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DOI: 10.1055/s-0040-1701432
Acupuntura y la electroacupuntura en el tratamiento del síndrome del túnel carpiano: Revisión sistemática
Artikel in mehreren Sprachen: English | españolPublikationsverlauf
01. November 2019
22. November 2019
Publikationsdatum:
26. Mai 2020 (online)
Resumen
Introducción El síndrome del túnel carpiano (STC) es la neuropatía por compresión más diagnosticada de la extremidad superior. El tratamiento en casos leves y moderados es extenso y controvertido, en casos graves se realiza intervención quirúrgica.
Objetivo Analizar la evidencia científica sobre la efectividad del tratamiento con acupuntura y electroacupuntura del STC.
Métodos Se ha seguido la declaración PRISMA. Se realizó una búsqueda bibliográfica en: Clinical Evidence BMJ, NICE, Cochrane Library, PubMed, PEDro, Science Direct, SciELO, Google Scholar. Con la estrategia de búsqueda “acupuncture,” “electroacupuncture” “carpal tunnel syndrome.” La búsqueda se limitó según criterios de inclusión. El riesgo de sesgo de cada estudio se ha determinado con la escala Cochrane. El nivel de evidencia y el grado de recomendación se ha determinado con la escala SIGN.
Resultados En la búsqueda se encontraron 698 artículos en total. Una vez aplicados los criterios de inclusión y exclusión se incluyeron 21 artículos. El nivel de evidencia del conjunto de los artículos es medio-alto, el grado de recomendación es medio y el riesgo de sesgo neutro tiene tendencia a ser bajo. Los artículos evaluados denotan una mejora sintomática y neurofisiológica tanto periférica como central dado que proporciona una respuesta cerebral asociada a la función del nervio mediano.
Conclusión La acupuntura y la electroacupuntura son una opción terapéutica para el STC leve-moderado que tiene un grado de evidencia científica medio, con tendencia a ser alto y con un grado de recomendación medio.
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References
- 1 Alfonso C, Jann S, Massa R, Torreggiani A. Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review. Neurol Sci 2010; 31 (03) 243-252
- 2 Stevens JC. ; American Association of Electrodiagnostic Medicine. AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 1997; 20 (12) 1477-1486
- 3 Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Med J 2008; 77 (01) 6-17
- 4 Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH. ; AAEM Quality Assurance Committee. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 1993; 16 (12) 1392-1414
- 5 MacDermid JC, Doherty T. Clinical and electrodiagnostic testing of carpal tunnel syndrome: a narrative review. J Orthop Sports Phys Ther 2004; 34 (10) 565-588
- 6 Dorwart BB. Carpal tunnel syndrome: a review. Semin Arthritis Rheum 1984; 14 (02) 134-140
- 7 Viikari-Juntura E, Silverstein B. Role of physical load factors in carpal tunnel syndrome. Scand J Work Environ Health 1999; 25 (03) 163-185
- 8 Chammas M. Carpal tunnel syndrome. Chir Main 2014; 33 (02) 75-94
- 9 Millesi H, Zöch G, Rath T. The gliding apparatus of peripheral nerve and its clinical significance. Ann Chir Main Memb Super 1990; 9 (02) 87-97
- 10 Lundborg G. Intraneural microcirculation. Orthop Clin North Am 1988; 19 (01) 1-12
- 11 Ettema AM, Amadio PC, Zhao C, Wold LE, An KN. A histological and immunohistochemical study of the subsynovial connective tissue in idiopathic carpal tunnel syndrome. J Bone Joint Surg Am 2004; 86 (07) 1458-1466
- 12 Lundborg G. Nerve entrapment. In: Lundborg G. , editor. Nerve injury and repair. Philadelphia (PA): Churchill Livingstone; 1988: 102-148
- 13 Page MJ, Massy-Westropp N, O'Connor D, Pitt V. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev 2012; 7 (07) CD010003
- 14 Marshall S, Tardif G, Ashworth N. Local corticosteroid injection for carpal tunnel syndrome. Cochrane Database Syst Rev 2007; 2 (02) CD001554
- 15 Boyer MI. Corticosteroid injection for carpal tunnel syndrome. J Hand Surg Am 2008; 33 (08) 1414-1416
- 16 Gong HS, Baek GH, Oh JH, Lee YH, Jeon SH, Chung MS. Factors affecting willingness to undergo carpal tunnel release. J Bone Joint Surg Am 2009; 91 (09) 2130-2136
- 17 Leyva Glez M, Palomina Carmenate E, Barrios Hdez J, Cruz Font J, Romero Hdez L. Acupuntura del Microsistema Su Jok y quiropraxia en el Síndrome del Túnel Carpiano. Correo Científico Méd Holguín 2011 15(01):
