Wu S F, Chan R C, Hsu T C
Department of Physical Medicine and Rehabilitation, Veterans General Hospital-Taipei.
Zhonghua Yi Xue Za Zhi (Taipei). 1991 Aug;48(2):125-30.
The incidence of carpal tunnel syndrome ranks first by far among all entrapment neuropathies. Many foreign studies have been reported over the years concerning the diagnosis of carpal tunnel syndrome, but very few about its treatment effects. Moreover, data have been based on the patients' subjective reports of their symptoms. Our data, however, are wholly derived from objective electromyographic examination. Five treatment approaches were compared for patients suffering from carpal tunnel syndrome in this study. Ninety-nine hands of 61 patients were divided into five treatment groups vitamins B6 & B12, steroid injection, hand splint, splint combined with vitamins, and splint combined with injection. Each patient was evaluated with electrodiagnostic study before the treatment, and 1 and 2 months after the treatment. Treatment with hand splinting, local injection at wrist, and combined therapies were all superior in effect to vitamins B6 & B12 alone in sensory nerve conduction study. The effects of treatment appeared faster in the groups with local injection and local injection combined with hand splinting in the sensory and motor nerve conduction studies. The results of this study suggest that treatment with vitamins B6 & B12 alone does not suit carpal tunnel syndrome well and that hand splint combined with steroid injection is the better conservative treatment.
在所有压迫性神经病变中，腕管综合征的发病率目前位居首位。多年来，国外已有许多关于腕管综合征诊断的研究报道，但关于其治疗效果的报道却很少。此外，以往的数据都是基于患者对自身症状的主观报告。然而，我们的数据完全来自客观的肌电图检查。本研究对腕管综合征患者的五种治疗方法进行了比较。61例患者的99只手被分为五个治疗组：维生素B6和B12组、类固醇注射组、手部夹板组、夹板联合维生素组以及夹板联合注射组。在治疗前、治疗后1个月和2个月，对每位患者进行电诊断研究评估。在感觉神经传导研究中，手部夹板治疗、腕部局部注射治疗以及联合治疗的效果均优于单独使用维生素B6和B12治疗。在感觉和运动神经传导研究中，局部注射组以及局部注射联合手部夹板组的治疗效果出现得更快。本研究结果表明，单独使用维生素B6和B12治疗腕管综合征效果不佳，手部夹板联合类固醇注射是较好的保守治疗方法。
