JPH0566825B2 - - Google Patents

Description

[Detailed description of the invention]

[Industrial Application Field] The present invention is a therapeutic device for assisting expectoration in patients who have difficulty coughing up sputum in respiratory diseases such as chronic bronchitis, bronchiolitis, bronchial asthma, bronchiectasis, pulmonary tuberculosis, and emphysema. Regarding. More specifically, the present invention relates to an interference low-frequency electrical therapy device that applies electrical stimulation to the trachea and bronchi of the chest to facilitate the expectoration of accumulated sputum. [Prior art] In recent years, with the increase and aging of the population and changes in the living environment such as air pollution, chronic bronchitis, bronchial asthma,
The number of patients with chronic respiratory diseases such as emphysema is on the rise. Among the symptoms associated with these tract diseases, such as phlegm, cough, and shortness of breath, difficulty in expectoration is a symptom that is frequently seen in clinical practice, and is especially common in patients with chronic obstructive pulmonary disease, such as chronic bronchitis, bronchial asthma, etc. It is one of the main symptoms of emphysema, etc., along with difficulty in breathing. In the treatment of respiratory diseases, it is very important to remove phlegm, which is likely to cause respiratory failure, respiratory tract infection, etc., and drug therapy and physical therapy are available as expectoration methods for this purpose. Known expectorants used in drug therapy include, for example, iodo salts, benzylamines, enzyme agents, cysteine preparations, and allevert. All of these expectorants act directly or indirectly on the rheological properties of sputum, such as stickiness, stringiness, and thixotropy, but due to the nature of drug administration, side effects are unavoidable, and they are harmful to the human body. often have a negative impact on In addition, there are many cases in which drugs are not sufficient to remove sputum. On the other hand, a paused sputum drainage method (drainage) is known as physical therapy. This treatment involves tilting the patient's entire body or chest so that sputum can be expelled by gravity. In addition, this method makes it easier to expectorate sputum by tapping the chest wall lightly (clapping and tapping) or by vibrating the chest from the outside (vibration). However, while there is less concern about the side effects of the drug therapy,
It has the disadvantage that it is difficult to expectorate enough phlegm. In addition, as a type of physical therapy, 10Hz in the airway
The following method of sending pressure waves directly into the airways and trachea to promote sputum clearance has been proposed, but further improvements are needed. Some of the present inventors have disclosed a completely new physical sputum removal method using a treatment device for improving respiratory function and/or symptoms, which is an electric current therapy device that can generate known frequency waves (Unexamined Japanese Patent Publication No. Publication number 60-31766)
However, the sputum expectoration effect due to interference low-frequency electrical stimulation is
It varies greatly depending on the electrical stimulation conditions and treatment location.
Further extensive research has led to the completion of the present invention. [Object of the Invention] An object of the present invention is to provide a treatment device for more reliably and safely assisting patients with respiratory diseases who have difficulty coughing up sputum. [Structure of the Invention] In order to achieve the above object, the present inventors have investigated conditions and treatment positions that facilitate the expectoration of sputum accumulated in the trachea and bronchi of the chest using interference low-frequency electrical stimulation, and have found an excellent treatment position. By discovering the expectorant effect, we have completed the therapeutic device of the present invention. That is, the present invention includes current generating means for generating two types of carrier wave currents having a medium frequency and a frequency difference of 30 to 150 Hz, and two pairs for energizing each of the second type of carrier wave currents. conductor means, current detection means for detecting the current when energized, current adjustment means for adjusting the current at 6 mA or more when energized, and time setting means for setting the energization time. and the two pairs of conductor means are such that one of the electrodes forming the ends of each pair of conductor means is placed on the chest and the other on the back, and the currents from each pair of conductor means cross each other. The present invention provides an electric treatment device for expectoration in which each of the electrodes is positioned. Hereinafter, the electric treatment device of the present invention will be described in further detail using the drawings as necessary. FIG. 1 is a block diagram schematically showing one example of a preferred embodiment of the electric therapy device of the present invention. In the figure, the current generating means 1 includes a carrier wave oscillator 2, a therapeutic wave oscillator 3, and a phase shifter 4. As another example, two carrier wave oscillators with different frequencies may be used as the current generating means. The medium frequency referred to in the present invention is preferably on the order of 1000Hz, and a specific example is 3000 to 5000Hz.
A range of degrees is used in practice. More specifically, around 4000Hz, the electrical impedance of the human skin is low and it is easy to conduct electricity to the body, and the threshold for electrical shocks (macroshocks) to living organisms is much higher than commercial currents (50 to 60Hz). It is used because it is safe. . It is desirable that the treatment frequency reproduced in this example as the interference low frequency be oscillated within the range of 30Hz to 150Hz.
=4100Hz. This 4100Hz carrier wave and other
A carrier wave of 4000 Hz is outputted from two terminals each through two pairs of conductors 8, and electrical treatment can be performed from four electrodes 9 on a living body. Further, as shown in FIG. 1, the electric therapy device of the present invention includes current detection means 6 for detecting the current flowing through the two pairs of electrodes 9 and current display means 7 for displaying the detected current, and further includes a current display means 7 for displaying the detected current. It has adjustment means 5 including current adjustment means and means for setting energization time. Specific examples of the current adjusting means include means for changing the amplification degree of an output amplifier, means for changing the resistance value of an output resistor, and the like. As illustrated in Figure 2, two locations on the chest of the human body,
