轻中度腕管综合征发病机制及非手术治疗方法的研究进展

侯清誉; 尹思源; 马季; 逄坤瑶; 王洪峰

doi:10.13481/j.1671-587X.20240332

吉林大学学报(医学版) ›› 2024, Vol. 50 ›› Issue (3) : 847 -853. DOI: 10.13481/j.1671-587X.20240332

综述

轻中度腕管综合征发病机制及非手术治疗方法的研究进展

侯清誉,尹思源,马季,逄坤瑶,王洪峰

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Research progress in pathogenesis of mild to moderate carpal tunnel syndrome and its nonsurgical treatment methods

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摘要

腕管综合征（CTS）是一种常见的周围神经卡压性疾病，腕管内压力升高、高强度活动及肥胖为CTS的主要病因，其中轻中度CTS患者较多。腕管内压力升高和局部血氧供应障碍导致神经传导减弱为CTS主要的发病机制。目前临床上轻中度CTS的治疗方法主要有手术治疗和非手术治疗。非手术治疗为轻中度CTS患者的优先选择，西医疗法以口服药物为治疗基础，但因其存在一定的不良反应无法长期使用；局部封闭治疗和体外冲击波治疗对于活动频繁且症状较重的CTS患者有较好的疗效；传统中医疗法因患者痛苦小、医疗费用低和疗效显著等优点也成为部分CTS患者的选择。现对近年来轻中度CTS的发病机制和治疗进展进行综述，在临床中根据轻中度CTS患者的具体情况设计个体化治疗方案，为轻中度CTS患者精准治疗提供参考。

Abstract

Carpal tunnel syndrome （CTS） is one of the most common peripheral nerve entrapment disorders， the elevated pressure in the carpal tunnel， high-intensity activities and obesity are the main causes， and the patients with mild to moderate CTS are more prevalent. The main pathogenesis of CTS involves the increasing of carpal tunnel pressure and impaired local blood oxygen supply leading to reduced nerve conduction. Currently， the clinical treatment methods for mild to moderate CTS mainly include surgical and nonsurgical treatments. Nonsurgical treatment is the preferable choice for the patients with mild to moderate CTS. The western medical treatment primarily rely on oral medications， but their long-term use is limited due to the certain adverse effects； the local blockade and extracorporeal shock wave therapies show better efficacy for the patients with frequent activities and severe symptoms； the traditional Chinese medicine treatment also becomes a choice for some CTS patients due to their advantages of less pain， lower medical costs， and significant effectiveness. This study reviews the recent advancements in the pathogenesis and treatment of mild to moderate CTS， in order to design the personalized treatment methods for the mild to moderate CTS patients based on their specific conditions in clinical settings and provide the references for precise treatment of the mild to moderate CTS patients.