調制中頻電刺激器之研製及應用於疼痛治療之評估

The Development of Modulated Middle-frequency Electrical Stimulator and the Evaluation of Its Application in Pain Treatment

許善華(Shen-Hwa Shu)

指導教授 ： 翁清松

中原大學/工學院/醫學工程研究所/碩士(2004年)

https://doi.org/10.6840/cycu200400295

摘要

目前市面上販售的中頻電刺激器非常少，且其輸出波形都是以低頻正弦波來調制中頻波，對於電刺激人體時刺激感並不強，此外，國內市售或進口的電刺激器輸出強度的調整均是以旋鈕方式抑或是數段按鍵調整，對使用者來說缺乏定量的數據，對患者來說，易感受到上述兩種強度調整的方式極不方便。
本研究的目的在於研製出可調制不同頻率的中頻電刺激器，以提供臨床實驗參數選用上多種的選擇。系統設計中將傳統調制中頻波形(以低頻正弦波調制中頻波)修改為以低頻方波來調制中頻波，對於電刺激人體時產生的刺激感較強，且受測者感覺較舒適。另外將強度控制鈕設計成數位按鍵微調方式，可避免傳統旋鈕調整上的不靈敏以及彌補輸出強度只可數段粗調的不便。並將輸出電流特性調整為適合臨床上使用的參數範圍。
新系統研發完成後，則進行系統測試，以確定系統之安全性; 並進行網球肘及上背痛患者疼痛治療的評估。除了觀察網球肘及上背痛患者電刺激前後良導絡值的變化之外，並比較不同實驗組別電刺激前後VAS值的變化，最後再與相關文獻做比較。
研究結果發現，系統輸出特性都在安全的範圍之內，且功能較多。而應用在網球肘患者的疼痛治療中，受測者接受了2Hz或是100Hz的調制中頻電刺激後都能感覺有舒緩疼痛的現象，且於VAS值的表現中產生有意義的下降(p<0.01)，說明了這兩種刺激參數本身都具有療效存在。而在經絡特性的調整方面，2Hz調制中頻波能使受測者其12經絡良導絡電流值產生顯著的下降(p<0.05); 而100Hz調制中頻波能使受測者12經絡良導絡值產生顯著的上升(p<0.05)。
上背痛患者在接受2Hz或是100Hz的調制中頻電刺激之後，都能感覺有舒緩疼痛的現象，且在VAS值的表現中產生有意義的下降(p<0.01)，說明了這兩種刺激參數本身都具有療效存在。而患者在接受2Hz及100Hz調制中頻波電刺激後，其12經絡良導絡值均產生顯著的下降(p<0.05)，我們也發現，治療急性上背痛患者，選用的中頻波調制頻率愈高，作用愈深，對於抑制人體興奮性的作用也愈高。
本研究研製的調制中頻波電刺激器，可提供臨床實驗參數選用上更多種的選擇，另外由實驗的結果可得知，不管是2Hz或是100Hz調制中頻電刺激對於網球肘及上背痛病患都具有止痛的療效存在，且能夠調整人體的經絡特性。

關鍵字

調制中頻電刺激 ； 網球肘 ； 上背痛 ； 良導絡

並列摘要

There are very few mid-frequency electrical stimulators available in the market, and their mid-frequency waveforms are mostly modulated by low frequency sinewaves, which do not have much effect to the human body. Most domestic or imported electrical stimulators use knob to adjust the parameters, which lack of a quantified data.
The purpose of this research was to construct a mid-frequency electrical stimulator with modulated different frequencies. The design of the system used low frequency square wave to create mid-frequency wave, which is stronger in intensity and more effective when stimulating human. It also was more comfortable to patients. In order to avoid unstable intensity of the stimulator, the research modified the knob to digital controllers. The output current characterisics were also adjusted to the ranges that are suitable for clinical use.
After the development of the new system, it was tested to ensure the safely of the system. Evaluation was then made by treating patients with either tennis elbow or upper back pain. The change of Ryodoraku values and the VAS values in the patients before and after the electrical stimulation were compared.
The results of the research showed that the output characteristics of the system were all in safe ranges and had more functions. Another finding was that patients with tennis elbow all felt the soothingness after either 2Hz or 100Hz modulated middle-frequencies electrical stimulation. Also the VAS values were decreased (p<0.01). This demonstrated that the two stimulating characteristics had clinical effectiveness. The 2Hz modulated middle-frequency wave showed a significant decrease in the meridian 12 Ryodoraku values (p<0.05). The 100Hz frequency modulated middle-frequency wave showed a significant increase in the 12 meridian Ryodoraku values (p<0.05).
Patients with upper back pain also felt the soothingness after either 2Hz or 100Hz modulated middle-frequency electrical stimulation. The VAS values also showed a meaningful decrease. Patients who were treated with 2Hz or 100 Hz modulated middle-frequency waves also had a signficant decrease (p<0.01) in their 12 meridian Ryodoraku values.

並列關鍵字

modulated middle-frequency electrical stimulator ； tennis elbow ； upper back pain ； Ryodoraku

參考文獻

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