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Collaborative Treatment Information

Collaborative Treatment Clinical Practice Guidelines

Collaborative Treatment Information

Collaborative Treatment Clinical Practice Guidelines

Collaborative Treatment Clinical Practice Guidelines

G00-G99

VI. Diseases of the nervous system

성인 손목터널증후군 수술 환자에게 한약 투약과 의과 협진 치료를 시행하는 것은 증상 및 기능 개선에 효과적이므로 한약 투약과 의과 협진 치료를 시행하는 것을 고려할 수 있다.

연구 논문에서 손목터널증후군 수술 후 의과 약물 복용과 함께 보양환오탕을 복용하거나, 손목 부목과 함께 보양환
오탕가이진탕을 복용하여 유의한 효과를 나타내었다고 보고하였으므로, 손목터널증후군 수술 후 환자에게 한약치료 복
용 치료 시 이에 준하는 방식으로 치료하는 것이 적절하다.

C/Low

  • 腕管综合征术后应用补阳还五汤效果观察. Journal of Practical
    Traditional Chinese Medicine. 2019(03):287-8. Link

  • Clinical Observation on Treatment of Moderate and Severe Choroid
    Stasis Type Carpal Tunnel Syndrome with Buyang Huanwu Decoction. 福建中医药大
    学. 2020. Link

  • Observation and Analysis of the Rehabilitation Intervention
    Results of Buyang Huanwu Decoction and Regulative Erchen Decoction on Carpal Tunnel
    Syndrome after Operation. 南京中医药大学. 2019. Link

  • 腕管综合征术后应用补阳还五汤效果观察. Journal of Practical
    Traditional Chinese Medicine. 2019(03):287-8. Link

  • Clinical Observation on Treatment of Moderate and Severe Choroid
    Stasis Type Carpal Tunnel Syndrome with Buyang Huanwu Decoction. 福建中医药大
    学. 2020. Link

  • Observation and Analysis of the Rehabilitation Intervention
    Results of Buyang Huanwu Decoction and Regulative Erchen Decoction on Carpal Tunnel
    Syndrome after Operation. 南京中医药大学. 2019. Link

성인 손목터널증후군 환자에게 침, 추나, 한방물리요법 등 한의 복합 치료 와 의과 약물을 사용한 협진 치료를 시행하는 것은 증상 및 기능 개선에 효과적이므로 한의 복합 치료와 의과 약물을 사용한 협진 치료를 시행하 는 것을 고려할 수 있다.

연구 논문에서 대릉(PC7, 大陵), 내관(PC6, 內關), 아시혈(阿是穴)에 1일 30분씩 주 2회, 2주간 유침 치료를 시
행하고, 손목에 대한 관절가동추나기법과 함께 침 치료 혈위를 자극하는 추나 치료를 1일 1회씩 15일간, 경근간섭
저주파를 1일 30분씩 15일간 시행하면서, 의과 약물 복용을 15일간 병행하여 유의한 효과를 나타내었다고 보고
하였으므로, 침, 추나, 한방물리요법과 의과 약물 복용 협진 치료 시 이에 준하는 방식으로 치료하는 것이 적절하다.

C/Low

  • 急性腕管综合征的非手术治疗方法、临床疗效及可行性观察. 吉林医学. 2013;34(30):6215-6216. Link

  • 急性腕管综合征的非手术治疗方法、临床疗效及可行性观察. 吉林医学. 2013;34(30):6215-6216. Link

성인 손목터널증후군 환자에게 의과 약물 복용, 신경차단술, 의과 약물 복 용과 물리요법 병행 치료에 비해 한약 투약과 의과 협진 치료를 시행하는 것이 증상 및 기능 개선에 효과적이므로 한약 투약과 의과 협진 치료를 시 행하는 것을 고려해야 한다.

문헌을 근거로 의과 약물 복용, 신경차단술, 의과 약물과 체외충격파 병행 치료 등의 의과 치료에 한약치료 복용을 병행
하여 3∼8주 정도 시행하여 유의한 효과를 나타내었다고 보고하였다. 한약치료는 보양환오탕(補陽還五湯), 신통축어
탕(身痛縮瘀湯), 황기계지오물탕(黃芪桂枝五物湯), 익기활혈탕(益氣活血湯) 등을 주로 활용하며, 어혈(瘀血)이
나 기체(氣滯), 기타 변증(辨證)을 활용한 처방을 사용할 수 있다.