The two electrodes on the back are attached so that the A-A' pair and the B-B' pair intersect. From the intersection of A-A' and B-B', an interference low frequency, in this example 100 Hz, is generated in the living body. Surprisingly, this interferometric low-frequency electrical stimulation produced an excellent expectorant aid effect. The mechanism of action is that interferometric low-frequency electrical stimulation increases airway fluid secretion, changes the rheological properties of sputum itself to make it easier to flow, and also improves mucociliary transport speed in the trachea, resulting in improved sputum production as a whole. Animal experiments have shown that it is effective. Therefore, we investigated how to apply this expectorant effect to the human body, considering its effects and disadvantages. The frequency of the interference low frequency is preferably within the range of 30 to 150 Hz based on the results of general modification from the perspective of cutting phlegm, as will be described later. Below 30Hz, the stimulation is too strong and may be uncomfortable in some cases. When the frequency exceeds 150Hz, the expectorant effect decreases. Particularly preferably 50 to 100 Hz. The lower limit of the therapeutic current value needs to be 6 mA or more, since electrical stimulation is not felt much when it is less than 3 mA, and it is difficult to obtain an expectorant effect when it is less than 5 mA. Regarding the upper limit of the treatment current value, the influence of intense electrical stimulation on the human body is more likely to be a problem than the degree of expectorant effect, for example.
At 50 mA or more, the electric stimulation is felt to be quite strong and there is a tendency for muscles etc. to twitch, which is undesirable because it gives the patient a sense of anxiety. The upper limit cannot be generalized due to individual differences, and it is particularly preferable to set the upper limit depending on the user in terms of safety for those using the therapeutic device of the present invention. In addition, for such safety measures, in the expectoration electric therapy device of the present invention, an upper limit of the current during energization is set, and when the energized current becomes higher than the upper limit, the current is automatically reduced. It is desirable to incorporate, for example, into the adjustment means 5 of FIG. 1, excessive current prevention means for stopping the current supply (that is, adjusting the current adjustment means such as the amplifier shown in FIG. 1) or stopping the current supply.
Furthermore, it would be more practically useful if the upper limit of the current could be set according to the suitability of the user. The electrical treatment time can be selected within the range of 5 to 30 minutes. The expectorant effect is thought to be caused by interference low-frequency electrical stimulation via the parasympathetic nervous system and by the above-mentioned mechanism of action, and it has been observed in clinical practice that it lasts from several hours to more than ten hours during treatment. Therefore, the treatment time is preferably within the range of 10 to 20 minutes, which is the time during which the living body can sufficiently receive the electrical stimulation. Electrode pair on the left chest and right back (B-B' pair in Figure 2)
and electrode pairs on the right chest and left back (Fig. 2 A-A' pair)
When two carrier waves of different frequencies, for example 4000Hz and 4100Hz, are energized and treated, an interference wave of 100Hz is generated.
Electrical stimulation produces an expectorant effect. In the case of the apparatus of the embodiment shown in FIG. 1, for example
Means for supplying two carrier waves in the range of 3000 to 5000 Hz and means for oscillating their frequency difference are required, and are configured as a carrier wave oscillator, a therapeutic wave oscillator, a phase shifter, and an output amplifier. Alternatively, it may be constructed from an oscillator and an amplifier that independently oscillate and amplify two carrier waves from the beginning. In either case, means for setting the frequency of the therapeutic wave, that is, the interference low frequency wave, within the range of 30 to 150 Hz, and means for controlling the output current are provided. Additionally, a timer means for setting the energization treatment time is attached. As shown in Figure 2, there are two locations on the chest and two locations on the back.
Adhesive conductive conductors, hydrous sponge conductor fixing bands, and fixtures can be used as means for attaching conductor electrodes to locations. In this way, if the conductor is fixed without relying on the suction force of a vacuum pump, the entire treatment device can be made compact and can be used as a portable device, which is very useful in practice. The present invention will be explained in more detail with reference to Examples below, but the therapeutic device of the present invention is not limited to these Examples in any way. Example 1 A total of 103 patients, 42 men and 61 women, were diagnosed with chronic bronchitis (56 cases), bronchial asthma (19 cases), and bronchiolitis (11 cases).
example), and “difficulty cutting phlegm” such as emphysema (7 cases)
For patients with chronic respiratory diseases who complain of this, we used an interference low-frequency expectorator treatment device, which is an embodiment of the present invention, which is an improved SK manufactured by Minato Medical Science Co., Ltd. that can output up to 150 Hz, and a medium suction sponge conductor electrode. It was attached to the back of the chest and treated at 50, 70, 100 and 150Hz for 10 minutes. The results are shown in Tables 1 and 2. 11 cases (10.7%) had marked improvement (sputum clearance improved by 2 or more levels), and 29 cases (28.1%) moderate improvement (1 level improvement in sputum clearance). %),
Mild improvement (sputum clearance has not improved by one level, but
Other symptoms improved in 40 cases (38.9%).
Therefore, 77.7% of patients showed mild improvement or better, demonstrating excellent expectorant effects.

