[1]杨爱晓,杨改清,张 通.神经松动术联合关节松动术对轻中度原发性腕管综合征患者疼痛及症状的影响[J].医学信息,2023,36(21):106-109.[doi:10.3969/j.issn.1006-1959.2023.21.024]
　YANG Ai-xiao,YANG Gai-qing,ZHANG Tong.Effect of Nerve Mobilization Combined with Joint Mobilization on Pain and Symptoms in Patients with Mild to Moderate Primary Carpal Tunnel Syndrome[J].Journal of Medical Information,2023,36(21):106-109.[doi:10.3969/j.issn.1006-1959.2023.21.024]
点击复制

神经松动术联合关节松动术对轻中度原发性腕管综合征患者疼痛及症状的影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年21期
页码:
106-109
栏目:
论著
出版日期:
2023-11-01

文章信息/Info

Title:
Effect of Nerve Mobilization Combined with Joint Mobilization on Pain and Symptoms in Patients with Mild to Moderate Primary Carpal Tunnel Syndrome
文章编号:
1006-1959（2023）21-0106-04
作者:
杨爱晓; 杨改清; 张 通
（1.首都医科大学康复医学院，北京 100068；2.北京按摩医院康复科，北京 100068；3.天津市西青医院康复科，天津 300380）
Author(s):
YANG Ai-xiao; YANG Gai-qing; ZHANG Tong
(1.Rehabilitation Medical College,Capital Medical University,Beijing 100068,China;2.Rehabilitation Department of Beijing Massage Hospital,Beijing 100068,China;3.Rehabilitation Department of Tianjin Xiqing Hospital,Tianjin 300380,China)
关键词:
原发性腕管综合征; 神经松动术; 关节松动术; 疼痛症状; 电生理指标
Keywords:
Primary carpal tunnel syndrome; Nerve mobilization; Joint mobilization; Pain symptoms; Electrophysiological indicators
分类号:
R68；R74
DOI:
10.3969/j.issn.1006-1959.2023.21.024
文献标志码:
A
摘要:
目的 探究神经松动术联合关节松动术对轻中度原发性腕管综合征（CTS）患者疼痛及症状的影响。方法 以2021年9月-2022年8月北京按摩医院收治的60例轻中度CTS患者为研究对象，按照随机数字表法分为对照组（30例）与观察组（30例）。对照组给予关节松动术治疗，观察组应用神经松动术联合关节松动术治疗，比较两组治疗前后疼痛程度[视觉模拟评分（VAS）]、症状改善情况[波士顿腕管问卷调查表（BCTQ）评分]、腕管压力（休息位、握拳位）、上肢关节功能（Fugl-Meyer上肢功能评分、Mayo腕关节功能评分）、电生理指标[正中神经感觉传导速度（SCV）、正中神经运动传导速度（MC）]。结果 观察组治疗后VAS、BCTQ评分均低于对照组（P＜0.05）；观察组治疗后腕管压力（休息位、握拳位）小于对照组（P＜0.05）；观察组治疗后Fugl-Meyer上肢功能评分、Mayo腕关节功能评分高于对照组（P＜0.05）；观察组治疗后SCV、MC高于对照组（P＜0.05）。结论 神经松动术联合关节松动术治疗轻中度CTS效果确切，可有效改善患者的疼痛及症状表现，降低其腕管压力，提升上肢关节功能的同时改善其电生理指标。
Abstract:
Objective To explore the effect of nerve mobilization combined with joint mobilization on pain and symptoms in patients with mild to moderate primary carpal tunnel syndrome (CTS).Methods Sixty patients with mild to moderate CTS admitted to Beijing Massage Hospital from September 2021 to August 2022 were divided into control group (30 patients) and observation group (30 patients) according to the random number table method. The control group was treated with joint mobilization, and the observation group was treated with nerve mobilization combined with joint mobilization. The pain degree [visual analogue scale (VAS)], symptom improvement [Boston carpal tunnel questionnaire (BCTQ) score], carpal tunnel pressure (resting position, fist position), upper limb joint function (Fugl-Meyer upper limb function score, Mayo wrist function score), electrophysiological indexes [median nerve sensory conduction velocity (SCV), median nerve motor conduction velocity (MC)] were compared between the two groups before and after treatment.Results After treatment, the scores of VAS and BCTQ in the observation group were lower than those in the control group (P<0.05); the carpal tunnel pressure ( rest position, fist position) in the observation group was lower than that in the control group (P<0.05); Fugl-Meyer upper limb function score and Mayo wrist function score in the observation group were higher than those in the control group (P<0.05); SCV and MC in the observation group were higher than those in the control group (P<0.05).Conclusion Nerve mobilization combined with joint mobilization is effective in the treatment of mild to moderate CTS, which can effectively improve the pain and symptoms of patients, reduce the pressure of carpal tunnel, improve the function of upper limb joints and improve their electrophysiological indexes.

