针刀联合局部康复运动治疗腕管综合征的临床研究

丛晓迪

【摘要】 目的：探究针刀联合局部康复运动治疗腕管综合征（CTS）的效果。方法：选取2020年2月-2021年2月本院针灸科病房收治的CTS患者70例为研究对象。依据住院病例号码随机将患者分为康复运动组和针刀康复联合组，每组35例。康复运动组进行康复运动治疗法，针刀康复联合组进行针刀松解术治疗和康复运动治疗。比较两组治疗前后患侧手末端运动潜伏期（DML）、感觉神经传导速度（SCV）、感觉神经动作电位（SNAP）、正中神经横截面积（CSA）、剪切波传播速度（SWV）、手功能评分，观察两组治疗效果。结果：治疗后，两组DML均较治疗前下降，SCV、SNAP均较治疗前升高，差异均有统计学意义（P<0.05）。治疗后，针刀康复联合组DML低于康复运动组，SCV、SNAP均高于康复运动组，差异均有统计学意义（P<0.05）。治疗后，两组手功能各项评分均较治疗前升高，且针刀康复联合组均高于康复运动组，差异均有统计学意义（P<0.05）。治疗后，两组CSA和SWV均较治疗前下降，且针刀康复联合组均明显低于康复运动组，差异均有统计学意义（P<0.05）。针刀康复联合组有效率为94.29%，明显高于康复运动组的71.43%，差异有统计学意义（P<0.05）。结论：针刀联合局部康复运动治疗具有提高轴浆运输传递速率、修复髓鞘生理结构、缓解正中神经受压、松解韧带、切断筋膜及肌肉间的粘连等功效，可有效缓解CTS患者桡侧手指麻木、疼痛、运动感觉異常等症状，提高手功能。

【关键词】 针刀 腕管综合征 正中神经 康复运动

Clinical Study of Acupotomy Combined with Local Rehabilitation Exercise in the Treatment of Carpal Tunnel Syndrome/CONG Xiaodi. //Medical Innovation of China， 2021， 18（27）： 0-074

[Abstract] Objective： To explore the effect of acupotomy combined with local rehabilitation exercise in the treatment of carpal tunnel syndrome （CTS）. Method： A total of 70 patients with CTS treated in the acupuncture ward of our hospital from February 2020 to February 2021 were selected as the research objects. According to the number of inpatients， the patients were randomly divided into rehabilitation exercise group and acupotomy rehabilitation combined group， 35 cases in each group. The rehabilitation exercise group received rehabilitation exercise therapy， the acupotomy rehabilitation combined group received acupotomy release treatment and rehabilitation exercise treatment. The distal motor latency （DML）， sensorynerve conduction velocity （SCV）， sensory nerve action potential （SNAP）， cross-sectional area （CSA）， shear wave velocity （SWV） and hand function score of the affected side were compared between the two groups before and after treatment， the therapeutic effects of the two groups were observed. Result： After treatment， DML in both groups decreased compared with before treatment， SCV and SNAP were higher than those before treatment， the differences were statistically significant （P<0.05）. After treatment， DML in the acupotomy rehabilitation combined group was lower than that in the rehabilitation exercise group， SCV and SNAP were higher than those in the rehabilitation exercise group， the differences were statistically significant （P<0.05）. After treatment， all hand function scores of the two groups were higher than those before treatment， the acupotomy rehabilitation combined group were higher than those of the rehabilitation exercise group， the differences were statistically significant （P<0.05）. After treatment， CSA and SWV in the two groups were lower than those before treatment， and the acupotomy rehabilitation combined group were significantly lower than those in the rehabilitation exercise group， the differences were statistically significant （P<0.05）. The effective rate of acupotomy rehabilitation combined group was 94.29%， which was significantly higher than 71.43% in rehabilitation exercise group， the difference was statistically significant （P<0.05）. Conclusion： Acupotomy combined with local rehabilitation exercise therapy can improve the axoplasmic transport rate， repair the physiological structure of myelin sheath， relieve the compression of median nerve， release ligaments， cut off the adhesion between fascia and muscles， and effectively relieve the symptoms of radial finger numbness， pain， motor paresthesia and other symptoms of CTS patients， and improve hand function.

[Key words] Acupotomy Carpal tunnel syndrome Median nerve Rehabilitation exercise

First-author’s address： Affiliated Hospital of Liaoning University of Traditional Chinese Medicine， Shenyang 110032， China

doi：10.3969/j.issn.1674-4985.2021.27.018

腕管综合征（carpal tunnel syndrome，CTS）的发病是因腕管内正中神经受压，以致正中神经所支配部位发生运动及感觉障碍[1]。……