電療是什么(me) 電療的療法(fa)與(yu)作(zuo)用

簡介

electrotherapy （參考另一(yi)個說法(fa)：electro-convulsive therapyorelectroconvulsive therapy, 即(ji)電(dian)(dian)(dian)(dian)(dian)痙攣療(liao)(liao)(liao)法(fa)，簡稱電(dian)(dian)(dian)(dian)(dian)療(liao)(liao)(liao)或(huo) ECT)利用(yong)不(bu)同類(lei)型(xing)電(dian)(dian)(dian)(dian)(dian)流(liu)(liu)和電(dian)(dian)(dian)(dian)(dian)磁(ci)場(chang)治(zhi)(zhi)療(liao)(liao)(liao)疾病的(de)方法(fa)。物(wu)理治(zhi)(zhi)療(liao)(liao)(liao)方法(fa)中最常(chang)(chang)用(yong)的(de)方法(fa)之一(yi)。主(zhu)要有直(zhi)流(liu)(liu)電(dian)(dian)(dian)(dian)(dian)療(liao)(liao)(liao)法(fa)、直(zhi)流(liu)(liu)電(dian)(dian)(dian)(dian)(dian)藥物(wu)離子導入療(liao)(liao)(liao)法(fa)、低(di)頻(pin)脈沖電(dian)(dian)(dian)(dian)(dian)療(liao)(liao)(liao)法(fa)、中頻(pin)脈沖電(dian)(dian)(dian)(dian)(dian)療(liao)(liao)(liao)法(fa)、高頻(pin)電(dian)(dian)(dian)(dian)(dian)療(liao)(liao)(liao)法(fa)、靜(jing)(jing)電(dian)(dian)(dian)(dian)(dian)療(liao)(liao)(liao)法(fa) 。不(bu)同類(lei)型(xing)電(dian)(dian)(dian)(dian)(dian) 流(liu)(liu)對人體(ti)主(zhu)要生(sheng)理作用(yong)不(bu)同。直(zhi)流(liu)(liu)電(dian)(dian)(dian)(dian)(dian)是(shi)方向恒定的(de)電(dian)(dian)(dian)(dian)(dian)流(liu)(liu)，可(ke)改變體(ti)內(nei)離子分(fen)布，調(diao)整機體(ti)功(gong)能(neng)，常(chang)(chang)用(yong)來作藥物(wu)離子導入；低(di)、中頻(pin)電(dian)(dian)(dian)(dian)(dian)流(liu)(liu)刺激神經(jing)(jing)肌肉(rou)收縮，降低(di)痛閾，緩解粘連(lian)，常(chang)(chang)用(yong)于神經(jing)(jing)肌肉(rou)疾病，如損傷(shang)、炎癥(zheng)等；高頻(pin)電(dian)(dian)(dian)(dian)(dian)以其對人體(ti)的(de)熱(re)效(xiao)應和熱(re)外效(xiao)促進循環，消退炎癥(zheng)和水腫，刺激組織再生(sheng)，止(zhi)痛，常(chang)(chang)用(yong)以治(zhi)(zhi)療(liao)(liao)(liao)損傷(shang)、炎癥(zheng)疼痛癥(zheng)候(hou)群，大功(gong)率高頻(pin)電(dian)(dian)(dian)(dian)(dian)可(ke)用(yong)于加(jia)溫(wen)治(zhi)(zhi)癌；靜(jing)(jing)電(dian)(dian)(dian)(dian)(dian)主(zhu)要作用(yong)是(shi)調(diao)節(jie)中樞神經(jing)(jing)和植物(wu)功(gong)能(neng)，常(chang)(chang)用(yong)于神經(jing)(jing)官能(neng)癥(zheng)、高血壓(ya)早期(qi)、更(geng)年期(qi)癥(zheng)候(hou)群。

治療原理

電(dian)(dian)磁(ci)療(liao)(liao)(liao)(liao)(liao)法(fa)的一類，利用(yong)(yong)電(dian)(dian)能作(zuo)用(yong)(yong)于(yu)人體以防治疾病的方(fang)法(fa)。常用(yong)(yong)的電(dian)(dian)能有直流(liu)電(dian)(dian)、交流(liu)電(dian)(dian)和靜電(dian)(dian)三(san)類。臨床上(shang)應用(yong)(yong)的電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)方(fang)法(fa)有：直流(liu)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)（包(bao)括(kuo)電(dian)(dian)水浴療(liao)(liao)(liao)(liao)(liao)法(fa)、直流(liu)電(dian)(dian)離子導(dao)入(ru)療(liao)(liao)(liao)(liao)(liao)法(fa)），低(di)頻脈沖電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)（包(bao)括(kuo)感應電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)、電(dian)(dian)興奮療(liao)(liao)(liao)(liao)(liao)法(fa)、電(dian)(dian)睡眠療(liao)(liao)(liao)(liao)(liao)法(fa)、超強電(dian)(dian)刺激療(liao)(liao)(liao)(liao)(liao)法(fa)、經(jing)皮電(dian)(dian)刺激療(liao)(liao)(liao)(liao)(liao)法(fa)、間動電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)等(deng)），中頻電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)（包(bao)括(kuo)等(deng)幅中頻正弦(xian)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)、調(diao)制(zhi)中頻正弦(xian)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)、干(gan)擾電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)等(deng)),高頻電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)（包(bao)括(kuo)長波(bo)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)、中波(bo)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)、短波(bo)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)、超短波(bo)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)、微波(bo)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)及毫米(mi)波(bo)電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)）和靜電(dian)(dian)療(liao)(liao)(liao)(liao)(liao)法(fa)。

