Clinical Observation On Treatment Of Moderate And Severe Choroid Stasis Type Carpal Tunnel Syndrome With Buyang Huanwu Decoction

ObjectiveTo explore the clinical effect of Buyang Huanwu decoction combined with surger y in the treatment of moderate and severe carpal tunnel syndrome belonging to the sy ndrome of stasis blocking venation,and to explore the significance of the combination of the two kinds of treatment methods in clinic,aiming at providing a new idea for the treatment of moderate and severe carpal tunnel syndrome belonging to the syndro me of stasis blocking venation.MethodsA total of 80 patients with moderate and severe carpal tunnel syndrome belonging to the syndrome of stasis blocking venation that met the inclusion criteria of the rese arch,were selected from the affiliated people’s hospital of fujian university of tradition al chinese medicine.The patients were divided into the experimental group(n=40)and control group(n=40)by random digital table method.The control group was treated with mecobalamin for neurotrophy after conventional dissection and debonding of carp al tunnel,based on which the experimental group was treated with additional Buyang Huanwu decoction.The treatment course lasted for 4 weeks and the observation perio d lasted for 8 weeks.The changes of motor potential latency and sensory nerve conduc tion velocity in electromyogram of median ulnar nerve were observed before and at th e 4th and 8th week after the operation.The changes in positive rate of Tinel sign an d Phalen test and score of median nerve function were compared between before and at the 8th week after the operation.At the 8the week after treatment,the therapeutic effect was evaluated according to the TCM therapeutic effect evaluation standard.Results1.There was no statistically significant difference between the two groups of pati ents in comparing gender,age,course of disease,Tinel sign,Phalen test,motor latenc y of median nerve,and sensory nerve conduction velocity,and score of median nerve function before the treatment,with comparability(P>0.05).2.Comparison of Tinel sign: after 8 weeks of treatment,the positive rate of Tinel sign after treatment in both groups was lower than that before the treatment,and the difference was statistically significant(P<0.05).The improvement of Tinel sign in the experimental group after treatment was better than that of the control group,and the difference was statistically significant(P<0.05).3.Comparison of Phalen test: after 8 weeks of treatment,the positive rate of Pha len test after treatment in both groups was lower than that before the treatment,and t he difference was statistically significant(P<0.05).The improvement of the positive ra te of Phalen test in the experimental group after treatment was superior than that in t he control group,and the difference was statistically significant(P<0.05).4.Comparison of electromyogram of median nerve: there was no significant differ ence in the motor potential latency and sensory nerve conduction velocity of median n erve between the two groups before the treatment(P>0.05).After the treatment,intra-group comparison showed that the motor potential latency of electromyogram and sen sory nerve conduction velocity were improved in the two groups after 4 weeks and 8weeks of treatment,and differences were statistically significant(P<0.05).Inter-group comparison showed that after 4 weeks and 8 weeks treatment,the motor potential l atency of electromyogram and sensory nerve conduction velocity in the experimental g roup improved significantly compared with the control group(P<0.05).5.Scores of median nerve function: there was no significant difference in compar ing scores of median nerve function between the two groups before the treatment(P>0.05).After treatment,intra-group comparison showed that the scores of median nerve were better than that before the treatment after 8 weeks in the two groups,and diffe rences were statistically significant(P<0.05).Comparison between the two groups sho wed that the score of median nerve function of the experimental group was higher tha n that of the control group after 8 weeks of treatment(P<0.05).6.Evaluation of TCM therapeutic effect evaluation standard: after the treatment,a ll of the cases included in the study in the experimental group and control group hav e obtained good clinical effect,the total effective rate of the experimental group was95%,and that of the control group was 77.5%.The comparison of total effective rate of the two groups showed Z=2.821,P=0.005<0.05,and the difference was statisticall y significant.ConclusionsThe clinical efficacy of combination tof Buyang Huanwu decoction with surgery i n the treatment of patients with moderate and severe carpal tunnel syndrome belongin g to the syndrome of stasis blocking venation was much more significant,and when c ompared with the use of neurotrophic agent after the carpal tunnel decompression,it h as more advantageous.Moreover,it can accelerate the recovery of carpal median nerv e electrophysiology and amyotrophic muscle of thenar,and help to improve the functi on of thumb opposition,shorten the recovery time,in order to improve the quality of life and promote recovery of labor ability of patients as soon as possible,which was worthy of promotion.