JP2010125303A - Low frequency therapeutic apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a low frequency therapeutic apparatus which outputs therapeutic pulses synchronized with rhythm of the autonomic nerve with a heartbeat as a base. <P>SOLUTION: The low frequency therapeutic apparatus detects R, P, T, Q, S waves from an electrocardiographic waveform acquired by an electrocardiographic waveform detection part 2 (normally, an electrocardiograph) and produces respective gate signals in a gate signal generation part 4, corresponding to: (1) PQ time that is the systole of the atrium and a period wherein the influence of the parasympathetic nerve on an atrioventricular node is large; (2) RT time that is the systole of the ventricle and a period wherein the influence of the sympathetic nerve on a blood discharge amount is large; and (3) TP time that is the diastole of the ventricle and a period wherein a venous return is transmitted via the parasympathetic nerve. Actually required gate signal and interrupt signal are generated in an interrupt control part 5 according to output timing of the pulse set via a user interface 7. During a time when the gate signal is asserted, a main controller 6 having received the interruption drives a pulse generation circuit 8, an amplification circuit 9, and an output circuit 10 to output low frequency pulses to the subject. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

The present invention relates to a low-frequency treatment apparatus that outputs a low-frequency pulse in synchronization with the movement of an autonomic nerve of a living body based on the heartbeat.

2. Description of the Related Art Conventionally, a low-frequency treatment apparatus that treats a human body by applying a low-frequency pulse by applying a pair of devices or electrodes to a human skin or the like is widely used.

In addition, since acupuncture reduces heart rate, it has been known for a long time that acupuncture stimulation affects not only local responses but also systemic responses through autonomic nerves.

For this reason, in order to perform an effective low-frequency treatment synchronized with the autonomic nerve of a living body, treatment is performed while consciously controlling the state of the patient's autonomic nerve.

Specific measures include a posture that can be moved at will (the sympathetic nerve is highly stressed when standing or sitting and suppressed in the supine position) and breathing timing (the parasympathetic nerve increases during expiration and is suppressed during inspiration). Treatment is performed while managing.
JP-A-8-744 JP-A-8-299465

However, since the autonomic nervous function that the living body originally performs automatically other than the body position and breathing cannot be arbitrarily controlled, it is difficult to say that treatment based on the state of the autonomic nerve is truly performed only by the body position and breathing.

In addition, in the conventional low frequency treatment apparatus, the frequency of the set pulse is not related to the rhythm of the living body. Therefore, particularly in the setting similar to the heart rate such as 1 Hz, the accurate frequency given from the low frequency treatment apparatus is given at a constant period. Therefore, it is forcibly applied from the outside while slightly deviating from the rhythm of the heart with fluctuations derived from the living body, and it cannot be said that the treatment is in a state where the living body is relaxed.

Therefore, the present invention pays attention to the pulsation of the heart, and by adjusting the timing of the pulse output on the low frequency treatment device side so as to match the rhythm of the autonomic nerve actually acting in the living body, more effective treatment can be performed. The object is to construct a low-frequency treatment device.

A heart that beats alternately and repeatedly contracts and relaxes, and the electrical stimulation generated by the sinus node, which is the heart pacemaker, is transmitted to the ventricle via the atrioventricular node through the command system called the stimulus transmission system, and the heart beats regularly. It is out. However, there are precise “fluctuations” in the heart rate, and these “fluctuations” decrease or disappear when the autonomic nervous function is impaired. Used for inspection.

Functionally, the sympathetic nerve and parasympathetic nerve (vagus nerve) distributed in the heart act on the sinus node and atrioventricular node, the sympathetic nerve increases the number of beats, and the parasympathetic nerve decreases the number of beats. Sympathetic nerves also affect blood output.

Sympathetic nerves are distributed throughout the atria and ventricles. In particular, the sympathetic nerves are densely distributed in the muscles of the ventricles, and the contractile force is increased by the excitement of the sympathetic nerves. In this way, the heart can pump out blood volume 4 to 5 times that at rest.

The parasympathetic nerve (vagus nerve) is mainly distributed in the sinus node and the atrioventricular node, and in particular, it controls the atrioventricular node densely, but is hardly distributed in the ventricle. The right atrium has a baroreceptor that constantly monitors the amount of venous return. This information is also transmitted to the medulla via the vagus nerve and fed back to the sinus node.

Therefore, the present invention adjusts the timing of the pulses applied to the eyelids and electrodes on the low frequency treatment device side based on the motion of the heart that has a close relationship with the functions of the sympathetic and parasympathetic nerves.

The movement of the heart can be grasped by an electrocardiogram waveform as shown in FIG. P wave, Q wave, R wave, S wave, T wave, and U wave appear in order corresponding to the activity of each part of the myocardial cell.

The P wave reflects the excitement of the atria and the atria contract. The PQ time until the next Q wave corresponds to the time until the excitement emanating from the sinus node is transmitted to the ventricle, but more than 70% is spent passing the atrioventricular node. Therefore, the period from the P wave to the Q wave is considered to be a period in which the influence of the parasympathetic nerve is particularly large in a state where the parasympathetic nerve is dominant.