B/Moderate

  • 中西药合用治疗腕管综合征疗效分析. Journal of Practical Traditional
    Chinese Medicine. 2019(10) :1207-1208. Link

  • The Clinical Cases Observation of Flavored Astragalus and Cinnamou
    Twig Five Ingredients Decoction on the Treatment of Carpal Tunnel Syndrome(CTS). 广州中医药大学. 2011. Link

  • Clinical Observation of Yiqihuoxue Decoction in the Treatment of Patients
    with Carpal Tunnel Syndrome in QI Deficiency and Blood Stasis. 南京中医药大学.
    2019. Link

  • Clinical Study of Buyang Huanwu Decoction Combined with Shock
    Wave in the Treatment of Carpal Tunnel Syndrome of Blood Stasis Due to Qi Deficiency. 浙
    江中医药大学. 2019. Link

  • 中药内服结合腕管封闭治疗腕管综合征61例. Hebei Journal of
    Traditional Chinese Medicine. 2013(01):73-74 Link

  • 补阳还五汤配合冲击波治疗腕管综合征33例. Guiding Journal
    of Traditional Chinese Medicine and Pharmacy. 2015(13):70-72. Link

  • 中西药合用治疗腕管综合征疗效分析. Journal of Practical Traditional
    Chinese Medicine. 2019(10) :1207-1208. Link

  • The Clinical Cases Observation of Flavored Astragalus and Cinnamou
    Twig Five Ingredients Decoction on the Treatment of Carpal Tunnel Syndrome(CTS). 广州中医药大学. 2011. Link

  • Clinical Observation of Yiqihuoxue Decoction in the Treatment of Patients
    with Carpal Tunnel Syndrome in QI Deficiency and Blood Stasis. 南京中医药大学.
    2019. Link

  • Clinical Study of Buyang Huanwu Decoction Combined with Shock
    Wave in the Treatment of Carpal Tunnel Syndrome of Blood Stasis Due to Qi Deficiency. 浙
    江中医药大学. 2019. Link

  • 中药内服结合腕管封闭治疗腕管综合征61例. Hebei Journal of
    Traditional Chinese Medicine. 2013(01):73-74 Link

  • 补阳还五汤配合冲击波治疗腕管综合征33例. Guiding Journal
    of Traditional Chinese Medicine and Pharmacy. 2015(13):70-72. Link

성인 손목터널증후군 환자에게 손목 부목에 비해 한방물리요법과 의과협진 치료를 시행하는 것이 증상 및 기능 개선에 효과적이므로 한방물리요법과 의과 협진 치료를 시행하는 것을 고려해야 한다.

문헌을 근거로 손목터널증후군에 손목 부목 고정 치료는 증상 및 기능 개선에 효과적인 것으로 알려져 있으며, 연
구 논문에서 손목 부목에 혈위초음파, 단파, 레이저, 파라핀욕 등을 병행하여 3주∼3개월간 협진 치료를 시행하는
것이 유의한 효과를 나타내었다고 보고하였으므로, 손목부목과 한방물리요법 협진 치료 시 이에 준하는 방식으로
치료하는 것이 적절하다

B/Moderate

  • Comparison of splinting and
    splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome. Clin Rheumatol.
    2009;28:1059-1065. Link

  • Low-level laser therapy with a
    wrist splint to treat carpal tunnel syndrome: a double-blinded randomized controlled trial.
    Lasers Medicine Science.2014;29:1279-1287. Link

  • Laser Therapy in the
    Treatment of Carpal Tunnel Syndrome: ARandomized Controlled Trial. Photomedicine and
    laser surgery. 2007;25:34-39. Link

  • Efficacy of paraffin wax bath for carpal tunnel syndrome: a randomized
    comparative study. Int J Biometeorol. 2017:1-8. Link

  • Comparison of the effectiveness of orthotic intervention,
    kinesiotaping, and paraffin treatments in patients with carpal tunnel syndrome: A
    single-blind and randomized controlled study. Journal of hand therapy.2019;32:297-304. Link

  • The Effectiveness of Conservative Treatments
    of Carpal Tunnel Syndrome: Splinting, Ultrasound, and Low-Level Laser Therapies.
    Photomedicine and Laser Surgery. 2009;27:119-125. Link

  • Ultrasound therapy adds no benefit to splinting in carpal tunnel syndrome.
    Muscle and Nerve. 2019;60:538-543. Link