人體(ti)(ti)(ti)內除含大量水分，還有(you)很多能(neng)(neng)導(dao)電(dian)(dian)(dian)(dian)的(de)(de)(de)(de)電(dian)(dian)(dian)(dian)解(jie)質(zhi)和(he)非導(dao)電(dian)(dian)(dian)(dian)的(de)(de)(de)(de)電(dian)(dian)(dian)(dian)介質(zhi)，因此(ci)人的(de)(de)(de)(de)機(ji)體(ti)(ti)(ti)實際上(shang)是(shi)一(yi)個既有(you)電(dian)(dian)(dian)(dian)阻又有(you)電(dian)(dian)(dian)(dian)容性(xing)質(zhi)的(de)(de)(de)(de)復雜導(dao)體(ti)(ti)(ti)，這是(shi)電(dian)(dian)(dian)(dian)療的(de)(de)(de)(de)物(wu)質(zhi)基礎。電(dian)(dian)(dian)(dian)能(neng)(neng)作(zuo)用(yong)于(yu)人體(ti)(ti)(ti)引起(qi)體(ti)(ti)(ti)內的(de)(de)(de)(de)理化(hua)反應(ying)(ying)(ying)(ying)，并通過神經－體(ti)(ti)(ti)液作(zuo)用(yong)，影(ying)響(xiang)組(zu)織(zhi)和(he)器官(guan)的(de)(de)(de)(de)功(gong)能(neng)(neng)，達到消除病(bing)(bing)因、調節功(gong)能(neng)(neng)、提高代(dai)謝、增(zeng)強(qiang)免疫、促進病(bing)(bing)損組(zu)織(zhi)修復和(he)再(zai)生(sheng)的(de)(de)(de)(de)目(mu)的(de)(de)(de)(de)。機(ji)體(ti)(ti)(ti)對不(bu)同(tong)(tong)性(xing)質(zhi)的(de)(de)(de)(de)電(dian)(dian)(dian)(dian)流(liu)(liu)(liu)反應(ying)(ying)(ying)(ying)不(bu)一(yi)，治(zhi)療機(ji)理亦異。低頻(pin)電(dian)(dian)(dian)(dian)流(liu)(liu)(liu)可改(gai)變(bian)神經和(he)肌肉細胞的(de)(de)(de)(de)膜電(dian)(dian)(dian)(dian)位，使(shi)之(zhi)興奮而產(chan)生(sheng)收縮；低頻(pin)調制(zhi)的(de)(de)(de)(de)中(zhong)頻(pin)電(dian)(dian)(dian)(dian)流(liu)(liu)(liu)可使(shi)感覺神經的(de)(de)(de)(de)粗纖維(wei)興奮，抑(yi)制(zhi)細纖維(wei)沖動(dong)的(de)(de)(de)(de)傳入，因此(ci)鎮痛(tong)作(zuo)用(yong)較(jiao)強(qiang)；高頻(pin)電(dian)(dian)(dian)(dian)流(liu)(liu)(liu)對機(ji)體(ti)(ti)(ti)組(zu)織(zhi)產(chan)生(sheng)熱效應(ying)(ying)(ying)(ying)和(he)非熱效應(ying)(ying)(ying)(ying)，從而達到治(zhi)療目(mu)的(de)(de)(de)(de)。同(tong)(tong)種電(dian)(dian)(dian)(dian)流(liu)(liu)(liu)在(zai)使(shi)用(yong)方法和(he)劑量大小不(bu)同(tong)(tong)時，引起(qi)人體(ti)(ti)(ti)的(de)(de)(de)(de)反應(ying)(ying)(ying)(ying)也有(you)差異。此(ci)外人體(ti)(ti)(ti)的(de)(de)(de)(de)不(bu)同(tong)(tong)器官(guan)和(he)組(zu)織(zhi)、不(bu)同(tong)(tong)的(de)(de)(de)(de)功(gong)能(neng)(neng)狀態和(he)病(bing)(bing)理改(gai)變(bian)，對電(dian)(dian)(dian)(dian)流(liu)(liu)(liu)的(de)(de)(de)(de)反應(ying)(ying)(ying)(ying)也不(bu)盡(jin)相同(tong)(tong)。低、中(zhong)頻(pin)電(dian)(dian)(dian)(dian)流(liu)(liu)(liu)還可用(yong)以判斷神經肌肉的(de)(de)(de)(de)運動(dong)功(gong)能(neng)(neng)，用(yong)以診(zhen)斷周圍神經病(bing)(bing)損程度(du)。故在(zai)康(kang)復醫學中(zhong)低、中(zhong)頻(pin)電(dian)(dian)(dian)(dian)流(liu)(liu)(liu)用(yong)來作(zuo)重(zhong)要的(de)(de)(de)(de)治(zhi)療和(he)功(gong)能(neng)(neng)評定的(de)(de)(de)(de)手段(duan)。