The subsequent QRS wave reflects the excitement of the ventricular muscle, and corresponds to the time zone in which the ventricular muscle is excited from the end of the S wave to the start of the T wave. The systole of the ventricle is from the apex of the R wave to the vicinity of the end of the T wave, blood is ejected into the artery, and blood flows into the atria. Therefore, the period from the R wave to the T wave is considered to be a period in which the influence of the sympathetic nerve is particularly great when the sympathetic nerve is increased.

The T wave appears when the ventricular cardiomyocytes charge (repolarize) energy, and the period from the end of the T wave to the next R wave corresponds to the ventricular diastole. Vena cava blood flows through the right atrium with baroreceptors into the dilated right ventricle, and pulmonary blood flows through the pulmonary vein and left atrium into the dilated left ventricle. The cause of the U wave that appears after the T wave has not been clarified.

The detection of the U wave from the P wave can be detected by differentiating the obtained electrocardiographic waveform in the time direction. The P wave, R wave, T wave, and U wave can be detected by changing the slope of the waveform from positive to negative, that is, (dV / dT) changing from positive to negative. Among the obtained points, the one with the largest ECG signal value is the R wave. Therefore, a buffer for storing values for four points whose slope changes from positive to negative is provided, and if it is the largest compared with the values of the past three points, it can be identified as an R wave. If the R wave can be specified, the T wave, the U wave, and the P wave will be in order from the R wave. The Q wave and the S wave can be detected by changing (dV / dT) from negative to positive, and the S wave can be specified to come after the R wave.

The present invention includes means for detecting an electrocardiogram waveform, means for detecting an R wave from the obtained electrocardiogram waveform, and means for detecting a P wave, a Q wave, an S wave, and a T wave in addition to the R wave. (1) means for generating a gate signal (PQ time) corresponding to the period from the P wave to the Q wave, and (2) generating a gate signal (RT time) corresponding to the period from the R wave to the T wave. And (3) means for generating a gate signal (TP time) corresponding to a period from the T wave to the P wave, and one of the three gate signals or The low frequency treatment apparatus is configured to output a pulse having a preset frequency during a period in which the gate signals are combined.

In the generation of the gate signal in the above (1), (2), and (3), a part of the P wave, Q wave, R wave, S wave, and T wave is used as a reference signal wave, and the delay time from the reference signal wave is set. This includes the case where the gate signal is simply generated by setting.

In addition, it is optimal to use an electrocardiogram waveform to detect the heart motion, but in the present invention, a gate signal is generated from a signal waveform obtained by a device that observes the heart motion other than the electrocardiogram waveform. include.

For example, if the acceleration pulse waveform as shown in FIG. 2 is used, the ventricular systole can be determined. Therefore, instead of the R wave, the initial positive contraction wave (a wave) of the acceleration pulse wave meter is used as a substitute for the R wave. A gate signal can be easily generated.

For example, it is recommended to suppress sympathetic nerves and enhance parasympathetic nerves for stress-related diseases, and to increase sympathetic nerves for bronchial asthma attacks. Therefore, in low-frequency treatment and low-frequency electroacupuncture treatment, in addition to research on the frequency to be applied according to the type of disease, the site to be stimulated (pot), the depth of acupuncture, etc., the breathing and body position are controlled by the patient. It is being considered to perform treatment while controlling the autonomic nerves by managing in the above.

The present invention outputs a pulse in accordance with the rhythm of the autonomic nerve derived from the living body called the heartbeat on the low frequency therapy apparatus side, so that in addition to the conventional research, the low frequency therapy method synchronized with the autonomic nerve of the living body more suitable for the disease Can be developed.

FIG. 3 is a block diagram of a low frequency treatment device according to the present invention. An electrocardiogram signal detection unit 2 that detects an electrocardiogram waveform of the subject from an electrode attached to the subject 1, and detects an R wave, a P wave, a T wave, a Q wave, and an S wave from the obtained electrocardiogram waveform. From the R wave and P, T, Q, S wave detection unit 3 and the detected R wave, P wave, T wave, Q wave, S wave, (1) PQ time, (2) RT time, (3) A gate signal generation unit 4 that generates a gate signal of TP time, an interrupt control unit 5 that generates an interrupt signal to the controller and a desired gate signal that combines the generated gate signals of (1), (2), and (3) The main controller 6 that controls the low-frequency treatment device, the user interface 7 that displays the setting and operation status of the low-frequency treatment device, and a predetermined frequency or a single pulse in accordance with instructions from the main controller Generated pulse generation circuit unit 8 , An amplifier circuit 9 that the generated pulse to the voltage and power amplifier, and an output circuit section 10 for outputting the low frequency pulses output adjustment. An electrocardiograph is used for the electrocardiogram signal detection unit 2 from the subject 1, and an electrocardiogram analog output from the electrocardiograph is used as an input signal to the R wave and P, T, Q, S wave detection unit 3. Yes.

