CN1620323A - 通过可被神经接收的电波形治疗哮喘和呼吸疾病 - Google Patents

通过可被神经接收的电波形治疗哮喘和呼吸疾病 Download PDF

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CN1620323A
CN1620323A CNA028275756A CN02827575A CN1620323A CN 1620323 A CN1620323 A CN 1620323A CN A028275756 A CNA028275756 A CN A028275756A CN 02827575 A CN02827575 A CN 02827575A CN 1620323 A CN1620323 A CN 1620323A
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埃莉诺·舒勒
克劳德·K·李
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3601Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of respiratory organs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014External stimulators, e.g. with patch electrodes
    • A61N1/3603Control systems
    • A61N1/36031Control systems using physiological parameters for adjustment
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014External stimulators, e.g. with patch electrodes
    • A61N1/3603Control systems
    • A61N1/36034Control systems specified by the stimulation parameters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/37211Means for communicating with stimulators
    • A61N1/37252Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data

Abstract

一种治疗哮喘和呼吸疾病的方法和装置。该方法从存储区域选择表示人体器官功能的信号波形,之后把所选择的波形传输到跟身体直接接触的治疗部件,再由治疗部件把信号波形传播到特殊的人体器官来调整器官功能。提供了一个用来传输信号波形到治疗部件的控制模块。该控制模块包含所选择并传送给治疗部件的信号波形,并可以提供计算机存储以获得更多的存储容量和信号波形的处理。