種類

直流電療法

直流電(dian)(dian)(dian)方(fang)向(xiang)恒定，強度(du)不(bu)隨時(shi)間變(bian)化(hua)。理療用(yong)(yong)的(de)(de)直流電(dian)(dian)(dian)電(dian)(dian)(dian)壓一(yi)般(ban)在 50～80V，電(dian)(dian)(dian)流強度(du)0.05～0.1mA/cm2。當直流電(dian)(dian)(dian)作(zuo)(zuo)用(yong)(yong)于人(ren)體(ti)(ti)(ti)時(shi),體(ti)(ti)(ti)液(ye)(ye)中電(dian)(dian)(dian)解質發生電(dian)(dian)(dian)解作(zuo)(zuo)用(yong)(yong)，產生正(zheng)、負離(li)(li)子(zi)，正(zheng)、負離(li)(li)子(zi)各(ge)向(xiang)其極(ji)(ji)性(xing)相(xiang)反的(de)(de)電(dian)(dian)(dian)極(ji)(ji)移動。與(yu)此(ci)同時(shi)膠體(ti)(ti)(ti)液(ye)(ye)中的(de)(de)荷(he)電(dian)(dian)(dian)膠粒(分散(san)質)向(xiang)一(yi)極(ji)(ji)移動稱為電(dian)(dian)(dian)泳；水分子(zi)（分散(san)媒(mei)）向(xiang)另一(yi)極(ji)(ji)移動稱電(dian)(dian)(dian)滲。處(chu)于直流電(dian)(dian)(dian)正(zheng)極(ji)(ji)作(zuo)(zuo)用(yong)(yong)下(xia)(xia)的(de)(de)組織(zhi)內(nei)(nei)部將(jiang)發生下(xia)(xia)述變(bian)化(hua)：由于Ca2 ，Mg2 等(deng)兩(liang)價離(li)(li)子(zi)向(xiang)負極(ji)(ji)移動的(de)(de)速(su)度(du)比(bi)K ，Na 等(deng)1價離(li)(li)子(zi)慢，因(yin)而(er)前者(zhe)在正(zheng)極(ji)(ji)附(fu)近(jin)的(de)(de)相(xiang)對濃(nong)度(du)較(jiao)大(da)(da)。Ca2 ，Mg2 等(deng)兩(liang)價離(li)(li)子(zi)有降(jiang)低組織(zhi)興奮(fen)(fen)的(de)(de)作(zuo)(zuo)用(yong)(yong)，對正(zheng)極(ji)(ji)下(xia)(xia)的(de)(de)機體(ti)(ti)(ti)鎮(zhen)靜作(zuo)(zuo)用(yong)(yong)。CL-在正(zheng)極(ji)(ji)附(fu)近(jin)濃(nong)度(du)較(jiao)大(da)(da),與(yu)H 化(hua)合成(cheng)HCl,使該(gai)處(chu)組織(zhi)液(ye)(ye)呈酸性(xing)。人(ren)體(ti)(ti)(ti)細胞(bao)膜(mo)的(de)(de)構成(cheng)蛋白質都荷(he)負電(dian)(dian)(dian)，在正(zheng)極(ji)(ji)作(zuo)(zuo)用(yong)(yong)下(xia)(xia)負電(dian)(dian)(dian)荷(he)消失，相(xiang)互間排(pai)斥力減弱，距離(li)(li)減小(xiao)而(er)密(mi)集，同時(shi)因(yin)電(dian)(dian)(dian)滲作(zuo)(zuo)用(yong)(yong)使局部組織(zhi)含水量(liang)下(xia)(xia)降(jiang)，故膜(mo)的(de)(de)通透性(xing)降(jiang)低。處(chu)于直流電(dian)(dian)(dian)負極(ji)(ji)作(zuo)(zuo)用(yong)(yong)下(xia)(xia)的(de)(de)組織(zhi)內(nei)(nei)部將(jiang)發生如下(xia)(xia)變(bian)化(hua)：K ，Na 等(deng)1價離(li)(li)子(zi)濃(nong)度(du)相(xiang)對較(jiao)大(da)(da)，增強該(gai)處(chu)機體(ti)(ti)(ti)組織(zhi)的(de)(de)興奮(fen)(fen)狀態。Na 移至負極(ji)(ji)下(xia)(xia)與(yu)OH-化(hua)合成(cheng)NaOH,使組織(zhi)液(ye)(ye)呈堿性(xing)。細胞(bao)膜(mo)蛋白質電(dian)(dian)(dian)荷(he)增強,排(pai)斥力提(ti)高，細胞(bao)膜(mo)距離(li)(li)增大(da)(da)而(er)分散(san)，同時(shi)因(yin)組織(zhi)內(nei)(nei)含水量(liang)增加(jia)，故細胞(bao)膜(mo)的(de)(de)通透性(xing)提(ti)高。

