Ashworth Nigel L
University of Alberta, Edmonton, Canada.
BMJ Clin Evid. 2011 Oct 21;2011:1114.
Carpal tunnel syndrome is a neuropathy caused by compression of the median nerve within the carpal tunnel. However, the severity of symptoms and signs does not often correlate well with the extent of nerve damage.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, non-drug treatments, surgical treatments, and postoperative treatments for carpal tunnel syndrome? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 57 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, carpal tunnel release surgery (open and endoscopic), diuretics, internal neurolysis, local and systemic corticosteroids, massage therapy, nerve and tendon gliding exercises, non-steroidal anti-inflammatory drugs (NSAIDs), pyridoxine, therapeutic ultrasound, and wrist splints.
腕管综合征是一种由正中神经在腕管内受压引起的神经病变。然而，症状和体征的严重程度往往与神经损伤的程度并不密切相关。
我们进行了一项系统评价，旨在回答以下临床问题：药物治疗、非药物治疗、手术治疗及腕管综合征术后治疗的效果如何？我们检索了：截至2011年7月的Medline、Embase、Cochrane图书馆及其他重要数据库（临床证据综述会定期更新；请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品及医疗保健产品监管局（MHRA）等相关机构的危害警示。
我们发现57项系统评价、随机对照试验或观察性研究符合我们的纳入标准。我们对干预措施的证据质量进行了GRADE评估。
在本系统评价中，我们呈现了以下干预措施的有效性和安全性相关信息：针灸、腕管松解手术（开放式和内镜式）、利尿剂、内部神经松解术、局部和全身用皮质类固醇、按摩疗法、神经和肌腱滑动练习、非甾体抗炎药（NSAIDs）、维生素B6、超声治疗及腕部夹板。
