Branco K, Naeser M A
Acupuncture Healthcare Services, Westport, Massachusetts, USA.
J Altern Complement Med. 1999 Feb;5(1):5-26. doi: 10.1089/acm.1999.5.5.
Outcome for carpal tunnel syndrome (CTS) patients (who previously failed standard medical/surgical treatments) treated primarily with a painless, noninvasive technique utilizing red-beam, low-level laser acupuncture and microamps transcutaneous electrical nerve stimulation (TENS) on the affected hand; secondarily, with other alternative therapies.
Open treatment protocol, patients diagnosed with CTS by their physicians.
Treatments performed by licensed acupuncturist in a private practice office.
Total of 36 hands (from 22 women, 9 men), ages 24-84 years, median pain duration, 24 months. Fourteen hands failed 1-2 surgical release procedures. INTERVENTION/TREATMENT: Primary treatment: red-beam, 670 nm, continuous wave, 5 mW, diode laser pointer (1-7 J per point), and microamps TENS (< 900 microA) on affected hands. Secondary treatment: infrared low-level laser (904 nm, pulsed, 10 W) and/or needle acupuncture on deeper acupuncture points; Chinese herbal medicine formulas and supplements, on case-by-case basis. Three treatments per week, 4-5 weeks.
Pre- and posttreatment Melzack pain scores; profession and employment status recorded.
Posttreatment, pain significantly reduced (p < .0001), and 33 of 36 hands (91.6%) no pain, or pain reduced by more than 50%. The 14 hands that failed surgical release, successfully treated. Patients remained employed, if not retired. Follow-up after 1-2 years with cases less than age 60, only 2 of 23 hands (8.3%) pain returned, but successfully re-treated within a few weeks.
Possible mechanisms for effectiveness include increased adenosine triphosphate (ATP) on cellular level, decreased inflammation, temporary increase in serotonin. There are potential cost-savings with this treatment (current estimated cost per case, $12,000; this treatment, $1,000). Safe when applied by licensed acupuncturist trained in laser acupuncture; supplemental home treatments may be performed by patient under supervision of acupuncturist.
对于腕管综合征（CTS）患者（此前标准药物/手术治疗失败），主要采用无痛、非侵入性技术进行治疗，该技术利用红色光束、低强度激光针刺以及微安级经皮电刺激神经疗法（TENS）作用于患手；其次采用其他替代疗法。
开放治疗方案，患者由医生诊断为CTS。
由持牌针灸师在私人诊所进行治疗。
共36只手（来自22名女性、9名男性），年龄24 - 84岁，中位疼痛持续时间为24个月。14只手经历了1 - 2次手术松解但失败。干预/治疗：主要治疗：使用670纳米红色光束、连续波、5毫瓦二极管激光指针（每点1 - 7焦耳）以及微安级TENS（< 900微安）作用于患手。次要治疗：红外线低强度激光（904纳米，脉冲式，10瓦）和/或在更深的穴位进行针刺；根据具体情况使用中药配方和补充剂。每周治疗3次，共4 - 5周。
治疗前后的梅尔扎克疼痛评分；记录职业和就业状况。
治疗后，疼痛显著减轻（p <.0001），36只手中的33只（91.6%）无疼痛或疼痛减轻超过50%。14只手术松解失败的手成功得到治疗。患者若未退休则仍保持就业。对年龄小于60岁的病例进行1 - 2年随访，23只手中只有2只（8.3%）疼痛复发，但在几周内成功再次治疗。
有效性的可能机制包括细胞水平上三磷酸腺苷（ATP）增加、炎症减轻、血清素暂时增加。这种治疗可能节省成本（目前估计每例成本为12,000美元；这种治疗为1,000美元）。由接受过激光针刺培训的持牌针灸师应用时安全；补充性家庭治疗可在针灸师监督下由患者进行。
