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经皮电离子导入皮质类固醇治疗腕管综合征的系统评价和荟萃分析。

Use of Iontophoresis with Corticosteroid in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis.

机构信息

Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain.

Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Puerta del Mar, Hospital Puerto Real, Cadiz Bay-La Janda Health District, 11006 Cadiz, Spain.

出版信息

Int J Environ Res Public Health. 2023 Feb 28;20(5):4287. doi: 10.3390/ijerph20054287.

Abstract

BACKGROUND

Carpal tunnel syndrome is a neuropathy that affects the median nerve. The aim of this review is to synthesize the evidence and perform a meta-analysis on the effects of iontophoresis in people with carpal tunnel syndrome.

METHODS

The search was carried out using PubMed, Web of Science, Scopus, CINHAL Complete, Physiotherapy Evidence Database, and SciELO. The methodological quality was evaluated using PEDro. A standardized or mean difference meta-analysis (Hedge's g) using a random-effects model was calculated.

RESULTS

Seven randomized clinical trials using iontophoresis for electrophysiological, pain, and functional outcomes were included. The mean of PEDro was 7/10. No statistical differences were obtained for the median sensory nerve conduction velocity (SMD = -0.89; = 0.27) or latency (SMD = -0.04; = 0.81), motor nerve conduction velocity (SMD = -0.04; = 0.88) or latency (SMD = -0.01; = 0.78), pain intensity (MD = 0.34; = 0.59), handgrip strength (MD = -0.97; = 0.09), or pinch strength (SMD = -2.05; = 0.06). Iontophoresis only seemed to be superior in sensory amplitude (SMD = 0.53; = 0.01).

CONCLUSIONS

Iontophoresis did not obtain an enhanced improvement compared to other interventions, but no clear recommendations could be made due to the limited number of included studies and the heterogeneity found in the assessment and intervention protocols. Further research is needed to draw sound conclusions.

摘要

背景

腕管综合征是一种影响正中神经的神经病变。本综述的目的是综合证据并对离子电渗疗法治疗腕管综合征患者的效果进行荟萃分析。

方法

使用 PubMed、Web of Science、Scopus、CINHAL Complete、Physiotherapy Evidence Database 和 SciELO 进行检索。使用 PEDro 评估方法学质量。使用随机效应模型进行标准化均数差荟萃分析(Hedge's g)。

结果

纳入了 7 项使用离子电渗疗法治疗电生理、疼痛和功能结局的随机临床试验。PEDro 的平均得分为 7/10。正中感觉神经传导速度(SMD = -0.89; = 0.27)或潜伏期(SMD = -0.04; = 0.81)、正中运动神经传导速度(SMD = -0.04; = 0.88)或潜伏期(SMD = -0.01; = 0.78)、疼痛强度(MD = 0.34; = 0.59)、握力(MD = -0.97; = 0.09)或捏力(SMD = -2.05; = 0.06)均无统计学差异。离子电渗疗法似乎仅在感觉幅度方面具有优势(SMD = 0.53; = 0.01)。

结论

与其他干预措施相比,离子电渗疗法并未获得更好的改善效果,但由于纳入研究数量有限且评估和干预方案存在异质性,因此无法做出明确的推荐。需要进一步的研究来得出可靠的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/429b/10001463/d041d62e67ed/ijerph-20-04287-g0A1.jpg

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