Faig-Martí Jordi, Martínez-Catassús Adriana
Hospital Sant Rafael, Pg. Vall d'Hebron 107-117, 08035, Barcelona, Catalonia, Spain.
J Orthop Traumatol. 2017 Dec;18(4):451-455. doi: 10.1007/s10195-017-0453-z. Epub 2017 Mar 15.
Palmitoylethanolamide (PEA) is an endogenous fatty acid amide that has shown anti-inflammatory activity and neuroprotection and has been used for the treatment of compressive syndromes. The aim of this study is to investigate the clinical and electrophysiological effects of conservative treatment with PEA in low to moderate carpal tunnel syndrome (CTS).
A prospective double-blinded randomized study was performed on 61 patients with a clinical and electrophysiologically confirmed diagnosis of low and moderate CTS. The patients were randomly assigned to two groups. Group N was given 300 mg of PEA twice a day over 60 days and Group P received a placebo with exactly the same appearance every 12 h for the same period. CTS was evaluated before and after treatment through clinical findings, Boston Carpal Tunnel Questionnaire, visual analog scale (VAS) and electrophysiological data. The results were evaluated with Student's t test and chi-squared test.
No differences were observed in either group compared to the initial status regarding Durkan's test, Phalen's test, VAS and electrophysiological data after treatment. The Boston Questionnaire showed better results in both groups, with an improvement in only the symptom severity scale (SSS; p = 0.002809) for group P and improvement in the functional status scale (FSS; p = 0.03334) and SSS (p = 0.005) for group N.
The results of this study suggest that treatment of CTS with PEA at a dose of 600 mg/day is not associated with an improvement of any clinical and electrophysiological parameters. However, we observed an improvement in the FSS in the Boston Questionnaire after treatment with PEA. Together with the results of other studies, we conclude that further studies of PEA in CTS at higher doses are necessary.
Level I of evidence according to 'The Oxford 2011 Level of Evidence'.
棕榈酰乙醇胺（PEA）是一种内源性脂肪酸酰胺，具有抗炎活性和神经保护作用，已被用于治疗压迫综合征。本研究的目的是探讨PEA保守治疗对轻至中度腕管综合征（CTS）的临床和电生理影响。
对61例临床和电生理确诊为轻至中度CTS的患者进行了一项前瞻性双盲随机研究。患者被随机分为两组。N组每天两次服用300mg PEA，持续60天，P组在同一时期每12小时服用外观完全相同的安慰剂。通过临床检查结果、波士顿腕管问卷、视觉模拟量表（VAS）和电生理数据对治疗前后的CTS进行评估。结果采用学生t检验和卡方检验进行评估。
治疗后，两组在Durkan试验、Phalen试验、VAS和电生理数据方面与初始状态相比均未观察到差异。波士顿问卷显示两组结果均较好，P组仅症状严重程度量表（SSS；p = 0.002809）有所改善，N组功能状态量表（FSS；p = 0.03334）和SSS（p = 0.005）有所改善。
本研究结果表明，每天600mg剂量的PEA治疗CTS与任何临床和电生理参数的改善均无关。然而，我们观察到PEA治疗后波士顿问卷中的FSS有所改善。结合其他研究结果，我们得出结论，有必要对更高剂量的PEA治疗CTS进行进一步研究。
根据《牛津2011证据水平》为I级证据。
