目的 探讨作业疗法结合经皮神经电刺激对脑卒中后肩痛的疗效。方法 选取2020年6月—2023年6月在肇庆市第一人民医院治疗的60例脑卒中后肩痛患者为研究对象,随机分为观察组和对照组各30例。其中,观察组进行作业疗法结合经皮神经电刺激;对照组单纯进行作业疗法。记录患者治疗前及治疗4周后的视觉模拟疼痛评分（VAS）,改良Barthel指数（MBI）和汉密顿抑郁量表评分（HAMD）,并对记录进行检验和t检验。结果 观察组和对照组的治疗效果比较差异有统计学意义（P=0.019）,观察组治疗有效率（93.33%）高于对照组（63.33%）;治疗前两组患者的VAS（P=0.536）和HAMD（P=0.558）分值比较差异无统计学意义,治疗后其VAS（P=0.049）及HAMD（P=0.023）分值均较治疗前下降,且观察组下降幅度分别为（2.23±1.14）分和（4.47±3.06）分,均高于对照组的（1.27±0.98）和（1.33±1.35）,组间比较差异有统计学意义;治疗前两组患者的MBI分值比较差异无统计学意义（P=0.216）,治疗后其MBI分值均较治疗前提高,且观察组提高幅度（21.87±10.25）较对照组（12.00±13.58）更显著,组间比较差异有统计学意义（P=0.003）。结论 作业疗法结合经皮神经电刺激可缓解脑卒中肩痛,改善患者日常生活能力和心理精神状态,减少抑郁的发生。

Objective To explore the therapeutic effect of occupational therapy combined with transcutaneous electrical nerve stimulation（TENS） on shoulder pain after stroke．Methods Sixty patients with post-stroke shoulder pain who were treated in the First People’s Hospital of Zhaoqing from June 2020 to June 2023 were selected as the study subjects and randomly divided into an observation group and a control group,with 30 cases in each group．Among them,the observation group received occupational therapy combined with TENS,while the control group received occupational therapy alone．This study recorded the Visual Analogue Scale（VAS）,modified Barthel Index（MBI）,and Hamilton Depression Rating Scale（HAMD）of patients before and after 4 weeks of treatment,and conducted the and t-test analysis．Results The test analysis showed a significant difference in treatment effectiveness between the observation group and the control group（P=0.019）,with the observation group having a significantly higher treatment effectiveness rate（93.33%）than the control group（63.33%）;t-test analysis showed that there was no statistically significant difference in VAS（P=0.536）and HAMD（P=0.558）indicators between the two groups of patients before treatment．However,after treatment,the VAS（P=0.049）and HAMD（P=0.023）indicators decreased compared to before treatment．The observation group had decreased（2.23±1.14）and（4.47±3.06）,respectively,which were significantly higher than the control group’s（1.27±0.98）and（1.33±1.35）,and the inter group differences were statistically significant;before treatment,there was no statistically significant difference in MBI indicators between the two groups of patients（P=0.216）．After treatment,their MBI indicators increased compared to before treatment,and the observation group（21.87±10.25）showed a more significant improvement compared to the control group（12.00±13.58）．The difference between the groups was statistically significant（P=0.003）．Conclusions Occupational therapy combined with TENS can significantly alleviate shoulder pain after stroke,improve daily living ability and psychological state of patients,and reduce the occurrence of depression．

目的 探讨电针联合低频电刺激对中风后上肢弛缓瘫患者上肢功能重建的影响。方法 选择2019年10月—2022年2月期间我院收治的100例中风后上肢弛缓瘫患者,按随机数字表法分为对照组（C组）和观察组（O组）,各50例。C组实施电针治疗,O组在C组基础上增加低频电刺激。对比2组的上肢肌群RMS值、徒手肌力、上肢功能。结果 入组时2组的腕屈伸肌群均方根值（RMS）对比无差异（P>0.05）,干预1、2、3、4周后,O组的腕屈伸肌群RMS值高于C组（P<0.05）。干预4周后,O组的徒手肌力优于C组（P<0.05）。O组的Fugl-Meyer -上肢功能、Wolf 上肢运动功能评定（WMFT）得分高于C组（P<0.05）。结论 在电针治疗基础上联合低频电刺激能显著改善中风后上肢弛缓瘫患者的徒手肌力,增加患肢的肌电值,促进上肢功能恢复。