直流電正、負極下組織(zhi)內發生的理化(hua)變化(hua)，有調整神(shen)經的興奮性，改善局(ju)部水(shui)腫(zhong)或脫水(shui)現象，促(cu)進血液(ye)循環和代(dai)謝(xie)功能(neng)(neng)的作用。并可通過分節(jie)反射，改善內臟的活動功能(neng)(neng)。臨床上常用直流電來鎮痛、止癢、軟化(hua)瘢痕、消腫(zhong)、促(cu)進組織(zhi)再生，改善中樞和周圍神(shen)經功能(neng)(neng)等。

直流(liu)電(dian)(dian)(dian)(dian)還(huan)(huan)能將藥(yao)(yao)物(wu)離(li)子(zi)導(dao)(dao)入人(ren)體(ti),達(da)到(dao)治(zhi)療目的(de)(de),這(zhe)稱直流(liu)電(dian)(dian)(dian)(dian)離(li)子(zi)導(dao)(dao)入療法。它是利用(yong)電(dian)(dian)(dian)(dian)荷同性相斥的(de)(de)原理，將藥(yao)(yao)物(wu)離(li)子(zi)或荷電(dian)(dian)(dian)(dian)微(wei)粒經皮膚汗腺(xian)導(dao)(dao)入人(ren)體(ti)。此法綜(zong)合利用(yong)直流(liu)電(dian)(dian)(dian)(dian)和藥(yao)(yao)物(wu)兩者(zhe)的(de)(de)治(zhi)療作(zuo)(zuo)用(yong)，臨(lin)床上(shang)應用(yong)較多。藥(yao)(yao)物(wu)導(dao)(dao)入量(liang)取決于電(dian)(dian)(dian)(dian)量(liang)大小(xiao)、藥(yao)(yao)物(wu)濃(nong)度、電(dian)(dian)(dian)(dian)極面積和通(tong)電(dian)(dian)(dian)(dian)時間(jian)。通(tong)電(dian)(dian)(dian)(dian)時間(jian)過(guo)(guo)(guo)長，則(ze)局部(bu)(bu)組織(zhi)內離(li)子(zi)堆(dui)積而(er)產生(sheng)極化現象，使(shi)導(dao)(dao)入量(liang)明顯減(jian)少，故臨(lin)床上(shang)一般通(tong)電(dian)(dian)(dian)(dian)20～30分鐘。導(dao)(dao)入的(de)(de)藥(yao)(yao)物(wu)不但可(ke)(ke)對局部(bu)(bu)組織(zhi)起作(zuo)(zuo)用(yong)，還(huan)(huan)可(ke)(ke)通(tong)過(guo)(guo)(guo)體(ti)液循(xun)環(huan)把(ba)藥(yao)(yao)物(wu)送到(dao)遠隔(ge)器(qi)官(guan)起治(zhi)療作(zuo)(zuo)用(yong)。離(li)子(zi)導(dao)(dao)入除采用(yong)直流(liu)電(dian)(dian)(dian)(dian)外，還(huan)(huan)可(ke)(ke)利用(yong)單(dan)向低頻脈沖電(dian)(dian)(dian)(dian)流(liu)或半波正弦中頻電(dian)(dian)(dian)(dian)流(liu)。導(dao)(dao)入藥(yao)(yao)物(wu)因病而(er)異，急性化膿性炎癥可(ke)(ke)用(yong)抗生(sheng)素(su)類(lei)，過(guo)(guo)(guo)敏(min)性疾(ji)病用(yong)脫(tuo)敏(min)藥(yao)(yao)物(wu)，風濕性病則(ze)用(yong)水楊酸類(lei)藥(yao)(yao)物(wu)。

低頻脈沖電療法

采(cai)用頻(pin)率在1kHz以(yi)下的低頻(pin)脈(mo)(mo)沖電(dian)流。這(zhe)種電(dian)流在人體內(nei)可引起離子和(he)荷電(dian)微粒的迅速移動，因而對感覺神(shen)經(jing)和(he)運動神(shen)經(jing)有明顯的刺激作用。低頻(pin)脈(mo)(mo)沖電(dian)流因波(bo)(bo)形不同，可分為(wei)方波(bo)(bo)、梯形波(bo)(bo)、指數曲(qu)線形波(bo)(bo)、三角波(bo)(bo)和(he)正(zheng)弦波(bo)(bo)等。根據臨(lin)床治療(liao)需要，可調整脈(mo)(mo)沖周期，脈(mo)(mo)沖寬度和(he)升、降波(bo)(bo)時(shi)間。有時(shi)以(yi)更低頻(pin)率的脈(mo)(mo)沖波(bo)(bo)去調制上述(shu)低頻(pin)脈(mo)(mo)沖，這(zhe)種波(bo)(bo)稱低頻(pin)調制波(bo)(bo)。

