腕隧道症候群的治療選擇

Treatment Options for Carpal Tunnel Syndrome

腕隧道症候群是常見的上肢神經病變。臨床上治療方式有許多選擇，包含物理治療（如副木、護腕等）、藥物治療（局部類固醇注射、維生素B、C）及手術療法等，目前各醫療院所、各科之治療方式並沒有共識。本文利用實證醫學觀點探討各種治療方式對於腕隧道症候群的療效。我們根據臨床問題進行搜尋，將關鍵字以PICO方式呈現，並進行文獻搜尋與評讀。根據文獻之證據示，手術和副木及類固醇都有證據支持治療效果。副木的效果和口服類固醇差不多，但和局部注射類固醇的比較沒有明確的證據。手術的長期療效是最好的，然而也會產生較多併發症及副作用。

Carpal tunnel syndrome is a common neuropathy of the upper limbs. Clinically, there are many treatment options, including physical therapy (e.g., splints, hand brace), medication (e.g., local steroid injection, Vitamin B, C) and surgery. In current clinical practice, there is no consensus in different hospitals and medical departments about its treatment. By applying “evidence-based medicine”, we evaluated the effects of each treatment option for carpal tunnel syndrome. We first performed a search based upon a clinical question. All keywords were developed in accordance with PICO, then the critical appraisal was performed. According to the literature, there is sufficient evidence to the evaluate effectiveness of surgery, splints and steroid for carpal tunnel syndrome. Splints provide comparable clinical improvement compared to oral corticosteroid, but there is insufficient evidence regarding the effectiveness of splint over local steroid injection. Surgical treatment provides superior benefit, but also has more complications and side effects. (J Med Health. 2016;5(1):85-91)