  • Effects of placebo-controlled continuous
    and pulsed ultrasound treatments on carpal tunnel syndrome: a randomized trial.
    Clinics. 2014; 69(8): 542-528 Link

  • Comparison of the Short-Term Effectiveness
    of Short-Wave Diathermy Treatment in Patients With Carpal Tunnel Syndrome: A
    Randomized Controlled Trial. Arch Rheumatol 2014;29(4):298-303. Link

  • Comparison of splinting and
    splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome. Clin Rheumatol.
    2009;28:1059-1065. Link

  • Low-level laser therapy with a
    wrist splint to treat carpal tunnel syndrome: a double-blinded randomized controlled trial.
    Lasers Medicine Science.2014;29:1279-1287. Link

  • Laser Therapy in the
    Treatment of Carpal Tunnel Syndrome: ARandomized Controlled Trial. Photomedicine and
    laser surgery. 2007;25:34-39. Link

  • Efficacy of paraffin wax bath for carpal tunnel syndrome: a randomized
    comparative study. Int J Biometeorol. 2017:1-8. Link

  • Comparison of the effectiveness of orthotic intervention,
    kinesiotaping, and paraffin treatments in patients with carpal tunnel syndrome: A
    single-blind and randomized controlled study. Journal of hand therapy.2019;32:297-304. Link

  • The Effectiveness of Conservative Treatments
    of Carpal Tunnel Syndrome: Splinting, Ultrasound, and Low-Level Laser Therapies.
    Photomedicine and Laser Surgery. 2009;27:119-125. Link

  • Ultrasound therapy adds no benefit to splinting in carpal tunnel syndrome.
    Muscle and Nerve. 2019;60:538-543. Link

  • Effects of placebo-controlled continuous
    and pulsed ultrasound treatments on carpal tunnel syndrome: a randomized trial.
    Clinics. 2014; 69(8): 542-528 Link

  • Comparison of the Short-Term Effectiveness
    of Short-Wave Diathermy Treatment in Patients With Carpal Tunnel Syndrome: A
    Randomized Controlled Trial. Arch Rheumatol 2014;29(4):298-303. Link

성인 손목터널증후군 환자에게 손목 부목이나 의과 약물 복용에 비해 전침 치료와 의과 협진 치료를 시행하는 것이 증상 및 기능 개선에 효과적이므로 전침 치료와 의과 협진 치료를 시행하는 것을 고려할 수 있다.

문헌을 근거로 야간 손목 부목과 전침 치료를 협진하여 시행하거나, 의과 약물 복용과 전침 치료를 협진하여 시행
할 수 있다. 전침 치료는 전침 치료 권고안(R3-1 및 R3-2)의 임상적 고려사항을 참조하여 치료할 수 있다.

C/Low

  • Electroacupuncture and wrist splinting for carpal tunnel syndrome: a randomised trial.
    Hong Kong Med J. 2017 Jun;23 Suppl 2(3):28-31. Link

  • The Effectiveness of Exercise Therapy and Dry Needling on Wrist Range
    of Motion, Pinch and Grip Force in Carpal Tunnel Syndrome: a Randomized Clinical Trial.
    Asian J Sports Med. 2019 December; 10(4):e83927. Link

  • 电针治疗轻中度腕管综合征患者的疗效及对电生
    理参数的影响. 现代生物医学进展. 2018;18(2):343-347. Link

  • 电生理对电针治疗轻中度腕管综合征疗效评价的研究. 广州中医药大学. 2011 Link

  • Acupuncture and related interventions for carpal tunnel syndrome: systematic review. Clin
    Rehabil. 2020 Jan;34(1):34-44. Link

  • Acupuncture and related interventions
    for the treatment of symptoms associated with carpal tunnel syndrome. Cochrane Database
    Syst Rev. 2018 Dec 2;12(12):CD011215. Link

  • Acupuncture and related interventions for treating carpal tunnel syndrome: A systematic review. Global Advances
    in Health and Medicine. 2018:7:256. Link

  • Electroacupuncture and wrist splinting for carpal tunnel syndrome: a randomised trial.
    Hong Kong Med J. 2017 Jun;23 Suppl 2(3):28-31. Link

  • The Effectiveness of Exercise Therapy and Dry Needling on Wrist Range
    of Motion, Pinch and Grip Force in Carpal Tunnel Syndrome: a Randomized Clinical Trial.
    Asian J Sports Med. 2019 December; 10(4):e83927. Link

