Oral drug of choice in carpal tunnel syndrome
Oral drug of choice in carpal tunnel syndrome
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DOI：
10.1212/wnl.51.2.390
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发表时间：
1998-08-01
期刊：
影响因子：
9.9
通讯作者：
Lo, YK
中科院分区：
文献类型：
--
作者：
Chang, MH;Chiang, HT;Lo, YK
背景：轻度至中度腕管综合征（CTS）的保守治疗是可变的。目的：评价常用口服药物如利尿剂、非甾体抗炎药（NSAID）和类固醇治疗CTS的有效性。研究方法：对具有CTS临床症状和体征（经标准电诊断证实）的患者进行的前瞻性、随机、双盲和安慰剂对照研究。基线评估包括标准化症状问卷，对五类症状（疼痛、麻木、感觉异常、虚弱/笨拙和夜间觉醒！从0（无症状）到10（严重）。五个类别中的每一个的总评分被称为总体症状评分（GSS）。基线评估后，患者被随机分配至以下治疗组：1）安慰剂治疗4周（n = 16）; 2）利尿剂治疗4周（n = 16）;（三氯噻嗪，每日2 mg; n = 16）; 3）4周NSAID缓释（SR）（替诺昔康-SR，每日20 mg; n = 18）;和4）泼尼松龙，每日20 mg，2周，随后是每日10 mg的另一个2周剂量（n = 23）。第2周和第4周的随访评估结果与基线评分相同。分析GSS的变化以确定统计学差异。结果：安慰剂组、NSAID-SR组和利尿剂组在第二周和第四周GSS与基线相比无显著降低。然而，类固醇组4周时的平均评分从基线27.9 +/- 6.9显著降低至10 +/- 7.4。结论：对于选择保守治疗的轻中度CTS患者，糖皮质激素的获益更大。
Background: Conservative treatment of mild to moderate carpal tunnel syndrome (CTS) is variable. Objective: To evaluate the effectiveness of commonly used oral medications such as diuretics, nonsteroid antiinflammatory drugs (NSAIDs), and steroids In the treatment of CTS. Methods: Prospective, randomized, double-blind and placebo-controlled study of patients with clinical symptoms and signs of CTS, confirmed by standard electrodiagnosis. Baseline assessments included a standardized symptom questionnaire, rating five categories of symptoms (pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening! on a scale from 0 (no symptoms) to 10 (severe). The total score in each of the five categories was termed the global symptom score (GSS). After baseline assessment, patients were randomized to the following treatment arms: 1) 4 weeks of placebo (n = 16); 2) 4 weeks of diuretic (trichlormethiazide, 2 mg daily; n = 16); 3) 4 weeks of NSAID-slow release (SR) (tenoxicam-SR, 20 mg daily; n = 18); and 4) 2 weeks of prednisolone, 20 mg daily, followed by another 2-week dosage of 10 mg daily (n = 23). Results of follow-up assessments in the second and the fourth weeks were identical to baseline scores. The changes in GSS were analyzed to determine the statistical difference. Results: No significant reduction from baseline GSS was seen at second, and fourth weeks in the placebo, NSAID-SR, and diuretic groups. However, the mean score at 4 weeks in the steroid group decreased significantly from a baseline of 27.9 +/- 6.9 to 10 +/- 7.4. Conclusion: For patients with mild to moderate CTS who opt for conservative treatment, corticosteroids are of greater benefit.