Naeser Margaret A, Hahn Kyung-Ae K, Lieberman Barbara E, Branco Kenneth F
Department of Neurology, Boston University School of Medicine, Psychology Research Service, MA, USA.
Arch Phys Med Rehabil. 2002 Jul;83(7):978-88. doi: 10.1053/apmr.2002.33096.
To investigate whether real or sham low-level laser therapy (LLLT) plus microamperes transcutaneous electric nerve stimulation (TENS) applied to acupuncture points significantly reduces pain in carpal tunnel syndrome (CTS).
Randomized, double-blind, placebo-control, crossover trial. Patients and staff administered outcome measures blinded.
Outpatient, university-affiliated Department of Veterans Affairs medical center.
Eleven mild to moderate CTS cases (nerve conduction study, clinical examination) who failed standard medical or surgical treatment for 3 to 30 months.
Patients received real and sham treatment series (each for 3-4wk), in a randomized order. Real treatments used red-beam laser (continuous wave, 15mW, 632.8nm) on shallow acupuncture points on the affected hand, infrared laser (pulsed, 9.4W, 904nm) on deeper points on upper extremity and cervical paraspinal areas, and microamps TENS on the affected wrist. Devices were painless, noninvasive, and produced no sensation whether they were real or sham. The hand was treated behind a hanging black curtain without the patient knowing if devices were on (real) or off (sham).
McGill Pain Questionnaire (MPQ) score, sensory and motor latencies, and Phalen and Tinel signs.
Significant decreases in MPQ score, median nerve sensory latency, and Phalen and Tinel signs after the real treatment series but not after the sham treatment series. Patients could perform their previous work (computer typist, handyman) and were stable for 1 to 3 years.
This new, conservative treatment was effective in treating CTS pain; larger studies are recommended.
探讨对腕管综合征（CTS）患者的穴位进行真正的或模拟的低强度激光疗法（LLLT）加微安级经皮电神经刺激（TENS）是否能显著减轻疼痛。
随机、双盲、安慰剂对照、交叉试验。患者和工作人员在测量结果时均处于盲态。
大学附属医院退伍军人事务部医疗中心门诊。
11例轻至中度CTS患者（神经传导研究、临床检查），他们接受标准药物或手术治疗失败3至30个月。
患者按随机顺序接受真正的和模拟的治疗系列（各3 - 4周）。真正的治疗采用红色激光束（连续波，15mW，632.8nm）照射患手的浅穴位，红外激光（脉冲，9.4W，904nm）照射上肢和颈部椎旁区域的深穴位，以及对患侧手腕进行微安级TENS治疗。这些设备无痛、无创，无论是真正的还是模拟的都不会产生感觉。在一块悬挂的黑色帘子后面治疗手部，患者不知道设备是开启（真正治疗）还是关闭（模拟治疗）。
麦吉尔疼痛问卷（MPQ）评分、感觉和运动潜伏期以及Phalen征和Tinel征。
真正治疗系列后MPQ评分、正中神经感觉潜伏期以及Phalen征和Tinel征显著降低，而模拟治疗系列后未降低。患者能够从事之前的工作（电脑打字员、杂工），且病情稳定1至3年。
这种新的保守治疗方法对治疗CTS疼痛有效；建议开展更大规模的研究。
