830 nm二極體雷射治療腕道症候群研究：臨床成效初探

Carpal Tunnel Syndrome Treatment with 830nm Diode Laser on Transverse Carpal Ligament: A Pilot Study

江昭皚(Joe-Air Jiang) ； 張文典(Wen-Dine Chang) ； 吳季樺(Jih-Huah Wu) ； 葉純妤(Chun-Yu Yeh)

《醫護科技學刊》 9卷4期 (2007/10) Pp. 283-293

https://doi.org/10.6563/TJHS.2007.9(4).3

摘要

腕道症候群是中年婦女及常使用手部工作者所產生的疾病，有效的治療可以緩解症狀所產生的疼痛及神經性麻痺，過去治療皆考慮直接用雷射照射神經分部區域，以治療受損的神經組織，治療效果仍無定論，本研究使用兩個830 nm波長的紅外線雷射二極體輸出60mw的低能量雷射（輸出頻率爲10 Hz，治療劑量97J/(平方公分)），直接照射壓迫正中神經的橫腕韌帶，研究以單盲隨機進行，研究設計分爲使用雷射治療的實驗組及使用無輸出偽雷射治療的對照組，經過兩週進行每週5次的照射療程，停止治療後再追蹤兩週，以自覺疼痛量表、神經傳導測試、費任氏徵象測試及提尼氏徵象測試，評估治療前、兩週治療後與再兩週追蹤後的疼痛程度及神經性症狀程度，比較兩組中輕微及中度腕道症候群患者經雷射及偽雷射的治療效果，研究結果顯示830 nm低能量雷射照射橫腕韌帶治療輕微腕道症候群，兩週治療後能有效的減緩疼痛及神經性症狀。

關鍵字

低能量雷射 ； 腕道症候群 ； 自覺疼痛量表 ； 費任氏徵象測試 ； 提尼氏微象測試

並列摘要

The purpose of this placebo-controlled study was to investigate the therapeutic effects of 830nm diode laser for treating transverse carpal ligament (TCL) in carpal tunnel syndrome (CTS). Methods: Twenty-eight cases of mild-to-moderate carpal tunnel syndrome were randomly divided into two groups. The cases in the laser group received actual laser treatment (10Hz, 60mW, 9.7J/cm^2, 830nm) while the placebo group received sham laser treatment (without laser output). Both groups were treated five times per week for two weeks and were reexamined after two weeks. In each patient, the therapeutic effects were measured by nerve conduction study (NCS), visual analogue scale, and physical examination (Phalen sign and Tinel' sign). Results: After the two-week treatment, both mild and moderate CTS groups had significantly reduced pain scores (p＜0.05). However, only the mild CTS group retained the change two weeks after the treatment. In NCS and physical examination, only subjects with mild CTS in laser group revealed statistically significant improvement after the two-week treatment (p＜0.05).Conclusions: Low-level laser applied on TCL improves pain and neurological symptoms in mild CTS patients.

並列關鍵字

Low-level laser ； carpal tunnel syndrome ； visual analogue scale ； Phalen sign ； Tinels sign

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