参考文献/References:

[1]杨文强,王琦,于炎冰,等.正中神经减压术治疗不同病因所致腕管综合征的对比研究[J].中华神经医学杂志,2022,21(6):606-610.[2]Shi Q,Pavlos B,Lalone EA,et al.Comparison of the Short-term and Long-term Effects of Surgery and Nonsurgical Intervention in Treating Carpal Tunnel Syndrome:A Systematic Review and Meta-analysis[J].Hand,2018,15(1):13-22.[3]林智聪,王进进.改良关节松动术结合推拿治疗老年神经根型颈椎病的临床观察[J].老年医学与保健,2017,23(3):223-225.[4]江泽平,黄珍,陈耀东,等.神经松动术和神经肌肉电刺激及二者联合治疗上肢周围神经损伤的疗效对比[J].广西医学,2021,43(14):1682-1685,1707.[5]Graham B,Peljovich AE,Afra R,等.2016 AAOS临床实践循证指南:腕管综合征管理[J].中国骨科临床与基础研究杂志,2017,9(4):247-250.[6]金雷,肖海军,陆义安,等.开放腕管松解术与关节镜下腕管松解术治疗腕管综合征的疗效比较[J].中国骨与关节损伤杂志,2021,36(7):763-765.[7]Forcelini CM,Chichelero ER,de Oliveira AT,et al.Boston Carpal Tunnel Questionnaire and Severity of Carpal Tunnel Syndrome[J].Journal of Clinical Neuromuscular Disease,2022,23(1):362-366.[8]寿依群,蒋红,陈文君,等.电针联合神经肌腱滑行训练治疗轻中度腕管综合征的疗效观察[J].中华物理医学与康复杂志,2017,39(1):38-42.[9]?譕ídková V,Nakládalová M,?譒těpánek L.Effects of Exercise and Enzyme Therapy in Early Occupational Carpal Tunnel Syndrome:A Preliminary Study[J].BioMed Research International,2019,3:1-7.[10]Park JJ,Choi JG,Son BC.Carpal Tunnel Syndrome Caused by Bifid Median Nerve in Association with Anomalous Course of the Flexor Digitorum Superficialis Muscle at the Wrist[J].The Nerve,2017,3(1):21-23.[11]曾国华,刘胜元.复方倍他米松局部注射联合关节松动术治疗腕管综合征临床研究[J].中国药业,2021,30(6):65-67.[12]陈焕梅,杨秀翠,郑琼飞,等.电针联合推拿对腕管综合征患者正中神经传导速度及腕关节运动功能康复的影响[J].环球中医药,2021,14(8):1525-1528.[13]黎维燚,季一超,刘阳,等.腕部肌腱滑动训练联合超声治疗对早期腕管综合征的疗效观察[J].浙江医学,2021,43(6):635-638.[14]刘勇,郭含军,李浩,等.小切口正中神经松解术治疗腕管综合征25例[J].生物骨科材料与临床研究,2017,14(6):38-40,44.[15]吴亮,杜维卫,张伟平,等.腕管综合征标准化治疗临床分析[J].中华手外科杂志,2017,33(1):64-65.[16]肖府庭,马艳,裴子文,等.神经松动术联合体外冲击波治疗轻中度腕管综合征的疗效观察[J].中华物理医学与康复杂志,2021,43(9):829-831.[17]田振峰,李洁冰,张帅,等.正中神经有限松解结合术后经皮神经电刺激治疗腕管综合征临床观察[J].现代中西医结合杂志,2019,28(31):3468-3470,3526.[18]Manni M,Bisaccia M,Rinonapoli G,et al.Reliability, Feasibility and Value of Ecography in Clinical-functional Results in Patients Affected by Carpal Tunnel Syndrome: is There a Correlation?[J].Acta Informatica Medica,2017,25(1):44-48.[19]张晓黎,郑永强,屈勇,等.行为、物理疗法联合药物对腕管综合征的疗效分析[J].临床神经病学杂志,2021,34(4):273-276.[20]董斌,陈娅,罗艳红,等.高频超声和神经电生理检查在腕管综合征疾病诊断中的对比分析[J].临床神经病学杂志,2019,32(6):414-417.

更新日期/Last Update: 1900-01-01