目的 观察低频电刺激治疗对脑卒中偏瘫疗效,并分析其对患者周围神经电生理学与形态学的影响。方法 选取本院94例脑卒中偏瘫患者,以数字表法随机分为两组,各47例,对照组接受基础康复治疗,实验组予以早期综合康复治疗(于对照组基础上进行低频电刺激治疗),比较两组治疗前后Berg平衡量表(BBS)评分、Fugl-Meyer运动功能(FMA)评分、关节(腕与踝)主动活动范围(AROM)、周围神经电生理学[感觉神经传导速度(SCV)、运动神经传导速度(MCV)、动态肌电图]与形态学[腕横纹正中神经(MN)横截面积(CSA)、宽度(W)以及厚度(T)]。结果 实验组治疗后BBS评分、上肢与下肢FMA评分高于对照组(P＜0.05),腕与踝AROM大于对照组(P＜0.05);实验组治疗后腓总神经与胫神经SCV、MCV高于对照组(P＜0.05),肱二头肌与腓肠肌协同收缩率均低于对照组(P＜0.05);两组治疗前后MN的CSA、T比较无差异(P＞0.05),实验组治疗后MN的W大于对照组(P＜0.05)。结论 低频电刺激联合早期综合康复治疗可有效提高脑卒中偏瘫患者平衡能力、关节活动度及上下肢功能,改善周围神经电生理学与形态学,减轻周围神经损伤。

Objective To observe the curative effect of low frequency electrical stimulation treatment on stroke hemiplegia, and analyze its influences on peripheral nerve electrophysiology and morphology of patients. Methods A total of 94 patients with stroke hemiplegia in the hospital were randomly divided into two groups by number table method, 47 cases in each group. The control group was given basic rehabilitation treatment, while experimental group was given early comprehensive rehabilitation treatment (low frequency electrical stimulation on basis of control group). The scores of Berg Balance Scale (BBS) and Fugl-Meyer assessment (FMA), joint (wrist, ankle) active range of motion (AROM), peripheral nerve electrophysiology [sensory conduction velocity (SCV), motor conduction velocity (MCV), dynamic electromyogram (EMG) ] and morphology [cross-sectional area (CSA) of carpal transverse median nerve (MN), width (W), thickness (T)] before and after treatment were compared between the two groups. Results After treatment, scores of BBS, upper and lower limbs FMA in experimental group were higher than those in control group (P<0.05), AROM of wrist and ankle was larger than that in control group (P<0.05). After treatment, SCV and MCV of common peroneal nerve and tibial nerve in experimental group were higher than those in control group (P<0.05), while co-contraction rates of biceps and gastrocnemius muscles were lower than those in control group (P<0.05). Before and after treatment, there were no differences in CSA and T of MN between the two groups (P>0.05). After treatment, W of MN in experimental group was greater than that in control group (P<0.05). Conclusion Low-frequency electrical stimulation combined with early comprehensive rehabilitation therapy may effectively increase the balance ability, joint range of motion and upper and lower limb function of stroke patients with hemiplegia, improve peripheral nerve electrophysiology and morphology, and reduce peripheral nerve injury.

