Ebenbichler G R, Resch K L, Nicolakis P, Wiesinger G F, Uhl F, Ghanem A H, Fialka V
Department of Physical Medicine and Rehabilitation, University of Vienna, Austria.
BMJ. 1998 Mar 7;316(7133):731-5. doi: 10.1136/bmj.316.7133.731.
To assess the efficacy of ultrasound treatment for mild to moderate idiopathic carpal tunnel syndrome.
Randomised, double blind, "sham" controlled trial with assessments at baseline, after 2 weeks' and 7 weeks' treatment, and at a follow up assessment 6 months later (8 months after baseline evaluation).
Outpatient clinic of a university department of physical medicine and rehabilitation in Vienna.
45 patients with mild to moderate bilateral carpal tunnel syndrome as verified by electroneurography.
20 sessions of ultrasound (active) treatment (1 MHz, 1.0 W/cm2, pulsed mode 1:4, 15 minutes per session) applied to the area over the carpal tunnel of one wrist, and indistinguishable sham ultrasound treatment applied to the other. The first 10 treatments were performed daily (5 sessions/week); 10 further treatments were twice weekly for 5 weeks.
Score of subjective symptom ratings assessed by visual analogue scale; electroneurographic measures (for example, motor distal latency and sensory antidromic nerve conduction velocity).
Improvement was significantly more pronounced in actively treated than in sham treated wrists for both subjective symptoms (P < 0.001, paired t test) and electroneurographic variables (motor distal latency P < 0.001, paired t test; sensory antidromic nerve conduction velocity P < 0.001, paired t test). Effects were sustained at 6 months' follow up.
Results suggest there are satisfying short to medium term effects due to ultrasound treatment in patients with mild to moderate idiopathic carpal tunnel syndrome. Findings need to be confirmed, and ultrasound treatment will have to be compared with standard conservative and invasive treatment options.
评估超声治疗轻至中度特发性腕管综合征的疗效。
随机、双盲、“假治疗”对照试验，在基线、治疗2周和7周后以及6个月后的随访评估（基线评估后8个月）进行评估。
维也纳一所大学物理医学与康复系的门诊诊所。
45例经神经电生理检查证实为轻至中度双侧腕管综合征的患者。
对一只手腕腕管上方区域进行20次超声（主动）治疗（1兆赫，1.0瓦/平方厘米，脉冲模式1:4，每次治疗15分钟），对另一只手腕进行难以区分的假超声治疗。前10次治疗每天进行（每周5次）；再进行10次治疗，每周2次，共5周。
通过视觉模拟量表评估的主观症状评分；神经电生理指标（如运动远端潜伏期和感觉逆向神经传导速度）。
无论是主观症状（P<0.001，配对t检验）还是神经电生理变量（运动远端潜伏期P<0.001，配对t检验；感觉逆向神经传导速度P<0.001，配对t检验），主动治疗的手腕改善均明显比假治疗的手腕更显著。6个月随访时效果持续存在。
结果表明，超声治疗对轻至中度特发性腕管综合征患者有令人满意的短期至中期效果。研究结果需要得到证实，并且必须将超声治疗与标准保守和侵入性治疗方案进行比较。