The R wave and P, T, Q, and S wave detectors 3 perform pre-processing with a low-pass filter for noise removal, and then detect P, T, Q, and S waves based on R wave detection by differentiation of an electrocardiogram signal. Perform detection. The gate signal generation unit 4 generates (1) PQ time, (2) RT time, and (3) TP time gate signals from the obtained P, Q, R, S, and T waves, and then the interrupt control unit 5 Then, a desired gate signal set by the user interface 7 is generated, and an interrupt signal and gate signal status information are provided to the main controller 6. The main controller 6 that has received the interrupt clears the interrupt signal of the interrupt control unit 5, drives the pulse generation circuit unit 7, and the gate signal is asserted while polling the state of the gate signal of the interrupt control unit 5. During this period, the pulse generation circuit unit 7 is continuously driven. When the gate signal is negated, the pulse generation circuit unit 7 is stopped. The pulse generated in the pulse generation circuit unit 7 is amplified in voltage and power by the amplification circuit unit 9 and amplified to a predetermined treatment voltage, and then adjusted to a magnitude specified by the user interface 7 in the output circuit unit 10. Is output.

Next, FIG. 4 shows an embodiment in which the gate time is simply generated using a counter using the R wave as a reference signal. This is a low-frequency treatment device that outputs a low-frequency pulse (for example, 30 Hz) at a time setting of 1 msec only in the period excluding the ventricular systole based on the R wave, that is, in the ventricular diastole. In this embodiment, the detection of the R wave uses an electrocardiogram synchronization trigger signal output from the electrocardiograph 41.

The operation of this embodiment will be described in detail below. An R wave trigger output, which is an electrocardiographic synchronization signal from an electrocardiograph 41 having electrodes attached to the subject 40, is connected to a clear terminal of the D flip-flop 44 and a load terminal of the counter 45. Due to the occurrence of the R-wave trigger, the D terminal output of the D flip-flop 44 becomes “Low” and the switch 47 is turned OFF, so that the pulse of the low frequency treatment device 48 is not applied to the subject 40. The D terminal output of the D flip-flop 44 is input to the AND gate 43 through the inverter 42 as an enable signal of the time measuring 1 KHz clock 46 to the counter 45. At the same time, the counter 45 is loaded with the time (complement) for stopping the low frequency pulse by the R wave trigger, and the 1 kHz clock from the enabled AND gate 43 is input to the clock CLK terminal of the counter 45 to count the time measurement. Up starts. When the counter 45 is full, a carry occurs, the carry output C terminal is input to the clock CLK terminal of the D flip-flop 44, and the D terminal output of the D flip-flop 44 becomes "High". As a result, the switch 47 is turned on, and the pulse of the (general) low frequency treatment device 48 is applied to the subject 40. Further, the output of the D terminal of the D flip-flop 44 becomes “Low” via the inverter 42 and the output of the AND gate 43 is forced to “Low”, so that the time measurement 1 KHz clock input to the counter 45 is stopped and the time measurement is stopped. Canceled.

Further, the timing of the electrocardiogram waveform and the therapeutic application pulse will be described with reference to FIG. (A) is an electrocardiographic waveform of the subject 40 obtained by the electrocardiograph 41. In this embodiment, the electrocardiographic waveform is not directly used, but the (B) R wave trigger output of the electrocardiographic synchronization signal output from the electrocardiograph 41 is used. (C) is a timing diagram of the gate signal which is the D terminal output of the D flip-flop 44. Since the D flip-flop 44 is cleared and the time measurement is resumed in the counter 45 every R-wave trigger, even if the occurrence of the R-wave trigger becomes irregular, the R The gate signal is active (“High”) only during the period until the wave trigger. The switch 47 is turned ON / OFF by this (C) gate signal, and a therapeutic pulse as shown in (D) output pulse is applied to the subject.

It is a typical ECG waveform. A typical acceleration heartbeat waveform. It is a schematic block diagram showing an embodiment. It is a block connection diagram of an example. It is an operation | movement timing diagram of an Example.

Explanation of symbols

A ECG waveform B ECG synchronization signal (R-wave trigger)
C Gate signal D Output pulse for treatment

Claims (3)

A means for detecting an electrocardiogram waveform, a means for detecting an R wave from the obtained electrocardiogram waveform, and a means for detecting a P wave, a Q wave, an S wave, and a T wave in addition to the R wave (1) Means for generating a gate signal in a period corresponding to P wave to Q wave; and (2) means for generating a gate signal in a period corresponding to R wave to T wave; and (3) from T wave to P wave. A device for generating a gate signal for a period corresponding to the above, or a device for generating a gate signal combining these. The means for easily generating a gate signal according to claim 1, wherein a part of the P wave, Q wave, R wave, S wave, and T wave is used as a reference signal wave, and a delay time from the reference signal wave is set. A low-frequency treatment device comprising: 3. The low frequency treatment device according to claim 1, further comprising means for generating each gate signal from a signal waveform obtained by a device for observing a heart motion other than an electrocardiographic waveform.

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