Department of Neurology, Adnan Menderes University, Medical Faculty, Aydin, Türkiye.
J Clin Neurophysiol. 2009 Dec;26(6):446-53. doi: 10.1097/WNP.0b013e3181c298e3.
Our aims were to observe the effects of rehabilitation and surgery on idiopathic and diabetic carpal tunnel syndrome (CTS) and compare them with the natural course of the disease. Forty-two patients aged 33 to 74 years with clinically diagnosed, electrophysiologically confirmed, and laboratory screened hands with CTS (46 idiopathic and 34 diabetic) were enrolled in the study. Improvement of symptom severity and functional status after treatment using the Boston questionnaire (scales), changes of nerve conduction parameters (NCPs), and correlations between NCP and Boston questionnaires were outcome measures. Follow-up periods were 3 to 5 months and 6 to 12 months. In idiopathic CTS, surgery was effective according to scales and NCP. Rehabilitation was also effective according to scales but only in the late period. Nontreatment did not improve scales at a later period. In diabetic CTS, rehabilitation was not effective according to scales. Baseline and follow-up correlations between scales and NCP were weak and limited to sensory amplitudes (baseline), sensory amplitudes-velocity, and median motor distal latency (follow-up). Regression analysis also did not reveal any associations between scales and NCP. A repeated nerve conduction study was not meaningful if the diagnosis was definite. Treatment of CTS was definitely superior to spontaneous improvements. Rehabilitation was ineffective in diabetic CTS.
我们的目的是观察康复和手术对特发性和糖尿病性腕管综合征（CTS）的影响，并将其与疾病的自然病程进行比较。本研究纳入了 42 名年龄在 33 至 74 岁之间的患者，这些患者均具有临床诊断、电生理证实和实验室筛查的 CTS（46 例特发性和 34 例糖尿病性）。采用波士顿问卷（量表）评估治疗后症状严重程度和功能状态的改善、神经传导参数（NCP）的变化以及 NCP 和波士顿问卷之间的相关性。随访时间为 3 至 5 个月和 6 至 12 个月。在特发性 CTS 中，手术在量表和 NCP 方面均有效。康复治疗在量表方面也有效，但仅在后期有效。在后期，不进行治疗不会改善量表。在糖尿病性 CTS 中，康复治疗在量表方面无效。基线和随访时量表和 NCP 之间的相关性较弱，仅限于感觉幅度（基线）、感觉幅度-速度和正中运动末端潜伏期（随访）。回归分析也未发现量表和 NCP 之间存在任何关联。如果诊断明确，则重复神经传导研究没有意义。与自然改善相比，治疗 CTS 绝对有效。康复治疗对糖尿病性 CTS 无效。