- 18 Lao L, Zhang G, Wei F, Berman BM, Ren K. Electro-acupuncture attenuates behavioral hyperalgesia and selectively reduces spinal Fos protein expression in rats with persistent inflammation. J Pain 2001; 2 (02) 111-117
- 19 Lao L, Zhang RX, Zhang G, Wang X, Berman BM, Ren K. A parametric study of electroacupuncture on persistent hyperalgesia and Fos protein expression in rats. Brain Res 2004; 1020 (1-2): 18-29
- 20 Li A, Zhang RX, Wang Y. , et al. Corticosterone mediates electroacupuncture-produced anti-edema in a rat model of inflammation. BMC Complement Altern Med 2007; 7: 27
- 21 Zhang RX, Lao L, Wang X. , et al. Electroacupuncture attenuates inflammation in a rat model. J Altern Complement Med 2005; 11 (01) 135-142
- 22 Zhang RX, Lao L, Wang L, Liu B, Wang X, Ren K, Berman BM. Involvement of opioid receptors in electroacupuncture-produced anti-hyperalgesia in rats with peripheral inflammation. Brain Res 2004; 1020 (1–2): 12-17
- 23 Schulman RA, Liem B, Moroz A. Treatment of carpal tunnel syndrome with medical acupuncture. Med Acupunct 2008; 20 (03) 163-167
- 24 Shokunbi GO. Acupuncture and Ergonomic interventions in the management of carpal tunnel syndrome among industrial workers-Case studies. Nigerian J Med Rehabil 2014 17(01):
- 25 Napadow V, Liu J, Ryan A. , et al. Effect of Acupuncture on Carpal Tunnel Syndrome with fMRI Assessment of Cortical Somatotopy. Int Soc Magn Resonance Med 2004; 11 (01) 11-23
- 26 Zailaa A. Magnetic Resonance Imaging Evaluation of Acupuncture Effects on Carpal Tunnel Syndrome. 2010
- 27 Ding Q, Shen F. Effects of acupuncture and moxibustion of Yangchi point on carpal tunnel syndrome. Int J Traditional Chin Med 2013; 2: 117-119
- 28 Wong CHL, Wu XY, Wong W. Is adding electroacupuncture on top of nocturnal splinting an alternative treatment option for carpal tunnel syndrome patients?. AIMED 2016; 3 (01) 31-32
- 29 Dimitrova A, Murchison C, Oken B. Local effects of acupuncture on the median and ulnar nerves in patients with carpal tunnel syndrome: a pilot mechanistic study protocol. Trials 2019; 20 (01) 8
- 30 Chen L, Xue L, Li S, Kang T, Chen H, Hou C. [Clinical research on mild and moderate carpal tunnel syndrome treated with contralateral needling technique at distal acupoints and acupuncture at local acupoints]. Zhongguo Zhenjiu 2017; 37 (05) 479-482
- 31 Ural FG, Öztürk GT. The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study. Evid Based Complement Alternat Med 2017; 2017: 7420648
- 32 Maeda Y, Kim H, Kettner N. , et al. Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain 2017; 140 (04) 914-927
- 33 Hadianfard M, Bazrafshan E, Momeninejad H, Jahani N. Efficacies of Acupuncture and Anti-inflammatory Treatment for Carpal Tunnel Syndrome. J Acupunct Meridian Stud 2015; 8 (05) 229-235
- 34 Maeda Y, Kettner N, Lee J. , et al. Acupuncture Evoked Response in Contralateral Somatosensory Cortex Reflects Peripheral Nerve Pathology of Carpal Tunnel Syndrome. Med Acupunct 2013; a 25 (04) 275-284
- 35 Ho CY, Lin HC, Lee YC. , et al. Clinical effectiveness of acupuncture for carpal tunnel syndrome. Am J Chin Med 2014; 42 (02) 303-314
- 36 Maeda Y, Kettner N, Lee J. , et al. Acupuncture-evoked response in somatosensory and prefrontal cortices predicts immediate pain reduction in carpal tunnel syndrome. Evid Based Complement Alternat Med 2013; b 2013: 795906
- 37 Khosrawi S, Moghtaderi A, Haghighat S. Acupuncture in treatment of carpal tunnel syndrome: A randomized controlled trial study. J Res Med Sci 2012; 17 (01) 1-7
- 38 Kumnerddee W, Kaewtong A. Efficacy of acupuncture versus night splinting for carpal tunnel syndrome: a randomized clinical trial. J Med Assoc Thai 2010; 93 (12) 1463-1469
- 39 Yang CP, Wang NH, Li TC. , et al. A randomized clinical trial of acupuncture versus oral steroids for carpal tunnel syndrome: a long-term follow-up. J Pain 2011; 12 (02) 272-279
- 40 Yang CP, Hsieh CL, Wang NH. , et al. Acupuncture in patients with carpal tunnel syndrome: A randomized controlled trial. Clin J Pain 2009; 25 (04) 327-333
- 41 Napadow V, Kettner N, Liu J. , et al. Hypothalamus and amygdala response to acupuncture stimuli in Carpal Tunnel Syndrome. Pain 2007; a 130 (03) 254-266
- 42 Napadow V, Liu J, Li M. , et al. Somatosensory cortical plasticity in carpal tunnel syndrome treated by acupuncture. Hum Brain Mapp 2007; b 28 (03) 159-171
