مقايسه تأثير يونتوفورز دو داروي ضد التهاب غير استروئيدي و استروئيدي بر علائم بيماران مبتلا به سندرم كانال مچي-
Background and aim: Carpal tunnel syndrome is a common disorder, for which various conservative treatments have been suggested. The aim of this randomized clinical trial was to compare the iontophoretic effects of diclofenac and dexamethasone on patients with carpal tunnel syndrome.
Materials and Methods: Twelve hands from seven patients between 30 to 60 years of old (Mean=45.9 SD±8.3) were treated with pre-designed splint and iontophoresis. Four hands were treated with dexamethasone sodium phosphate and eight other hands had iontophoretic administration of sodium diclofenac. Cock-up splints were used for the patients during the course of treatment and 2 weeks follow up. Treatment continued for ten sessions during two weeks. They were advised not to take oral or parenteral anti-inflammatory drugs. Clinical symptom severity (SSS) and functional status (FSS) as well as visual analogue (VAS) scales were evaluated after iontophoretic treatment and two weeks follow up. Electrophysiological parameters such as distal sensory & motor latencies, amplitudes, nerve conduction velocities (NCV) were measured.
Results: Diclofenac group showed significant improvement in SSS score and sensory electrophysiological parameters of median nerve (P<0.05). Although, in dexamethasone group VAS and SSS scores decreased but there were no statistical significant differences in any intervals. With Comparison between two groups showed significant difference in distal motor latency after following up with more improvement in dexamethasone iontophoresis group (P<0.05).
Conclusion: Above findings showed efficacy of splint and iontophoretic administration of sodium diclofenac in treatment of patients with carpal tunnel syndrome. Although dexamethasone group showed no significant change, previous researches suggested the efficacy of ionophoretic administration of this anti-inflammatory medicine in clinical symptoms' improvement. Therefore, the lack of enough participants may be considered as a source for present results in this group. Although comparison between two groups, showed significant difference in distal motor latency after follow up (singnificant results in dexamethasone) but, due to small number of cases in follow up period, the validity of these results is questionable. Further researches are needed to confirm this difference.