CN1688360A - 经皮/表面联合电刺激 - Google Patents
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- 208000002193 Pain Diseases 0.000 claims description 22
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- 230000035559 beat frequency Effects 0.000 claims description 5
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- 230000004936 stimulating effect Effects 0.000 claims description 4
- 238000011282 treatment Methods 0.000 description 10
- 210000001519 tissue Anatomy 0.000 description 7
- 230000000694 effects Effects 0.000 description 6
- 230000000392 somatic effect Effects 0.000 description 5
- 230000008901 benefit Effects 0.000 description 4
- 238000002646 transcutaneous electrical nerve stimulation Methods 0.000 description 4
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- 238000002560 therapeutic procedure Methods 0.000 description 3
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- KTQKWSPZOZKAEE-LJADHVKFSA-N Met-enkephalin-Arg-Phe Chemical compound C([C@@H](C(=O)N[C@@H](CCSC)C(=O)N[C@@H](CCCN=C(N)N)C(=O)N[C@@H](CC=1C=CC=CC=1)C(O)=O)NC(=O)CNC(=O)CNC(=O)[C@@H](N)CC=1C=CC(O)=CC=1)C1=CC=CC=C1 KTQKWSPZOZKAEE-LJADHVKFSA-N 0.000 description 1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36014—External stimulators, e.g. with patch electrodes
- A61N1/36021—External stimulators, e.g. with patch electrodes for treatment of pain
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36014—External stimulators, e.g. with patch electrodes
- A61N1/36017—External stimulators, e.g. with patch electrodes with leads or electrodes penetrating the skin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/0404—Electrodes for external use
- A61N1/0408—Use-related aspects
- A61N1/0456—Specially adapted for transcutaneous electrical nerve stimulation [TENS]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0502—Skin piercing electrodes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/323—Interference currents, i.e. treatment by several currents summed in the body
Abstract
一种利用集成表面电极(112)的经皮/体表联合刺激仪(110)同时向深层组织以及目标区域的表皮释放电脉冲。
Description
相关申请书参考
本申请要求于2002年8月30日提交的美国临时专利申请No.60/406,914的优先权。这里,其全部内容通过参考引入本申请。
技术领域
本发明总体上涉及电刺激,并且更具体地,本发明涉及一种用于肌肉、神经和组织的经皮及体表综合电刺激的电子医疗设备和方法。
背景技术
经皮电刺激(也可称之为经皮神经调节疗法或(PNT))是但不局限于通过将细针电极插入到一个优选地为大约2-3厘米的深度,直接向深层组织释放电脉冲。经皮的定义就是:通过皮肤,并且通常利用细线状电极刺激深层肌肉组织、神经以及其它组织。经皮神经调节疗法(PNT)通常不会在治疗后立即显示其积极的作用,而是可能要用4个疗程之后才能感觉到其疗效。参见Seroussi RE等人发表的名为“Effectiveness of Percutaneous NeuromodulationTherapy for Patients with Chronic and Severe Low Back Pain”的文章,其收录出版在2003年3月的第3卷、第1期的期刊PainPractice中。经皮神经调节疗法的优点在于,通过10个疗程的一系列治疗,可以缓解疼痛长达6个月或者更长时间。参见Ghoname EA等人在JAMA 1999;281:818-23发表的名为“Percutaneouselectrical nerve stimulation for low back pain:a randomizedcrossover study”的文章。