作用

臨床上低(di)頻脈沖電療法主要應用于下(xia)述兩方(fang)面：

①用(yong)(yong)以(yi)刺(ci)(ci)激(ji)神經(jing)肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)，引起肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)收(shou)縮(suo)，肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)收(shou)縮(suo)能促(cu)進(jin)動脈供血(xue)、靜脈和淋巴回流，改善局部(bu)營養代謝，消退水腫(zhong)，還(huan)(huan)可(ke)提(ti)高肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)張(zhang)力，防止或(huo)延緩肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)萎縮(suo)過程；節律(lv)地(di)刺(ci)(ci)激(ji)神經(jing)肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)，可(ke)使肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)節律(lv)性(xing)收(shou)縮(suo)，用(yong)(yong)以(yi)防止由(you)于(yu)損傷或(huo)炎癥造成的(de)肌(ji)(ji)(ji)纖維和肌(ji)(ji)(ji)膜間(jian)(jian)、肌(ji)(ji)(ji)束之間(jian)(jian)的(de)粘連，保持肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)彈性(xing)，防止攣縮(suo)。此外，電(dian)刺(ci)(ci)激(ji)還(huan)(huan)可(ke)促(cu)進(jin)病損神經(jing)纖維的(de)再生(sheng)。 低頻脈沖(chong)電(dian)可(ke)用(yong)(yong)于(yu)強(qiang)度/時間(jian)(jian)曲(qu)線測定，以(yi)判(pan)斷肌(ji)(ji)(ji)肉(rou)(rou)(rou)(rou)失神經(jing)支配的(de)程度，并選(xuan)擇最(zui)佳治(zhi)療用(yong)(yong)脈沖(chong)參(can)數，以(yi)提(ti)高治(zhi)療效果。低頻脈沖(chong)電(dian)刺(ci)(ci)激(ji)療法還(huan)(huan)可(ke)治(zhi)療上運動神經(jing)元疾患所引起的(de)痙(jing)攣性(xing)癱，此法是(shi)利(li)用(yong)(yong)兩組低頻脈沖(chong)電(dian)流，交替刺(ci)(ci)激(ji)痙(jing)攣肌(ji)(ji)(ji)及其拮抗肌(ji)(ji)(ji)，利(li)用(yong)(yong)交互抑制的(de)反應使痙(jing)攣緩解(jie)。

②用于止(zhi)痛：主要采用超刺激電(dian)(dian)療(liao)法（用超出一(yi)般劑量的(de)電(dian)(dian)流強度的(de)低頻(pin)脈(mo)(mo)沖(chong)電(dian)(dian)療(liao)法）和經皮(pi)電(dian)(dian)刺激神(shen)經療(liao)法(TENS)。低頻(pin)電(dian)(dian)脈(mo)(mo)沖(chong)止(zhi)痛機理有兩種可能(neng)。其一(yi)，是低頻(pin)脈(mo)(mo)沖(chong)電(dian)(dian)阻抑止(zhi)了痛覺神(shen)經向中(zhong)樞傳遞沖(chong)動(dong)，但具體阻抑在(zai)何部(bu)位意見不一(yi)；有人認為在(zai)感覺神(shen)經纖維(wei)，有人認為在(zai)脊髓后角(jiao)細胞，也有認為在(zai)大(da)腦皮(pi)質的(de)感覺中(zhong)樞。其二(er)，是低頻(pin)脈(mo)(mo)沖(chong)電(dian)(dian)促進(jin)局部(bu)血液循環，消(xiao)散局部(bu)的(de)致痛物質，改善(shan)組織代謝功(gong)能(neng)，因(yin)而(er)起到止(zhi)痛效果(guo)。

治療效果

臨(lin)床常用低頻脈沖電(dian)流治療(liao)周圍神(shen)經疾(ji)病、各(ge)種肌肉萎縮、肢體血液及淋巴回流障礙、中樞神(shen)經功能失調、以及疼痛癥候群等。