目的 探讨凯格尔(Kegel)锻炼法结合生物反馈电刺激对产后盆底康复管理效果的影响。方法 选取2018年5月—2019年4月在我院妇产科阴道分娩的足月产妇200例,采用随机数字法分为对照组和观察组,每组各100例,对照组单纯给予Kegel锻炼法,观察组给予Kegel锻炼法结合生物反馈电刺激。干预2～3个月,比较两组患者盆底肌肉功能相关指标改善情况,并比较两组患者生活质量的改变。结果 干预后,观察组患者盆底肌Ⅰ类肌纤维肌力恢复正常率为86.0%(86/100),高于对照组的56.0%(56/100),观察组盆底肌Ⅱ类肌纤维肌力恢复正常率为83.0%(83/100),高于对照组的54.0%(54/100),差异均有统计学意义(P<0.05)。且干预后,观察组下腹不适、尿失禁、排尿异常、排便异常及阴道分泌物异常患者低于对照组(P<0.05),性生活质量评分高于对照组(P<0.05)。结论 Kegel锻炼结合生物反馈电刺激可促进盆底肌力,改善尿失禁、盆腔器官脱垂等盆底异常症状,提高患者生性生活质量。

Objective To explore the effect of Kegel exercise combined with biofeedback electric stimulation on the management of postpartum pelvic floor rehabilitation. Methods A total of 200 full-term pregnant women who delivered vaginally in our hospital from May 2018 to April 2019 were randomly divided into two groups: the control group and the observation group, with 100 cases in each group. The control group was only given Kegel exercise method, and the experimental group was given Kegel exercise method combined with biofeedback electrical stimulation. After 2～3 months of intervention, the improvement of pelvic floor muscle function and quality of life of the two groups were compared. Results After intervention, the recovery rate of pelvic floor muscle type I muscle strength in the observation group was 86.0% (86/100), higher than that in the control group (56/100), and the recovery rate of pelvic floor muscle type II muscle strength in the observation group was 83.0% (83/100), higher than that in the control group (54/100). The difference was statistically significant (P<0.05). After the intervention, the patients situations in the experimental group were lower than those in the control group (P<0.05) including abdominal discomfort, urinary incontinence, abnormal urination, abnormal defecation and abnormal vaginal secretion, and the score of sexual quality of life was higher than that in the control group (P<0.05). Conclusion Kegel exercise combined with biofeedback electrical stimulation may promote pelvic floor muscle strength, improve the symptoms of urinary incontinence, pelvic organ prolapse and other pelvic floor abnormalities, and improve the quality of life of patients.

目的 探讨经皮穴位电刺激对脑卒中偏瘫患者下肢功能的影响。方法 41例脑卒中患者随机分为TAES组和安慰刺激组,分别为21例和20例。两组常规治疗相同。TAES组采用KD-2A型经皮神经电刺激治疗仪治疗,刺激部位选择患侧下肢的4个穴位(足三里ST 36、太冲LV 13、阳陵泉GB 34、昆仑BI 60),频率100 Hz,脉宽0.2 ms,强度为患者最大耐受强度为限;安慰刺激组接受治疗的部位时间和疗程与TAES组相同,但每次治疗时没有电流输出。治疗前、治疗2周、治疗3周分别用综合痉挛量表(CSS)评定踝关节痉挛,Fugl-Meyer运动评定量表中下肢部分(FMA)评定下肢运动功能,Berg平衡量表(BBS)评定平衡功能。结果 组内比较:治疗2周和治疗3周后与治疗前比较两组CSS、FMA下肢部分、BBS评分差异有统计学意义(P<0.05);组间比较:治疗2周和3周后,TAES组CSS、FMA、BBS评分优于安慰刺激组,差异有统计学意义(P<0.05)。结论 TAES治疗能减轻脑卒中患者偏瘫下肢痉挛程度和提高平衡功能,改善下肢运动能力。