体表电刺激的定义是,利用置于皮肤表面的电极使多种类型的电流通过皮肤。现已表明这种类型的表面刺激能够使得镇痛起效相对迅速。参见1995年由Baltimore:Williams&Wilkins出版的,Robinson AJ等人编写的Clinical Electrophysiology第二版,第285-290页。但是,这种由表面刺激带来的缓解通常持续时间较短(即数小时,最好的是数天),参见Johnson MI等人在期刊PAIN1991;41:221-229发表的名为“An In-Depth Study of Long-Term Usersof Transcutaneous electrical Nerve Stimulation(TENS):Implications for clinical use of TENS”的文章,以及Hans JS等人在期刊PAID1991;47:295-298发表的名为“Effect of low-andhigh-frequency TENS on Met-enkephalin-Arg-Phe and dynorphinA immunoreactivity in human l umbar CSF”的文章。这种类型的刺激的例子是但不限于:体表神经电刺激(TENS)、神经肌肉电刺激(NMES)、干扰刺激、间动刺激、高伏特直流电刺激(HVGS)、电磁及脉冲电磁场刺激(EMF&PEMF)以及微电流刺激,参见1999年由Stamford:Appleton&Lange出版的,Nelson RM编写的ClinicalElectrotherapy第三版,第316-319页。体表电刺激可用于多种疼痛情况,但是其作用持续时间有限,而且最多只能缓和症状。使其与一种更持久的二次调节技术,例如PNT相结合,会产生更舒适并且更有效的结果。与单独使用PNT治疗相比较,患者还会更快地开始见到效果和益处。
但是,如上所述,使用经皮刺激并不一定在治疗之后立刻显示其积极作用,并且可能要用多达四个疗程的时间才能感觉到它的益处。体表刺激起效迅速,另一方面,通常作用持续时间较短。而且,在经皮刺激中使用的细针电极,在其插入时,会令人感觉非常不舒服。因此,到目前为止,在医疗行业中仍然存在着解决上述缺点和不足的需求。
发明内容
本发明主要用于在医学临床环境中对下腰疼痛、颈部疼痛和其它疼痛综合症中根部以及轴向部位的治疗。
本发明的各个实施例结合了表面刺激和经皮电刺激(见图1)。在一个实施例中,该系统具有电极和电路,这两者是向表浅性传入神经提供刺激,以及向患者提供快速镇痛的针定位系统的组成部分。疼痛缓解的迅速起效会有利于针电极插入,并且有利于患者愿意接受预定的疗程。将表面刺激系统结合到PNT系统中。
在另一个实施例中,体表刺激系统和经皮刺激系统两者是独立的。但是,体表刺激系统是与经皮系统共同使用的(见图2)。
将表面刺激和经皮刺激结合起来使用的好处在于患者能够获得迅速地疼痛缓解,获得更为舒适的针电极插入,以及最根本的是获得更持久的效果。
附图说明
参考附图能够更好的理解本发明各方面。附图中的各部件不必按照比例构成,而是明显地将重点放在说明本发明的原理上。而且,在附图中,同样的参考标号在所有视图中指示相应的部分。
图1是说明本发明的一个实施例的透视图;以及
图2是说明本发明的另一个实施例的透视图。
具体实施方式
下面将参考附图描述本发明的优选实施例及其变形。
图1表示一种用于对对象的一个目标区域(未示出)进行电刺激的电子医疗设备100。该目标区域(未示出)包括深层组织(未示出)以及皮肤表面(未示出)两者。电子医疗设备100利用一个经皮/体表联合刺激仪110同时产生电脉冲直接到目标区域的深层组织(未示出),以及到目标区域的皮肤表面(未示出)。使用经皮/体表联合刺激仪110来同时产生用于刺激的电脉冲,将一段由经皮刺激提供的长持续时间的疼痛缓解,与一段和由体表刺激的使用所提供的疼痛缓解迅速起效相联系的短持续时间相结合。
所产生的电脉冲是通过集成表面电极112传送到目标区域(未示出)的。集成表面电极112是与体表刺激仪104(图2)一起使用的表面电极108,以及与经皮刺激仪102(图2)一起使用的细针电极106的结合体。通过使用集成表面电极112,电脉冲被直接释放到深层组织、肌肉组织和神经中(经皮刺激),并且被通过皮肤表面传送到表浅性传入神经中(体表刺激)。利用集成表面电极112的经皮/体表联合刺激仪110提供了疼痛的快速缓解,更舒适地细针电极插入,并且给患者提供更长持续时间的疼痛缓解。
利用带有表面电极108的体表刺激仪104与一个独立的使用了细针电极106的经皮刺激仪102共同作用(图2),能够达到与使用了集成表面电极112的经皮/体表联合刺激仪110相似的效果。但是,如上所述,经皮/体表联合刺激仪110在同一次治疗中提供这两种刺激方法的有益之处。
经皮/体表刺激仪110可以用来产生一个干扰电流,这个干扰电流具有最低为1kHz、最高不超过20kHz的基本中频,并且产生不高于250Hz的合成拍频。该经体表传输的干扰电流能够促进骨生成,并且有助于骨质疏松症的治疗。
Claims (38)
1.一种用于对目标区域进行电刺激的电子医疗设备,包括:
经皮刺激仪;以及
与所述经皮刺激仪相连接的体表刺激仪。
2.根据权利要求1所述的电子医疗设备,其中所述经皮刺激仪包括细针电极。
3.根据权利要求1所述的电子医疗设备,其中所述体表刺激仪包括表面电极。
4.根据权利要求1所述的电子医疗设备,其中所述经皮刺激仪直接向深层组织释放电脉冲。
5.根据权利要求1所述的电子医疗设备,其中所述体表刺激仪向该目标区域的表面释放电脉冲。
6.根据权利要求1所述的电子医疗设备,其中所述经皮刺激仪获得长持续时间的疼痛缓解。
7.根据权利要求1所述的电子医疗设备,其中所述体表刺激仪获得短持续时间的疼痛缓解。
8.根据权利要求1所述的电子医疗设备,其中所述体表刺激仪获得迅速的疼痛缓解。
9.根据权利要求1所述的电子医疗设备,其中所述体表刺激仪产生具有最低为1kHz、最高不超过20kHz的基本中频的干扰电流。
10.根据权利要求9所述的电子医疗设备,其中所述干扰电流包括一个不高于0-250Hz的合成拍频。
11.一种用于对目标区域进行综合电刺激的电子医疗设备,包括经皮/体表联合刺激仪。
12.根据权利要求11所述的电子医疗设备,其中所述体表刺激仪包括集成表面电极。
13.根据权利要求12所述的集成表面电极,进一步包括结合了表面电极的细针电极。
14.根据权利要求11所述的电子医疗设备,其中所述经皮/体表联合刺激仪直接向深层组织释放电脉冲。
15.根据权利要求11所述的电子医疗设备,其中所述经皮/体表联合刺激仪向该目标区域的表面释放电脉冲。
16.根据权利要求11所述的电子医疗设备,其中所述经皮/体表联合刺激仪同时向深层组织和该目标区域的表面释放电脉冲。
17.根据权利要求11所述的电子医疗设备,其中所述经皮/体表联合刺激仪获得长持续时间的疼痛缓解。
18.根据权利要求11所述的电子医疗设备,其中所述经皮/体表联合刺激仪获得迅速的疼痛缓解。
19.根据权利要求11所述的电子医疗设备,其中所述经皮/体表联合刺激仪产生具有最低为1kHz、最高不超过20kHz的基本中频的干扰电流。
20.根据权利要求20所述的电子医疗设备,其中该干扰电流包括0-250Hz的合成拍频。
21.一种利用电刺激仪对深层组织和目标区域的表面同时进行电刺激的装置。
22.根据权利要求22所述的装置,其中该电刺激仪是一种经皮/体表联合刺激仪。
23.根据权利要求23所述的装置,其中所述经皮/体表联合刺激仪包括集成表面电极。