中頻電療法

采(cai)(cai)用(yong)(yong)(yong)(yong)頻(pin)(pin)(pin)(pin)(pin)率為(wei)(wei)1～100kHz的(de)中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)正(zheng)弦(xian)(xian)(xian)電(dian)(dian)(dian)(dian)流(liu)。臨(lin)床上(shang)常用(yong)(yong)(yong)(yong)頻(pin)(pin)(pin)(pin)(pin)率為(wei)(wei)2～5kHz,常用(yong)(yong)(yong)(yong)方法(fa)(fa)有(you)等幅(fu)中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)正(zheng)弦(xian)(xian)(xian)電(dian)(dian)(dian)(dian)療(liao)(liao)法(fa)(fa)、調幅(fu)中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)正(zheng)弦(xian)(xian)(xian)電(dian)(dian)(dian)(dian)療(liao)(liao)法(fa)(fa)和干(gan)擾電(dian)(dian)(dian)(dian)療(liao)(liao)法(fa)(fa)三種(zhong)。調制(zhi)(zhi)波(bo)(bo)頻(pin)(pin)(pin)(pin)(pin)率為(wei)(wei)10～200Hz,可(ke)采(cai)(cai)用(yong)(yong)(yong)(yong)全波(bo)(bo)或半波(bo)(bo)，連(lian)續調制(zhi)(zhi)或間(jian)斷(duan)調制(zhi)(zhi)，還可(ke)采(cai)(cai)用(yong)(yong)(yong)(yong)等幅(fu)波(bo)(bo)和調制(zhi)(zhi)波(bo)(bo)交替(ti)出現，或頻(pin)(pin)(pin)(pin)(pin)率交變的(de)調制(zhi)(zhi)波(bo)(bo)。調制(zhi)(zhi)中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)電(dian)(dian)(dian)(dian)流(liu)兼(jian)有(you)低、中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)電(dian)(dian)(dian)(dian)流(liu)的(de)特(te)點，用(yong)(yong)(yong)(yong)于止痛或促進血液循環，較低、中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)電(dian)(dian)(dian)(dian)單(dan)獨應(ying)用(yong)(yong)(yong)(yong)作用(yong)(yong)(yong)(yong)明顯；用(yong)(yong)(yong)(yong)于神經(jing)肌肉刺(ci)(ci)激(ji)時，由于皮膚刺(ci)(ci)痛小(xiao)，病(bing)人(ren)可(ke)耐受(shou)較大電(dian)(dian)(dian)(dian)量。干(gan)擾電(dian)(dian)(dian)(dian)是利用(yong)(yong)(yong)(yong)兩組(zu)(zu)頻(pin)(pin)(pin)(pin)(pin)率相差(cha)0～100Hz的(de)等幅(fu)中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)正(zheng)弦(xian)(xian)(xian)電(dian)(dian)(dian)(dian)流(liu)（臨(lin)床多用(yong)(yong)(yong)(yong)5±0.1kHz）,交叉(cha)輸(shu)入(ru)人(ren)體同一(yi)部(bu)位。在交叉(cha)部(bu)形(xing)成干(gan)擾電(dian)(dian)(dian)(dian)場(chang)，在體內按正(zheng)弦(xian)(xian)(xian)電(dian)(dian)(dian)(dian)波(bo)(bo)的(de)差(cha)拍原理(li)產生(sheng)0～100Hz的(de)低頻(pin)(pin)(pin)(pin)(pin)調制(zhi)(zhi)中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)電(dian)(dian)(dian)(dian)流(liu)。臨(lin)床上(shang)利用(yong)(yong)(yong)(yong) 3組(zu)(zu)等幅(fu)中(zhong)(zhong)(zhong)頻(pin)(pin)(pin)(pin)(pin)正(zheng)弦(xian)(xian)(xian)電(dian)(dian)(dian)(dian)流(liu)，從三維空間(jian)交叉(cha)輸(shu)入(ru)人(ren)體，形(xing)成立體干(gan)擾電(dian)(dian)(dian)(dian)場(chang)，其(qi)效果優于一(yi)般干(gan)擾電(dian)(dian)(dian)(dian)場(chang)。經(jing)改(gai)(gai)進后，采(cai)(cai)用(yong)(yong)(yong)(yong)3組(zu)(zu)強(qiang)度(du)交替(ti)改(gai)(gai)變的(de)正(zheng)弦(xian)(xian)(xian)電(dian)(dian)(dian)(dian)流(liu),使局(ju)部(bu)的(de)刺(ci)(ci)激(ji)作用(yong)(yong)(yong)(yong)更(geng)易為(wei)(wei)病(bing)人(ren)忍受(shou)，進一(yi)步提高(gao)治療(liao)(liao)效果，此方法(fa)(fa)稱為(wei)(wei)動(dong)態立體干(gan)擾電(dian)(dian)(dian)(dian)療(liao)(liao)法(fa)(fa)。

特點

①中(zhong)頻正弦(xian)電流不(bu)產生電解(jie)作(zuo)用，不(bu)引(yin)起組織的化學損傷(shang)；

②頻(pin)率(lv)高，組織阻抗小，可(ke)使(shi)用(yong)較大電流量；

③對(dui)感覺神經刺激較小，病人易于(yu)接受。

主要治療作用

①鎮痛：以正弦(xian)調制中頻(pin)電流最佳(jia)，對因急性(xing)軟組織(zhi)損傷造(zao)成的疼痛效(xiao)果較好(hao)；

②刺(ci)(ci)激肌肉收縮：以動態立體干擾電場效果最佳，疼痛(tong)刺(ci)(ci)激小,作用深入(ru),病人易于接(jie)受；

③促進血液循環,改善(shan)營養代謝；

④促進淋(lin)巴和靜脈回流(liu);⑤軟化瘢痕，松(song)解(jie)粘連。

治療效果

臨床(chuang)上(shang)常用(yong)中(zhong)頻電流治療軟組(zu)織損傷(shang)、神經炎、痛(tong)經、肢體循環障礙,周圍神經損傷(shang)引起的肌(ji)肉麻痹(bi),胃(wei)腸及膀胱平滑肌(ji)無(wu)力等。患急(ji)性化(hua)膿性炎癥者(zhe)、孕婦、血栓性靜脈炎患者(zhe)、安裝起搏器(qi)者(zhe)禁用(yong)。

高頻電療法

采用(yong)(yong)頻率為100kHz以(yi)(yi)上(shang)的高(gao)頻正弦(xian)電(dian)(dian)流(liu)(liu)，內(nei)(nei)生熱(re)是高(gao)頻電(dian)(dian)流(liu)(liu)對(dui)人體作(zuo)用(yong)(yong)的重(zhong)要基礎。高(gao)頻電(dian)(dian)場(chang)在人體組織(zhi)(zhi)內(nei)(nei)產生熱(re)的機理(li)與直(zhi)流(liu)(liu)電(dian)(dian)（或低頻電(dian)(dian)）由歐姆耗(hao)損產生熱(re)的機理(li)不一(yi)樣，人體組織(zhi)(zhi)在高(gao)頻電(dian)(dian)場(chang)作(zuo)用(yong)(yong)下，組織(zhi)(zhi)內(nei)(nei)電(dian)(dian)解(jie)質離子(zi)隨著高(gao)頻電(dian)(dian)場(chang)極性(xing)交變幾乎在原(yuan)位振動，振動時克服阻力(li)而生熱(re)。組織(zhi)(zhi)內(nei)(nei)的電(dian)(dian)介(jie)質具有等量電(dian)(dian)荷，以(yi)(yi)非極性(xing)分子(zi)和極性(xing)分子(zi)狀態存(cun)在。