- 43 Yao E, Gerritz PK, Henricson E. , et al. Randomized controlled trial comparing acupuncture with placebo acupuncture for the treatment of carpal tunnel syndrome. PM R 2012; 4 (05) 367-373
- 44 Beissner F, Meissner K, Bär KJ, Napadow V. The autonomic brain: an activation likelihood estimation meta-analysis for central processing of autonomic function. J Neurosci 2013; 33 (25) 10503-10511
- 45 Kim J, Loggia ML, Cahalan CM. , et al. The somatosensory link in fibromyalgia: functional connectivity of the primary somatosensory cortex is altered by sustained pain and is associated with clinical/autonomic dysfunction. Arthritis Rheumatol 2015; 67 (05) 1395-1405
- 46 Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016; 15: 1273-1284
- 47 Sato A, Sato Y, Uchida S. Blood flow in the sciatic nerve is regulated by vasoconstrictive and vasodilative nerve fibers originating from the ventral and dorsal roots of the spinal nerves. Neurosci Res 1994; 21 (02) 125-133
- 48 Ooi CC, Wong SK, Tan AB. , et al. Diagnostic criteria of carpal tunnel syndrome using high-resolution ultrasonography: correlation with nerve conduction studies. Skeletal Radiol 2014; 43 (10) 1387-1394
- 49 Ghasemi-Esfe AR, Khalilzadeh O, Mazloumi M. , et al. Combination of high-resolution and color Doppler ultrasound in diagnosis of carpal tunnel syndrome. Acta Radiol 2011; 52 (02) 191-197
- 50 Napadow V, Dhond R, Kennedy D, Hui KK, Makris N. Automated brainstem co-registration (ABC) for MRI. Neuroimage 2006; 32 (03) 1113-1119
- 51 Tecchio F, Padua L, Aprile I, Rossini PM. Carpal tunnel syndrome modifies sensory hand cortical somatotopy: a MEG study. Hum Brain Mapp 2002; 17 (01) 28-36
- 52 Coghill RC, Sang CN, Maisog JM, Iadarola MJ. Pain intensity processing within the human brain: a bilateral, distributed mechanism. J Neurophysiol 1999; 82 (04) 1934-1943
- 53 Derbyshire SW, Jones AK, Gyulai F, Clark S, Townsend D, Firestone LL. Pain processing during three levels of noxious stimulation produces differential patterns of central activity. Pain 1997; 73 (03) 431-445
- 54 Sim H, Shin BC, Lee MS, Jung A, Lee H, Ernst E. Acupuncture for carpal tunnel syndrome: a systematic review of randomized controlled trials. J Pain 2011; 12 (03) 307-314
- 55 Lund I, Lundeberg T. Are minimal, superficial or sham acupuncture procedures acceptable as inert placebo controls?. Acupunct Med 2006; 24 (01) 13-15
- 56 Linde K, Niemann K, Schneider A, Meissner K. How large are the nonspecific effects of acupuncture? A meta-analysis of randomized controlled trials. BMC Med 2010; 8: 75
- 57 Kaptchuk TJ, Stason WB, Davis RB. , et al. Sham device v inert pill: randomised controlled trial of two placebo treatments. BMJ 2006; 332 (7538): 391-397
- 58 Harris RE, Zubieta JK, Scott DJ, Napadow V, Gracely RH, Clauw DJ. Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage 2009; 47 (03) 1077-1085
- 59 Napadow V, Lee J, Kim J. , et al. Brain correlates of phasic autonomic response to acupuncture stimulation: an event-related fMRI study. Hum Brain Mapp 2013; 34 (10) 2592-2606
- 60 Claunch JD, Chan ST, Nixon EE. , et al. Commonality and specificity of acupuncture action at three acupoints as evidenced by FMRI. Am J Chin Med 2012; 40 (04) 695-712
- 61 Yan B, Li K, Xu J. , et al. Acupoint-specific fMRI patterns in human brain. Neurosci Lett 2005; 383 (03) 236-240
- 62 Zhang WT, Jin Z, Luo F, Zhang L, Zeng YW, Han JS. Evidence from brain imaging with fMRI supporting functional specificity of acupoints in humans. Neurosci Lett 2004; 354 (01) 50-53
- 63 Hui KK, Liu J, Makris N. , et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Hum Brain Mapp 2000; 9 (01) 13-25
- 64 Huang W, Pach D, Napadow V. , et al. Characterizing acupuncture stimuli using brain imaging with FMRI--a systematic review and meta-analysis of the literature. PLoS One 2012; 7 (04) e32960
- 65 Peyron R, Laurent B, García-Larrea L. Functional imaging of brain responses to pain. A review and meta-analysis (2000). Neurophysiol Clin 2000; 30 (05) 263-288
- 66 Shinoura N, Suzuki Y, Yamada R, Kodama T, Takahashi M, Yagi K. Fibers connecting the primary motor and sensory areas play a role in grasp stability of the hand. Neuroimage 2005; 25 (03) 936-941
- 67 Asghar AU, Green G, Lythgoe MF, Lewith G, MacPherson H. Acupuncture needling sensation: the neural correlates of deqi using fMRI. Brain Res 2010; 1315: 111-118