedly effective, 9 cases were effective and 2 cases were ineffective in the control group, there was a significant difference between the two groups (P < 0.05). Conclusion: the therapeutic effect of acupotomology on CTS is definite, and the therapeutic effect and safety of ultrasonic visu-alization acupotomology on CTS are better.