Bahrami Mohammad Hasan, Raeissadat Seyed Ahmad, Nezamabadi Mohammadrasoul, Hojjati Fateme, Rahimi-Dehgolan Shahram
Physical Medicine and Rehabilitation Department and Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, School of Medicine, Tehran, Iran.
Clinical Development Research Center of Shahid Modarres Hospital, Physical Medicine and Rehabilitation Department and Research Center, Shahid Beheshti University of Medical Sciences, School of Medicine, Tehran, Iran.
Orthop Res Rev. 2019 May 6;11:61-67. doi: 10.2147/ORR.S202780. eCollection 2019.
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper limb. Local injection of different substances has been increasingly used as an acceptable conservative treatment in non-severe cases. This study aimed to evaluate the efficacy and safety of local ozone injection in the management of non-severe CTS. In the current randomized controlled trial (RCT), 40 patients with mild or moderate CTS were included in two parallel groups. Both of them used the resting volar wrist splint for 8 weeks; while the intervention group received a single dose of local ozone injection, except for the same splinting protocol. The main outcome measures including visual analog scale (VAS) for pain; symptom severity or functional status, based on Boston questionnaire (BQ); and median nerve conduction study, were reassessed 10 weeks after the treatment. All of the measures including VAS, symptom severity, functional status and EDX improved significantly in both groups with the maximal changes in VAS. The VAS reduction was more remarkable in the ozone group than the control group [64% versus 45.3%, respectively]. Moreover, both of the BQ subscales showed significantly higher improvement in the ozone group compared to the control group (=0.01 and 0.02, respectively). Although the improvement of EDX parameters was slightly better in the ozone group, the difference was not significant. Neither minor nor major side effects were reported. Ozone therapy as a safe and low-cost method, could provide promising results among women with mild to moderate CTS, at least for short-term treatment. IRCT2016040913442N9.
腕管综合征(CTS)是上肢最常见的卡压性神经病变。在非严重病例中,局部注射不同物质作为一种可接受的保守治疗方法越来越受到青睐。本研究旨在评估局部注射臭氧治疗非严重腕管综合征的疗效和安全性。在当前的随机对照试验(RCT)中,40例轻度或中度腕管综合征患者被纳入两个平行组。两组患者均使用休息位掌侧腕部夹板8周;干预组除采用相同的夹板固定方案外,还接受单剂量局部臭氧注射。主要观察指标包括疼痛视觉模拟量表(VAS);基于波士顿问卷(BQ)的症状严重程度或功能状态;以及正中神经传导研究,在治疗后10周重新评估。包括VAS、症状严重程度、功能状态和神经电生理检查(EDX)在内的所有指标在两组中均有显著改善,VAS变化最大。臭氧组VAS降低比对照组更显著[分别为64%和45.3%]。此外,与对照组相比,臭氧组的BQ两个子量表均显示出显著更高的改善(分别为=0.01和0.02)。尽管臭氧组EDX参数的改善略好,但差异不显著。未报告轻微或严重的副作用。臭氧疗法作为一种安全且低成本的方法,对于轻度至中度腕管综合征女性患者可能会产生有前景的结果,至少在短期治疗中如此。IRCT2016040913442N9