特點

在高(gao)頻電場作(zuo)(zuo)用下，非(fei)極性分子(zi)極化形成(cheng)極性分子(zi)，與(yu)(yu)原有的極性分子(zi)一起隨電場交變而(er)急(ji)速轉動，在運動中(zhong)克服(fu)周圍(wei)阻(zu)力而(er)生熱。熱量大小與(yu)(yu)組(zu)織(zhi)(zhi)所受電磁場強度有關。組(zu)織(zhi)(zhi)受熱后可以(yi)促(cu)進局部血(xue)液循環，改(gai)善組(zu)織(zhi)(zhi)營(ying)養代(dai)謝，刺(ci)激組(zu)織(zhi)(zhi)再生，消退炎(yan)癥(zheng)，還可降低周圍(wei)神(shen)經興奮而(er)止痛(tong)，并(bing)可通(tong)過神(shen)經反射作(zuo)(zuo)用，調(diao)節中(zhong)樞神(shen)經功能(neng)和免疫(yi)系統功能(neng)。除(chu)熱效應外(wai)，高(gao)頻電尚有非(fei)熱效果，但研究尚不夠深入。高(gao)頻電療(liao)常(chang)用的方法(fa)有短波(bo)療(liao)法(fa)、超短波(bo)療(liao)法(fa)和微波(bo)療(liao)法(fa)。一種新的高(gao)頻電療(liao)法(fa)──毫米波(bo)療(liao)法(fa)已開始用于臨床。毫米波(bo)的頻率與(yu)(yu)人(ren)體(ti)組(zu)織(zhi)(zhi)細(xi)胞的固有振動頻率相近，通(tong)過諧振將(jiang)能(neng)量傳給(gei)人(ren)體(ti)組(zu)織(zhi)(zhi)，達到治療(liao)目的，這與(yu)(yu)上述方法(fa)的作(zuo)(zuo)用機理(li)不同。

應用

高頻(pin)(pin)電流臨(lin)床應用(yong)(yong)(yong)很廣，多用(yong)(yong)(yong)于(yu)急、慢性(xing)化膿性(xing)和(he)非化膿性(xing)炎癥、軟組織損傷、神(shen)經痛(tong)、神(shen)經損傷、風濕和(he)類風濕性(xing)關(guan)節(jie)(jie)炎、關(guan)節(jie)(jie)周(zhou)圍(wei)炎、急性(xing)腎功能衰(shuai)竭等。禁忌(ji)癥主要(yao)有活動性(xing)肺結核、出血、心(xin)力衰(shuai)竭、惡病質等。也可(ke)利用(yong)(yong)(yong)短波和(he)微波的熱效應治療(liao)惡性(xing)腫(zhong)瘤(liu)(liu)，瘤(liu)(liu)內血流量(liang)小于(yu)正常組織易于(yu)大(da)量(liang)積熱,故高頻(pin)(pin)電可(ke)使瘤(liu)(liu)內溫度(du)高于(yu)周(zhou)圍(wei)組織,達(da)42℃以上(shang)，這對(dui)腫(zhong)瘤(liu)(liu)細(xi)胞(bao)有明顯的殺傷作用(yong)(yong)(yong)。這種(zhong)療(liao)法稱(cheng)射(she)頻(pin)(pin)加溫治癌(ai)療(liao)法或微波加溫治癌(ai)療(liao)法。

靜電療法

利用(yong)(yong)靜(jing)電(dian)(dian)(dian)電(dian)(dian)(dian)場對人體(ti)的(de)作(zuo)用(yong)(yong)。常用(yong)(yong)電(dian)(dian)(dian)子(zi)(zi)管(guan)式靜(jing)電(dian)(dian)(dian)機，輸出兩極間(jian)的(de)高(gao)壓可高(gao)達50kV，為(wei)阻(zu)(zu)止短路危險，在輸出電(dian)(dian)(dian)路中(zhong)串聯高(gao)阻(zu)(zu)值(zhi)保護(hu)電(dian)(dian)(dian)阻(zu)(zu)，使短路電(dian)(dian)(dian)流在1mA以下。由于(yu)靜(jing)電(dian)(dian)(dian)電(dian)(dian)(dian)場方向(xiang)恒定,體(ti)內(nei)離子(zi)(zi)或(huo)有極性分子(zi)(zi)定向(xiang)移(yi)動，因(yin)而引起體(ti)內(nei)一(yi)(yi)系列變化。此外，火花放電(dian)(dian)(dian)和(he)靜(jing)電(dian)(dian)(dian)電(dian)(dian)(dian)場可使氧變為(wei)臭氧(O3)，對人體(ti)感(gan)受器有一(yi)(yi)定刺(ci)激作(zuo)用(yong)(yong)，全身應用(yong)(yong)對人體(ti)的(de)反應表現為(wei)：中(zhong)樞神(shen)經(jing)(jing)(jing)興奮(fen)性降(jiang)低(di)，植物神(shen)經(jing)(jing)(jing)系統(tong)功能改善，故臨床(chuang)常用(yong)(yong)于(yu)神(shen)經(jing)(jing)(jing)癥、早期(qi)高(gao)血壓、更年期(qi)綜合征、植物神(shen)經(jing)(jing)(jing)功能紊亂。局部應用(yong)(yong)時，可改善組織(zhi)的(de)血液循(xun)環和(he)營養狀(zhuang)態，抑制(zhi)感(gan)覺(jue)神(shen)經(jing)(jing)(jing)，常用(yong)(yong)于(yu)慢性潰(kui)瘍、皮膚瘙(sao)癢等。