Objective To investigate the effect of transcutaneous accupoint electrical stimulation(TAES)in enhancing motor and functional recovery of the lower extremity in subjects with stroke. Methods 41 subjects with first stroke were randomly assigned into 2 groups:TAES group and placebo stimulation group.All subjects received the same standard rehabilitation.In the TAES group.Model KD-2A stimulator was applied with 0.2 ms pulses,at 100 Hz within the subject's tolerance level on the 4 acupuncture points(ST 36,LV 3,GB 34,and Bl 60)in the affected lower legs for 60 min,5 days a week for 3 weeks;The time and the course of treatment of the placebo stimulation group was as well as the TAES group's,but no current output for each treatment.All subjects in the 2 groups received standard rehabilitation program.Measurements including composite spasticity score(CSS)for the spasticity of the ankle planter flexors,Fugl-Meyer motor assessment(FMA)for the lower extremity,and Berg Balance Scale(BBS)for balance were recorded before treatment,after 2 and 3 weeks' treatment. Results After 2 and 3 weeks of treatment,the CSS score in the TAES group was significantly lower than the placebo stimulation group(P<0.05)and the FMA score and BBS score in the TAES group was significantly higher than the placebo stimulation group(P<0.05). Conclusion Transcutaneous accupoint electrical stimulation significantly decreased ankle plantar flexor spasticity and improve motor function of the affected lower extremity.

目的 探讨经皮穴位电刺激对脑卒中偏瘫患者上肢运动功能的影响。方法 37例脑卒中患者随机分为TAES组(n=19)和安慰刺激组(n=18)。两组常规治疗相同。TAES组采用KD-2A型经皮神经电刺激治疗仪治疗,刺激部位选择患侧上肢的4个穴位(肩髃、曲池、外关、合谷),频率100 Hz,脉宽0.2 ms,强度以患者最大耐受强度为限;每天治疗1次,每次60 min,连续3周共15次;安慰刺激组接受治疗的部位、时间和疗程与TAES组相同,但每次治疗时没有电流输出。治疗前、治疗第2周、治疗第3周分别用上肢Fugl-Meyer评分和改良Barthel指数评分(MBI)评定上肢运动功能及日常生活活动能力。结果 治疗前,两组患者间的一般情况、FMA-UE 评分和MBI评分的比较差异无统计学意义(P>0.05)。经过治疗,两组患者的FMA-UE和MBI评分与治疗前比较均有改善(P<0.05);TAES组FMA-UE和MBI评分的改善较安慰刺激组明显(P<0.05)。结论 TAES治疗能够提高脑卒中患者上肢运动功能,提高生活自理能力。

Objective To investigate the effect of transcutaneous accupoint electrical stimulation (TAES) in enhancing upper limb function in subjects with stroke. Methods 37 subjects with first stroke were randomly assigned into 2 groups:TAES group(n=19) and placebo stimulation group(n=18). All subjects received the same standard rehabilitation. In the TAES group, Model KD-2A stimulator was applied with 0.2 ms pulses, at 100 Hz within the subject's tolerance level on the 4 acupuncture points (LI15, L I11, LI4, and SJ5) in the affected upper limb for 60 min, 5 days a week for 3 weeks; The time and the course of treatment of the placebo stimulation group were as well as the TAES group's, but no current output for each treatment. All subjects in the 2 groups received standard rehabilitation program. Measurements including Fugl-Meyer motor assessment (FMA-UE) and modified Barthel index(MBI) on affected side were recorded before treatment after 2 and 3 weeks' treatments. Results After 3 weeks treatments,the function scores on affected side of the two groups were improved significantly(P<0.05). And function scores of the TAES group were significantly improved than those of the placebo group (P<0.05). Conclusion Transcutaneous accupoint electrical stimulation significantly may improve the recovery of upper limb function.

        胃食管反流病是一种以烧心和反流为主要症状的胃食管动力障碍性疾病，现有的常规治疗存在药物依赖，手术风险高且易复发等局限性，而经皮电刺激作为一种新兴疗法，在治疗动力障碍性疾病时具有非侵入性、可逆性及调节生理功能的优势。因此本研究为了探讨经皮电刺激治疗胃食管反流病的进展，现从胃食管反流病的神经调控生理、不同经皮电刺激对治疗胃食管反流病的研究以及应用效果等方面进行综述，以期为胃食管反流病提供新的诊断思路和方法。

    In order to discuss the progress of transcutaneous electrical stimulation for the treatment of gastroesophageal reflux disease（GERD），the physiology of neuromodulation of GERD，the research on different transcutaneous electrical stimulation for the treatment of GERD，and the application effect were reviewed，with the aim of providing new diagnostic ideas and methods for GERD．