【table】

【table】

[Table] (B) Patient impression
AA: Very good
A: Good Example 2 A total of 136 patients with chronic bronchitis (29
e.g.), bronchiolitis (20 cases), bronchial asthma (35 cases),
Embodiments of the present invention capable of outputting 50, 70, and 100 Hz for patients with chronic respiratory diseases that make it difficult to cough up sputum, such as bronchiectasis (17 cases), pulmonary tuberculosis (8 cases), and emphysema (14 cases) Using an interference low-frequency expectorant treatment device, an adhesive guide was attached to the back of the chest and treatment was performed at 70Hz for 10 minutes.
The treatment current value is within the range of 3 to 24 mA, and the average
It was 13.6±2.8 (standard deviation) mA. The results are shown in Table 3. Significant improvement was observed in 13 patients (15.5%) in group I disease and 2 patients (3.6%) in group I disease, for a total of 15 patients (11.0%). Moderate improvement was achieved in 29 patients (34.5%) in the group and 7 patients (13.5%) in the group, for a total of 36 patients (26.5%).
%). Mild improvement occurred in 28 patients (33.3%) in the group;
There were 12 patients (23.1%) in the group, and a total of 40 patients (29.4%). Therefore, 83.3% of the groups showed mild improvement or better, and 40.4% of the groups showed excellent expectorant effects in a total of 68.9%. .
In particular, it was shown to be as effective as or more effective than expectorants against certain diseases. Furthermore, the relationship between the treatment current value and the degree of improvement is shown in Fig. 3, and it can be seen that the effect is expressed at 6 mA or more. Regarding the current value of approximately 24 mA, although the number of cases was small, it was confirmed that it is effective.

〔Effect of the invention〕

As shown in the examples, the expectorant electric therapy device of the present invention can exhibit an expectorant effect equal to or higher than that of an expectorant. In some cases, side effects such as remission of cough and remission of respiratory muscle fatigue may be obtained. That is, the therapeutic device of the present invention safely and reliably provides expectoration assistance to patients with chronic respiratory diseases who have difficulty coughing up sputum, and is of great benefit to medical care and the medical industry.

[Brief explanation of the drawing]

FIG. 1 is a block diagram of the treatment device of the present invention.
FIG. 2 shows an example of the mounting position of the conductor electrode. FIG. 3 shows the relationship between the degree of overall improvement and the therapeutic current value.

Claims (1)

[Claims] 1. Has a medium frequency and has a frequency difference of 30 to 150 Hz.
current generating means for generating two types of carrier wave currents, two pairs of conductor means for passing each of the two types of carrier wave currents, and current detecting means for detecting the current when energized. And the current when the current is applied is
It has a current adjustment means for adjusting the current to 6mA or more, and a time setting means for setting the energization time,
The two pairs of conductor means are arranged such that the electrodes forming the ends of each pair of conductor means are placed one on the chest and the other on the back and such that the currents from each pair of conductor means cross each other. An electric treatment device for expectoration that positions each of the above. 2. The current generating means has a frequency difference of 50 to 100 Hz.
2. The expectorant electric therapy device according to claim 1, which generates a carrier wave current of a certain amount. 3. Claim 1, wherein the time setting means is capable of setting the energization time within a range of 5 to 30 minutes.
Electrotherapeutic device for expectoration as described in section. 4. The expectorant electric therapy device according to claim 1, which is equipped with excessive current prevention means that reduces or stops the applied current when the current detection means detects a current that exceeds the upper limit of the current when applied. . 5. The expectorant electric therapy device according to claim 4, wherein the excessive current prevention means has means for setting an upper limit of the current at the time of the overcurrent.