症候群最嚴謹的試驗之一。這個試驗的優點包括整個實驗設計、評估 control theory)來解釋45-57。而實際上針灸對於治療腕隧道症候群的機
轉仍不是很清楚。其中，有一部分的原因或許是因為腕隧道症候群本
覺醒這個項目的治療優於口服類固醇的治療。
就存在著一定的治療效果呢? 所以有學者提出針灸治療疾病可能涵
如何？這個問題和針灸治療對於輕到中度的腕隧道症候群的病人相 礎，傳統中醫(Traditional Chinese Medicine, TCM) 認為人體的最基本 系統是經絡，是人體內“氣＂之運行與聯繫的網絡，也是這一連串能
來而在我們的試驗突顯其療效的原因之一。但由於世界各國對中國的 傳統針灸醫學也越來了解，所以在他們的試驗也越來越強調得氣的重 要70-72。
第六章 結論與未來研究方向
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附錄：
Acupuncture in patients with Carpal tunnel syndrome ~ A randomized control trial
Abstract
Objectives: To investigate the efficacy of acupuncture compared with
steroid treatment in patients with mild-to-moderate carpal tunnel
syndrome (CTS) as measured by objective changes in nerve conduction studies (NCS) and subjective symptoms assessment in a randomized, controlled study.
Methods: A total of 77 consecutive and prospective CTS patients
confirmed by NCS were enrolled in the study. Those who had fixed sensory complaint over the median nerve and thenar muscle atrophy were excluded. (A decrease of CMAP amplitude is grouped into moderate, not exclusion criteria). The CTS patients were randomly divided into two treatment arms: (1) two weeks of prednisolone 20 mg daily followed by two weeks of prednisolone 10 mg daily (n =39), and (2) acupuncture administered in 8 sessions over 4 weeks (n=38). A validated standard questionnaire as a subjective measurement was used to rate the five major symptoms (pain, numbness, paresthesia, weakness/clumsiness, and
nocturnal awakening) on a scale from 0 (no symptoms) to 10 (very
severe). The total score in each of the five categories was termed the global symptom score (GSS). Patients completed standard questionnaires at baseline and two and four weeks later. The changes in GSS were
analyzed to evaluate the statistical significance. NCS were performed at baseline and repeated at the end of the study to assess improvement. All main analyses used intent-to-treat.
Results: A total of 77 patients who fulfilled the criteria for
mild-to-moderate CTS were recruited in the study. There were 38 in the acupuncture group and 39 in the steroid group. The evaluation of GSS showed that there was a high percentage of improvement in both groups at weeks 2 and 4 (P<0.01), though statistical significance was not
demonstrated between the two groups (P=0.15). Of the 5 main symptoms scores (pain, numbness, paresthesia, weakness / clumsiness, nocturnal awakening), only one, nocturnal awakening, showed a significant decrease in acupuncture compared to the steroid group at week 4 (P
=0.03). Patients with acupuncture treatment had a significant decrease in distal motor latency (DML) compared to the steroid group at week 4 (P=0.012). Acupuncture was well tolerated with minimal adverse effects.
Conclusions: Short-term acupuncture treatment is as effective as
short-term low-dose prednisolone for mild-to-moderate CTS. For those who do have an intolerance or contraindication for oral steroid or for those who do not opt for early surgery, acupuncture treatment provides an alternative choice.
Key words: Acupuncture, Carpal tunnel syndrome, Steroid, Neiguan (PC6), Daling (PC7)