24.根据权利要求24所述的装置,其中所述集成表面电极包括结合了表面电极的细针电极。
25.根据权利要求22所述的装置,其中所述装置获得长持续时间的疼痛缓解。
26.根据权利要求22所述的装置,其中该装置获得迅速的疼痛缓解。
27.根据权利要求22所述的装置,其中该装置产生具有最低为1kHz、最高不超过20kHz的基本中频的干扰电流。
28.根据权利要求27所述的装置,其中该干扰电流包括0-250Hz的合成拍频。
29.一种利用经皮/体表联合刺激仪对目标区域进行电刺激的方法。
30.根据权利要求29所述的方法,所述方法包括利用集成表面电极。
31.根据权利要求30所述的方法,其中所述集成表面电极包括结合了表面电极的细针电极。
32.根据权利要求29所述的方法,所述方法包括直接向深层组织释放电脉冲。
33.根据权利要求29所述的方法,所述方法包括向该目标区域的表面释放电脉冲。
34.根据权利要求29所述的方法,所述方法包括同时向深层组织和该目标区域的表面释放电脉冲。
35.根据权利要求29所述的方法,所述方法获得长持续时间的疼痛缓解。
36.根据权利要求29所述的方法,所述方法获得迅速的疼痛缓解。
37.根据权利要求29所述的方法,所述方法产生具有最低为1kHz、最高不超过20kHz的基本中频的干扰电流。
38.根据权利要求37所述的方法,所述方法进一步包括产生0-250Hz的合成拍频的干扰电流。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US40691402P | 2002-08-30 | 2002-08-30 | |
US60/406,914 | 2002-08-30 |
Publications (1)
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CN1688360A true CN1688360A (zh) | 2005-10-26 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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CNA038234181A Pending CN1688360A (zh) | 2002-08-30 | 2003-09-02 | 经皮/表面联合电刺激 |
Country Status (8)
Country | Link |
---|---|
US (1) | US20040073269A1 (zh) |
EP (1) | EP1534384A2 (zh) |
JP (1) | JP2005537069A (zh) |
KR (1) | KR20060010708A (zh) |
CN (1) | CN1688360A (zh) |
AU (1) | AU2003263037A1 (zh) |
CA (1) | CA2496879A1 (zh) |
WO (1) | WO2004020040A2 (zh) |
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US7228180B1 (en) * | 2003-10-09 | 2007-06-05 | Stroke Play Ltd. | Methods for treating victims of cerebrovascular disease |
US20050149145A1 (en) * | 2003-12-29 | 2005-07-07 | Coulter George G. | Enhanced device for diminishing or eliminating the pain caused by superficial therapeutic injection or superficial body tissue sampling or the pain from a superficial injury as well as for the reduction of hemorrhage from an injured area |
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WO2005122740A2 (en) * | 2004-06-15 | 2005-12-29 | Compex Technologies, Inc. | Interferential and neuromuscular electrical stimulation system and apparatus |
-
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- 2003-09-02 US US10/652,562 patent/US20040073269A1/en not_active Abandoned
- 2003-09-02 CA CA002496879A patent/CA2496879A1/en not_active Abandoned
- 2003-09-02 EP EP03791988A patent/EP1534384A2/en not_active Withdrawn
- 2003-09-02 CN CNA038234181A patent/CN1688360A/zh active Pending
- 2003-09-02 JP JP2004532028A patent/JP2005537069A/ja active Pending
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- 2003-09-02 KR KR1020057003487A patent/KR20060010708A/ko not_active Application Discontinuation
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WO2004020040A2 (en) | 2004-03-11 |
US20040073269A1 (en) | 2004-04-15 |
KR20060010708A (ko) | 2006-02-02 |
WO2004020040A3 (en) | 2004-06-10 |
AU2003263037A9 (en) | 2004-03-19 |
AU2003263037A1 (en) | 2004-03-19 |
CA2496879A1 (en) | 2004-03-11 |
EP1534384A2 (en) | 2005-06-01 |
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