運用多種生理參數探討肌筋膜疼痛症之療效

Assessment of Pain in Myofascial Pain Syndrome Patients Using Multiple Physiological Parameters

周盈妤(Ying-Yu Chou)

指導教授 ： 莊炯承

中原大學/工學院/生物醫學工程研究所/碩士(2016年)

https://doi.org/10.6840/cycu201600058

摘要

背景：慢性疼痛雖然沒有立即致命的危機，卻嚴重影響病患的生活。而慢性疼痛中以肌筋膜疼痛症(Myofascial pain syndromes, MPS)最為常見。疼痛對MPS病患而言是極欲解決之主訴，也是病人就診之主要原因。但由於個體間充滿差異，對於主觀的疼痛感覺之定量是非常困難的。因此，如何有效評估疼痛是一項極待解決的重大議題。目的：本研究透過非侵入式的方法量測治療前後的心電圖訊號(Electrocardiography, ECG)、光體積變化描記圖訊號 (Photoplethysmography, PPG)以及膚電反應訊號(Galvanic skin response, GSR)，進而分析參數比較治療前後的差異，再搭配臨床上常用的面部表情量表法 (Ｗong -Banker)、口語性等級刻度尺(Verbal rating scale, VRS)、視覺類比刻度尺(Visual analogue scale, VAS)以及壓痛閥值(Pain pressure threshold, PPT)來做為評估的依據，期望能促使肌筋膜疼痛症患者得到更好疼痛管理品質。方法：本研究收取37位MPS病患，藉由多訊號擷取系統，本研究同步量測肌筋膜疼痛患者於治療前後ECG、PPG以及GSR三種生理訊號，經LabVIEW軟體分析處理計算出三種訊號之生理參數值，再使用SPSS統計軟體(Statistic Package for Social Science, SPSS)進行統計分析。主要針對三種生理訊號於肌筋膜疼痛治療前後之療效進行探討評估。結果：研究結果經統計分析得知，疼痛量表以及PPT結果皆為顯著性的下降，代表著疼痛的緩解。而PPG以及ECG幾乎所有自主神經參數於治療前後，藉由自主神經活性觀察，有著與疼痛減緩趨勢相同之顯著性改變，而GSR之交感神經參數則具有下降的趨勢。結論：本研究建構了一個多生理參數的量測系統，可以在非侵入的情況下測量GSR、PPG以及ECG三項生理訊號，比較肌筋膜疼痛症於治療前後的差異。本研究之結果配合先前文獻可知，ECG以及PPG之參數評估慢性MPS痛症之舒緩是可行的。

關鍵字

肌筋膜疼痛症 ； 心率變異度 ； 光體積描記圖 ； 膚電反應 ； 疼痛評估

並列摘要

Background: Chronic pain, although not immediately fatal crisis, but seriously affect the lives of patients. And chronic pain in myofascial pain syndrome (MPS) is most common. Pain in terms of MPS patients is depravity solution complaint, is the main reason of patient visits. However, due to differences between individuals filled, quantitating subjective sensation of pain it is very difficult. Therefore, how to effectively assess pain is an extremely important issue to be resolved. Purpose: This study through the electrocardiography (ECG), photoplethysmography (PPG) and galvanic skin response (GSR) signal before and after the non-invasive method of measuring treatment, further analysis parameters Compare the differences before and after treatment, and then with facial expressions commonly used in clinical scale method Wong -Banker, oral rating scale (VRS), visual analogue scale (VAS) and pain pressure threshold (PPT) to do based on the assessment, hoping to induce myofascial pain syndrome patients get better quality of pain management. Methods: The study collected 37 MPS patients, with multiple signal acquisition system, this study measured the myofascial pain patients before and after treatment ECG, PPG and GSR three physiological signals processed by LabVIEW software analysis .The physiological parameter value, and then use the SPSS statistical software (Statistic Package for Social Science, SPSS) for statistical analysis. It will focus on three physiological signals in myofascial pain before and after treatment efficacy were discussed. Results: Results Statistical analysis showed that the pain scale and PPT of the results are all significant of decline, representing the pain relief. And as well as almost all of the PPG and ECG autonomic nervous parameters before and after treatment, by autonomic nervous system activity observed with the same pain relief and significant changes in the trend, but sympathetic parameters of the GSR decreased. Conclusion: This study constructed a multiple physiological parameters measurement system that can measure the difference of GSR, PPG and ECG three physiological signals, and compare myofascial pain syndrome before and after treatment in the case of non-invasive. The results of this study with previous literature shows that the parameters of the ECG and PPG assessment relieve chronic pain of MPS are valid.

並列關鍵字

Myofascial pain syndrome ； Heart rate variability ； Photoplethysmography ； Galvanic skin response ； Pain assessment

參考文獻

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