以良導絡評估不同電刺激模式於 酸痛症之療效

Using Ryodoraku Device to Evaluate the Treatment Effects of Different Frequency Modes of Electrical Stimulation on Muscular Pains

謝文祥(Wen-Xiang Xie)

指導教授 ： 翁清松

中原大學/工學院/醫學工程研究所/碩士(2003年)

https://doi.org/10.6840/cycu200300665

摘要

AL-TENS (Acupuncture-like Transcutaneous Electrical Nerve Stimulation) 在過去常使用於治療急性和慢性酸痛病變上，是一種中醫理論與電刺激結合的治療方式。但由於過去的電刺激只提供了固定波形的組合，無法針對病患的需求給予適當的刺激，加上刺激時因為對穴位的位置認識不清，而無法達到一定的療效。
因此本研究的目的在於改善這些缺點，定義出一定的參數，使患者在接受電刺激時，能有一定的參數選擇（刺激頻率、位置、強度、時間等），並以Visual Basic 6.0設計一軟體評估患者的良導絡值，作為刺激時的參數選擇依據。另外，研發一含有電極貼片的護具，藉著護具上的表面電極及黏扣帶本身的延展性，達到自動對穴的效果，省去辨識穴位的困難。
實驗方面，首先量測50位健康男女的十二經絡原穴良導絡值作為刺激頻率選擇。在護具開發完成後，以25位健康男女進行每人15分鐘的電刺激實驗，以測試其穩定性及自動對穴的準確性。
臨床實驗方面，50位下背痛患者依其良導絡值分佈情形分別給予每人15分鐘、刺激強度為高強度的低頻、高頻或複合式頻率刺激。35位五十肩患者則僅給予複合式頻率刺激，最後再以良導絡值和VAS值評估實驗療效。
研究結果顯示，在護具開發上，穿戴含電極片之護具接受刺激時的良導絡變化百分比，和直接使用電極片刺激時沒有太明顯的差異，說明穿戴含電極片的護具接受刺激的可行性。
下背痛臨床實驗方面，發現低頻刺激（2Hz）可以提高刺激穴位的良導絡值(p<0.05)，而高頻刺激（100Hz）則是有效下降刺激穴位的良導絡值(p<0.05)，在複合式頻率刺激（2-100Hz）方面，刺激穴位上則顯示出有統計意義的上升或下降(p<0.05)。VAS值方面，三種刺激模式在刺激後都能使VAS值產生有意義的下降，說明三種刺激本身都有其療效存在。
五十肩臨床實驗結果顯示不論是高於或低於正常良導絡值的範圍者，在接受了複合式頻率的刺激後，其良導絡值也都產生了有意義的上升和下降(p<0.05)；VAS值方面，也產生了有意義的下降，說明了在未來的研究中，以複合式頻率刺激取代低頻刺激或高頻刺激的可行性。

關鍵字

良導絡 ； 五十肩 ； 下背痛 ； AL-TENS

並列摘要

Acupuncture-like Transcutaneous Electrical Nerve Stimulation (AL-TENS) has been used in acute and chronic pains for years. However, AL-TENS with different stimulation functions including wave number, wave range, wave amplitude, frequency, and time, can result in different treatment outcomes. In earlier studies, the treatment of electrical stimulation frequently fixed the waveform and on unidentified stimulating points, so it might not have the best treatment.
This research was to improve the functions. In software design, Microsoft Visual Basic 6.0 was used to design the operating system which was able to evaluate the Ryodoraku value and treatment result. We designed a pad with surface electrodes that fit over the acupoints, so patients could be treated with AL-TENS. Patients with frozen shoulder and patients with low back pain were recruited to be measured of Ryodoraku values and visual analog scores (VAS) of pain.
In low back pain treatment, 50 patients were recruited for this test. Group 1 patients that were in low range of Ryodoraku values received AL-TENS with high frequency. Group 2 patients that were in high range of Ryodoraku values received AL-TENS with low frequency. Group 3 patients that were in normal range of Ryodoraku values received AL-TENS with complex frequency. The stimulation time for all groups was 15 minutes.
In frozen shoulder treatment, 35 patients were recruited for this test. All patients received AL-TENS with complex frequency for 15 minutes.
From treated patients with low back pain, low frequency stimulation (2Hz) could increase the Ryodoraku values of stimulated acupoints (p<0.05); while the high frequency stimulation (100HZ) could decrease the Ryodoraku values of stimulated acupoints (p<0.05). At complex frequency stimulation, it changed the Ryodoraku values significantly (p<0.05). Pain VAS in three groups decreased significantly after treatments (p<0.05). This showed that the three ways have similar treatment effects but different mechanisms. From treated patients with frozen shoulder, the results showed that Ryodoraku values changed significantly (p<0.05). Also, decrease of pain VAS showed that the treatment was effective.

並列關鍵字

frozen shoulder ； AL-TENS ； low back pain ； Ryodoraku

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