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激光针灸治疗腕管综合征的疗效:一项前瞻性双盲随机对照试验的研究方案

Efficacy of laser acupuncture for carpal tunnel syndrome: A study protocol for a prospective double-blind randomized controlled trial.

作者信息

Chen Chuan-Chih, Wu Yung-Tsan, Su Yu-Chi, Shen Yu-Ping, Chen Fang-Pey

机构信息

Institute of Traditional Medicine, School of Medicine, National Yang-Ming University.

Department of Chinese Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center.

出版信息

Medicine (Baltimore). 2019 Jul;98(30):e16516. doi: 10.1097/MD.0000000000016516.

Abstract

INTRODUCTION

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that causes hand discomfort and work disability. Since no satisfactory conventional treatments for mild to moderate CTS exist, we apply complementary alternative medicine (CAM) to this problem. Laser acupuncture (LA), a new, non-invasive therapy which uses low-level-laser therapy (LLLT) in acupuncture could help to manage CTS. However, only one small randomized, double-blind and crossover trial had been conducted, which is not enough to provide an evidence-based assessment of the effects of LA on CTS.

OBJECTIVES

The aim of this study protocol is to investigate the efficacy of LA therapy on patients with mild to moderate CTS through sonography of the median nerve and offer clear parameters of LLLT.

METHODS

This study protocol is a prospective double-blind randomized controlled trial. Forty subjects aged 20 to 80 years old and diagnosed as having mild to moderate CTS will be randomly assigned to the intervention group (real LA, 3-sessions a week for 2 weeks) and control group (sham LA, 3-sessions a week for 2 weeks). All subjects will be asked to wear night splints as the fundamental management approach. The laser parameters will include a wavelength of 808 nm, power output of 300 mW and power density of 300 mW/mm, with ten seconds of treatment for each acupuncture point (PC4, PC6, PC7, PC8, LI4, LI10, LI11, HT3, HT7, and LU10). Sham LA treatment will be applied without any laser power output. The primary outcome will be based the Boston Carpal Tunnel Syndrome Questionnaire and secondary outcomes included a visual analog scale, cross sectional area of median nerve by sonography and electrophysiological test before interventions and after 2, 4, 8, 12 weeks postintervention.

TRIAL REGISTRATION

ClinicalTrials.gov (Identifier: NCT03580265).

摘要

引言

腕管综合征(CTS)是最常见的卡压性神经病变,可导致手部不适和工作能力丧失。由于目前尚无令人满意的针对轻至中度CTS的传统治疗方法,我们将补充替代医学(CAM)应用于这一问题。激光针灸(LA)是一种新的非侵入性疗法,它在针灸中使用低强度激光疗法(LLLT),可能有助于治疗CTS。然而,此前仅进行过一项小型随机双盲交叉试验,不足以对LA治疗CTS的效果进行循证评估。

目的

本研究方案的目的是通过正中神经超声检查来研究LA疗法对轻至中度CTS患者的疗效,并提供LLLT的明确参数。

方法

本研究方案为前瞻性双盲随机对照试验。40名年龄在20至80岁之间、被诊断为轻至中度CTS的受试者将被随机分配至干预组(真正的LA,每周3次,共2周)和对照组(假LA,每周3次,共2周)。所有受试者都将被要求佩戴夜间夹板作为基本治疗方法。激光参数将包括波长808纳米、输出功率300毫瓦和功率密度300毫瓦/平方毫米,每个穴位(PC4、PC6、PC7、PC8、LI4、LI10、LI11、HT3、HT7和LU10)治疗10秒。假LA治疗将在无任何激光输出功率的情况下进行。主要结局将基于波士顿腕管综合征问卷,次要结局包括视觉模拟量表、干预前及干预后2、4、8、12周通过超声检查得到的正中神经横截面积以及电生理测试结果。

试验注册

ClinicalTrials.gov(标识符:NCT03580265)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e31/6709042/554df09dde77/medi-98-e16516-g001.jpg

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