副作用

電療和其他治療方(fang)法一樣，電抽搐治療也(ye)有其特定的(de)副作(zuo)用和并發癥。現(xian)代改良電休克治療常見(jian)的(de)并發癥主要是頭痛、惡心、嘔吐和可逆性(xing)的(de)記憶(yi)減(jian)退(tui)。記憶(yi)減(jian)退(tui)出現(xian)的(de)比例較高，國外研究發現(xian)至(zhi)少有1/3的(de)患者表(biao)示在接受電療之后，出現(xian)了明顯的(de)記憶(yi)衰(shuai)退(tui)。但是，一般(ban)(ban)認為電休克治療對記憶(yi)的(de)影響是有限的(de)，并且通(tong)常只(zhi)是暫時(shi)的(de)，臨床(chuang)上這些癥狀一般(ban)(ban)在治療后都(dou)會自(zi)行好轉而無需處(chu)理(li)。

現代(dai)電(dian)療(liao)除了上述副(fu)作(zuo)用(yong)以(yi)外，還有不少(shao)缺點。首先，電(dian)休(xiu)(xiu)克治(zhi)療(liao)實施起來較為(wei)(wei)復雜且有一(yi)定的(de)(de)危險性，需要(yao)(yao)(yao)全麻(ma)和(he)(he)吸氧(yang)，基層醫院很(hen)難開展(zhan)。其次，由于電(dian)休(xiu)(xiu)克治(zhi)療(liao)技術和(he)(he)設備等要(yao)(yao)(yao)求高，所以(yi)治(zhi)療(liao)費(fei)用(yong)也較高。再有，電(dian)休(xiu)(xiu)克治(zhi)療(liao)和(he)(he)藥(yao)物治(zhi)療(liao)一(yi)樣不能一(yi)勞永逸，要(yao)(yao)(yao)維持治(zhi)療(liao)，否則許多(duo)患者的(de)(de)病情就會(hui)復發(fa)。所以(yi)一(yi)般推薦在電(dian)療(liao)后的(de)(de)6個月里，以(yi)藥(yao)物治(zhi)療(liao)或者非經常(chang)性的(de)(de)電(dian)療(liao)作(zuo)為(wei)(wei)后續維持治(zhi)療(liao)。

防止電(dian)(dian)療(liao)(liao)副(fu)作(zuo)(zuo)用(yong)的(de)(de)(de)方法：電(dian)(dian)療(liao)(liao)前要(yao)保證睡眠質量，營養(yang)(yang)和吸收水分充(chong)足，電(dian)(dian)療(liao)(liao)對人(ren)體會(hui)起(qi)(qi)到(dao)電(dian)(dian)化學(xue)作(zuo)(zuo)用(yong)，物(wu)理學(xue)上為電(dian)(dian)離作(zuo)(zuo)用(yong)，如果(guo)沒有充(chong)足的(de)(de)(de)水分和營養(yang)(yang)，在(zai)通過長時(shi)間(jian)(jian)(jian)，起(qi)(qi)碼在(zai)1個小時(shi)以上的(de)(de)(de)微電(dian)(dian)流電(dian)(dian)療(liao)(liao)，會(hui)起(qi)(qi)到(dao)電(dian)(dian)療(liao)(liao)虛(xu)脫的(de)(de)(de)作(zuo)(zuo)用(yong)，排除電(dian)(dian)療(liao)(liao)副(fu)作(zuo)(zuo)用(yong)，關鍵(jian)是在(zai)長時(shi)間(jian)(jian)(jian)電(dian)(dian)療(liao)(liao)中(zhong)，要(yao)適當休息(xi)片刻，電(dian)(dian)療(liao)(liao)30分鐘后，要(yao)稍事休息(xi)和補充(chong)水分，時(shi)間(jian)(jian)(jian)控制在(zai)2個小時(shi)內，做完(wan)電(dian)(dian)療(liao)(liao)要(yao)補充(chong)充(chong)足的(de)(de)(de)營養(yang)(yang)，這樣(yang)下來，病(bing)癥(zheng)消除，人(ren)也不(bu)會(hui)虛(xu)脫，記憶(yi)力不(bu)會(hui)受影響。