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安慰剂对照的连续和脉冲超声治疗对腕管综合征的影响:一项随机试验。

Effects of placebo-controlled continuous and pulsed ultrasound treatments on carpal tunnel syndrome: a randomized trial.

作者信息

Armagan Onur, Bakilan Fulya, Ozgen Merih, Mehmetoglu Ozlem, Oner Setenay

机构信息

Department of Physical Medicine and Rehabilitation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.

Department of Physical Medicine and Rehabilitation, Konya State Hospital, Eregli, Turkey.

出版信息

Clinics (Sao Paulo). 2014 Aug;69(8):524-8. doi: 10.6061/clinics/2014(08)04.

Abstract

OBJECTIVE

The aim of this placebo-controlled study was to evaluate the effects of pulsed and continuous ultrasound treatments combined with splint therapy on patients with mild and moderate idiopathic carpal tunnel syndrome.

METHODS

The study included 46 carpal tunnel syndrome patients who were randomly divided into 3 groups. The first group (n = 15) received a 0 W/cm2 ultrasound treatment (placebo); the second group (n = 16) received a 1.0 W/cm2 continuous ultrasound treatment and the third group (n = 15) received a 1.0 W/cm2 1:4 pulsed ultrasound treatment 5 days a week for a total of 15 sessions. All patients also wore night splints during treatment period. Pre-treatment and post-treatment Visual Analogue Scale, Symptom Severity Scale and Functional Status Scale scores, median nerve motor conduction velocity and distal latency and sensory conduction velocities of the median nerve in the 2nd finger and palm were compared. Clinicaltrials.gov: NCT02054247.

RESULTS

There were significant improvements in all groups in terms of the post-treatment Functional Status Scale score (p<0.05 for all groups), Symptom Severity Scale score (first group: p<0.05, second group: p<0.01, third group: p<0.001) and Visual Analogue Scale score (first and third groups: p<0.01, second group: p<0.001). Sensory conduction velocities improved in the second and third groups (p<0.01). Distal latency in the 2nd finger showed improvement only in the third group (p<0.01) and action potential latency in the palm improved only in the second group (p<0.05).

CONCLUSION

The results of this study suggest that splinting therapy combined with placebo and pulsed or continuous ultrasound have similar effects on clinical improvement. Patients treated with continuous and pulsed ultrasound showed electrophysiological improvement; however, the results were not superior to those of the placebo.

摘要

目的

本项安慰剂对照研究旨在评估脉冲超声和连续超声治疗联合夹板疗法对轻、中度特发性腕管综合征患者的疗效。

方法

本研究纳入46例腕管综合征患者,随机分为3组。第一组(n = 15)接受0 W/cm2超声治疗(安慰剂);第二组(n = 16)接受1.0 W/cm2连续超声治疗,第三组(n = 15)接受1.0 W/cm2 1:4脉冲超声治疗,每周5天,共15次。所有患者在治疗期间均佩戴夜间夹板。比较治疗前和治疗后视觉模拟量表、症状严重程度量表和功能状态量表评分、正中神经运动传导速度、远端潜伏期以及示指和手掌正中神经的感觉传导速度。Clinicaltrials.gov:NCT02054247。

结果

所有组在治疗后的功能状态量表评分(所有组p<0.05)、症状严重程度量表评分(第一组:p<0.05,第二组:p<0.01,第三组:p<0.001)和视觉模拟量表评分(第一组和第三组:p<0.01,第二组:p<0.001)方面均有显著改善。第二组和第三组的感觉传导速度有所改善(p<0.01)。仅第三组示指的远端潜伏期有所改善(p<0.01),仅第二组手掌的动作电位潜伏期有所改善(p<0.05)。

结论

本研究结果表明,夹板疗法联合安慰剂以及脉冲或连续超声对临床改善具有相似的效果。接受连续和脉冲超声治疗的患者显示出电生理改善;然而,结果并不优于安慰剂组。

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