  • 电针治疗轻中度腕管综合征患者的疗效及对电生
    理参数的影响. 现代生物医学进展. 2018;18(2):343-347. Link

  • 电生理对电针治疗轻中度腕管综合征疗效评价的研究. 广州中医药大学. 2011 Link

  • Acupuncture and related interventions for carpal tunnel syndrome: systematic review. Clin
    Rehabil. 2020 Jan;34(1):34-44. Link

  • Acupuncture and related interventions
    for the treatment of symptoms associated with carpal tunnel syndrome. Cochrane Database
    Syst Rev. 2018 Dec 2;12(12):CD011215. Link

  • Acupuncture and related interventions for treating carpal tunnel syndrome: A systematic review. Global Advances
    in Health and Medicine. 2018:7:256. Link

성인 손목터널증후군 환자에게 손목 부목이나 의과 약물 복용과 손목 부목 병행 치료에 비해 침 치료와 의과 협진 치료를 시행하는 것이 증상 및 기능 개선에 효과적이므로 침 치료와 의과 협진 치료를 시행하는 것을 고려해야 한다.

의과에서 만성 특발성 손목터널증후군의 수술 적응증과 시기에 대한 명확한 기준은 없다고 알려져 있으며, 일반적
으로 보존적 치료를 실패한 경도에서 중등도의 증상을 가진 손목터널증후군 환자가 수술 대상이라고 보고되어 있
다. 이에 일반적인 상황에서 특별한 기준점 없이 손목 부목, 의과 약물 복용, 신경차단술 등 의과 치료를 시행하는
환자에게 침 치료 및 다양한 한의학적 치료를 병행 치료하는 것도 가능하고, 마찬가지로 침 치료 등의 한의과 치료
및 의과 보존적 치료를 협진 치료하는 것도 가능하다. 침 치료 혈위는 침 치료 권고안(R1)의 임상적 고려사항을 참
조한다.

B/Moderate

  • Effects of forearm myofascial
    trigger point dry needling on pain and function of patients with carpal tunnel syndrome.
    Crescent Journal of Medical and Biological Sciences. 2020;7(3):362-367. Link

  • Acupuncture plus night splint for quality of life and
    disability in patients with carpal tunnel syndrome: a randomized controlled trial. Integr Med
    Res. 2019;8(4):284-288. Link

  • The Acupuncture Effect on Median Nerve Morphology in Patients
    with Carpal Tunnel Syndrome: An Ultrasonographic Study. Evid Based Complement Alternat
    Med.2017:7420648. Epub Link

  • Acupuncture in treatment of carpal tunnel syndrome:
    A randomized controlled trial study. 2012 Jan;17(1):1-7. Link

  • Efficacies of Acupuncture and Anti-
    inflammatory Treatment for Carpal Tunnel Syndrome. J Acupunct Meridian Stud . 2015
    Oct;8(5):229-235. Link

  • Acupuncture and related interventions for carpal tunnel syndrome: systematic review. Clin
    Rehabil. 2020;34(1):34-44. Link

  • Acupuncture and related interventions
    for the treatment of symptoms associated with carpal tunnel syndrome. Cochrane Database
    Syst Rev. 2018(12):CD011215. Link

  • Effects of forearm myofascial
    trigger point dry needling on pain and function of patients with carpal tunnel syndrome.
    Crescent Journal of Medical and Biological Sciences. 2020;7(3):362-367. Link

  • Acupuncture plus night splint for quality of life and
    disability in patients with carpal tunnel syndrome: a randomized controlled trial. Integr Med
    Res. 2019;8(4):284-288. Link

  • The Acupuncture Effect on Median Nerve Morphology in Patients
    with Carpal Tunnel Syndrome: An Ultrasonographic Study. Evid Based Complement Alternat
    Med.2017:7420648. Epub Link

  • Acupuncture in treatment of carpal tunnel syndrome:
    A randomized controlled trial study. 2012 Jan;17(1):1-7. Link

  • Efficacies of Acupuncture and Anti-
    inflammatory Treatment for Carpal Tunnel Syndrome. J Acupunct Meridian Stud . 2015
    Oct;8(5):229-235. Link

  • Acupuncture and related interventions for carpal tunnel syndrome: systematic review. Clin
    Rehabil. 2020;34(1):34-44. Link

  • Acupuncture and related interventions
    for the treatment of symptoms associated with carpal tunnel syndrome. Cochrane Database
    Syst Rev. 2018(12):CD011215. Link



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