臺灣博碩士論文加值系統

本論文研究目的為結合經皮神經刺激（TENS）與射頻（RF）波形的止痛效果；透過TENS「門閥理論」止痛原理，結合RF電場作用改善TENS電刺激因皮膚阻抗太高而無法直接刺激到痛點的缺點，故將兩種波形混合調變成一個新波形，達到克服皮膚阻抗同時具有低週波電刺激止痛效果。此PRF神經電刺激器分為五個部分，一、電源電路，二、TENS與RF訊號混合調變電路，三、電壓與電流量測，四、MCU控制與計算數據，五、資料儲存系統。
此人體試驗目的為藉由紀錄病患疼痛量表（VAS）及肩關節評分量表（CMS）來比較對照組、經皮神經脈衝電刺激器（TPRF）300V與經皮神經脈衝電刺激器（TPRF）500V對肩膀疼痛的止痛效果，此人體試驗一共收錄80位肩膀疼痛病人，並將其分為三組進行比較。

　　The purpose of this study is to combine both advantages of transcutaneous electrical nerve stimulation(TENS) and radiofrequency(RF) for treatment of pain.Accroding to analgesic effects of TENS based on the gate control theory, we combine it with RF electric field to improve the limited by epidermal impedance is too high to directly stimulate the pain points. So we modulate TENS and RF into a new stimulation waveform. This PRF peripheral nerve stimulation is mainly divided into five parts; 1) Power source. 2) The circuit of RF modulated by TENS. 3) Voltage and current measurement. 4) MCU control and calculates data. 5) Data storage system.
　　This clinical trial is a comparison that Visual Analogue Scale(VAS) and Constant-Murley Shoulder(CMS) of both Control group and TPRF 300V groups,TPRF 500V groups. This clinical trial a total of 80 patients with shoulder pain. These patients were randomly distributed into three groups.

目錄

摘要 i
ABSTRACT ii
致謝 iv
目錄 v
表目錄 viii
圖目錄 ix
第一章 緒論 1
1.1 前言 1
1.2 研究背景 2
1.3 研究動機 4
1.4 研究目的 7
1.5 論文架構 8
第二章 電刺激止痛機轉學說 9
2.1 疼痛的基礎認知 9
2.2 神經傳導 10
2.2.1 神經元 11
2.2.2 神經纖維的種類 12
2.2.3 動作電位與傳導 14
2.3 疼痛的傳導入徑 16
2.4 門閘理論 20
2.5 經皮神經電刺激 21
2.5.1 經皮神經電刺激理論基礎 22
2.5.2 經皮神經電刺激波形 23
2.6射頻電刺激器止痛機轉 25
2.6.1 射頻熱凝療法 26
2.6.2 脈衝式射頻電刺激 28
第三章 PRF神經電刺激器 30
3.1 電刺激器系統架構 30
3.2 電源 33
3.2.1 降壓電路 34
3.2.2 升壓電路 35
3.3 MCU 39
3.3.1 介面 41
3.3.2 TFT LCD 觸控螢幕 42
3.4 波型調變 44
3.4.1 LPC1768脈衝寬度調變PWM 45
3.4.2 LPC1768數位類比轉換DAC 48
3.4.3 波型控制 51
3.4.4 混波電路 52
3.5 PRF 放大器 55
3.6 波峰檢測器與電流傳感器 60
3.6.1 LPC1768 - DAC 61
3.6.2 波峰檢測器 63
3.6.3 電流傳感器 64
3.7 數據儲存系統 65
3.7.1 SD 記憶卡 66
3.7.2 FatFs 模組 68
3.7.3 RTC 70
第四章 人體試驗 71
4.1 病患 72
4.2 分組 73
4.3 試驗過程 75
4.3.1 ASA 健康狀態分級 77
4.3.2 VAS 視覺類比量表 78
4.3.3 PEG 疼痛量表 79
4.3.4 CMS 肩關節評分量表 80
4.4 治療 84
4.5 統計分析 87
4.5.1 受試者基本數據 88
4.5.2 PEG 統計分析 89
4.5.3 CMS 統計分析 91
4.6 試驗結果 93
第五章 結論與未來展望 94
5.1 結論 94
5.2 未來展望 94
參考文獻 95

 

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