Description

通过可被神经接收的电波形治疗哮喘和呼吸疾病
相关的申请
这是2000年11月27日提交的申请序列号为No.60/253,243,名称为“通过可被神经接收的电波形治疗哮喘和呼吸疾病”的申请的非临时专利申请。
发明背景
本发明涉及一种通过可被神经接收的电波形治疗哮喘和呼吸疾病的方法。
呼吸作用是人体生命的关键部分。肺从空气中得到氧并通过血流输送到整个人体。空气进入到肺必须经过支气管,而支气管在很多刺激的作用下能够张开或闭合。例如,一旦支气管响应于吸入变应原而发生收缩并且被粘液堵塞,象在哮喘发作时那样,则空气的量会急剧地减少并导致缺氧。支气管树收缩和被粘液堵塞的持续发展一直是对生命的威胁。本发明提供了一种降低粘液分泌并引起支气管树扩张的方法。
肺的导气通道从气管(呼吸管)开始,向下分支(分开)为左右支气管。随着分别进入相应的左右肺,其变成肺叶支气管随后是肺段支气管。应指出的是气管和主支气管由“C”字形的软骨环所支撑。这些软骨环帮助大的支气管结构的形状。“C”字形在后方开口,在开口位置处由肌肉封闭支气管。支气管肌肉在张开或封闭支气管时起着重要作用。当继续下移到终末细支气管时,支气管在直径方面经过了大约20次缩减,如果不算肺泡,终末细支气管就是最小的导气通道。
支气管的肌肉发达,并且在一定的刺激(包括来自大脑的输入)作用下能够改变其管(内部)腔的直径。终末细支气管分支为呼吸细支气管,而呼吸细支气管具有偶尔从它们的管壁上长出的肺泡。最后,细支气管通向肺泡管,肺泡管完全被衬以肺泡。
肺泡(或者小泡)是微小的囊一样的结构,氧和二氧化碳的交换在其中进行。它们通常也称为气囊。肺的肺泡区域被称为呼吸区。充满空气的气囊被衬以平的肺细胞,肺细胞分泌一种降低表面张力的表面活性物质来保持肺泡张开(打开)。在肺的血液供给和吸入的气体之间只有很薄的一层屏障,快速的气体交换就在其中发生。
支气管和气囊在两侧肺中工作。其中右肺3个叶,左肺2个叶。这个呼吸系统本质上有2个功能,即通气和气体交换。呼吸的机制由吸气(吸入)和呼气(呼出)组成。通气的驱动力是空气和肺泡内部肺压之间的气压差。在两侧肺中大约有3亿个肺泡在工作。
肺泡有两种类型。类型I呈煎蛋形,长的细胞质(除细胞核外细胞的所有可以工作的内容物)向外蔓延略微扩展出肺泡壁。类型II肺泡更加紧凑,并通过胞吐作用分泌表面活性物质。类型II肺泡的毁坏或受损会导致表面活性物质的不足,进而降低了顺应性(compliance),并直接导致肺水肿以及其它并发症。当空气从体外进入肺时,它逐渐变得湿润,并且当其到达肺泡时,气体的湿度已经达到完全饱和。
肺泡的血液供给由密集的肺部毛细血管网提供。二氧化碳从血液里扩散到肺泡并在肺泡处逸出进入肺内空间,同时氧从肺泡直接进入血液并输送到身体各处。
在有效的呼吸中许多神经和肌肉发挥着作用。专用于呼吸的最重要的肌肉是横隔膜。在正常的起伏呼吸时横隔膜移动大约1厘米,但在用力呼吸时横隔膜可以移动达到10厘米。左、右隔神经负责激活横隔膜的运动。横隔膜是把胸腔和腹腔分隔开的片状的肌肉,在正常平静呼吸时它的收缩和放松占胸腔容积变化的75%。作为大脑电信号的结果,横隔膜收缩在吸气时发生。呼气时横隔膜松弛并退回到它的静息位置。当因斜角肌和肋间外肌收缩而使胸腔扩大时,对吸气产生间接影响。有趣的是,横隔膜或者肋间外肌可以维持适当的胸腔运动来保持休息时的适当的换气。但在在完全尽力期间就需要横隔膜和肋间外肌共同参与到剧烈呼吸和快速呼吸之中。所有运动都通过从大脑传送到前面所述相应肌肉的神经电信号或波形来控制。
传入神经和传出神经一起延伸,并由底部传入肋间神经协助提供信息和信号,来控制横隔膜在呼吸中的作用。第四脑神经(滑车神经)在第三脑神经(动眼神经)和第五脑神经(三叉神经)的协助下,通过横隔神经在控制横隔膜方面发挥主要作用。在正常呼吸期间,呼气过程很大程度上是自动进行的,因为肺和胸壁会退回到它们正常的平衡位置。但对吸气来说,有很多胸部肌肉参与扩展肺和吸入空气。吸气过程通过横隔膜肌肉收缩时增大胸腔容积来完成。
正常呼吸的控制主要由脑干负责管理。然而,部分脑边缘系统和下丘脑具有在恐惧或愤怒时加速呼吸模式的能力。在一点一滴的呼吸控制中还有化学感受器参与其中,这些化学感受器位于延髓的第九脑神经(舌咽神经)和第十脑神经(迷走神经)的出口点附近,靠近延髓腹侧面。
由测量血液化学物质的感受器而产生的另外一些传入神经负责对氧合作用进行的状态进行某种报告。最重要的是位于颈部中的颈动脉分支处和主动脉中位于心脏处的心脏弧弓上下的外周化学感受器。传入神经支配带来快速的信息给大脑,以在大脑命令传出神经如何控制呼吸之前对其进行计算。前面所述的化学感受器直接与迷走神经如何作出响应,发出它自己的指令波形给支气管、肺和心脏有关,其中支气管、肺和心脏都跟呼吸和血液循环相关。也有测量压力、振动和运动等输入的机械感受器,这些机械感受器具有到呼吸和心脏系统的传入输入。在肺中也有牵张感受器来告知大脑肺的周期变化。还有温度感受器报告大脑各种器官的冷或热的状态。其它到脊髓和脑干的脑桥区的输入包括本体感受器(一种跟肌肉和腱相关的深部感受),它协调呼吸和肌肉活动。随后还有压力感受器,其发送传入信号给延髓中枢和脊髓中的心抑制中枢来帮助匹配脉搏、血压和呼吸频率,使它们相互和谐。
涉及到呼吸的中枢神经系统(脑)神经有第二、三、四、五、八、九脑神经,和重要的第十脑神经(迷走神经)。第一颅神经提供嗅觉信息,第二和第三脑神经则跟眼部输入相关,作为传入神经它们综合人体从外部所感知到了什么,并要求更快或更慢的呼吸频率,甚至屏住呼吸。第八脑神经提供听觉传入输入。各种传入感知系统提供了人体如何呼吸以正确响应身体外部事件的信息。
重要甚至可以说关键的呼吸控制,是由迷走神经及其节前神经纤维所激活的,其中迷走神经的节前神经纤维在嵌入支气管的交感神经节中形成突触,而支气管也被交感神经和副交感神经活动所削弱。交感神经分支可能对支气管没有影响或者它能够扩张内腔(孔)以允许更多的空气进入呼吸过程,这对哮喘病人是有帮助的,而副交感过程产生相反的效果,它能收缩支气管并增加分泌,这对哮喘病人是有害的。
发明内容
本发明提供了一种用于治疗哮喘和呼吸疾病的方法。从一存储区选择要在人体内产生并载送的已存储的波形。然后把所选的波形传输到与人体直接接触的治疗部件。该治疗部件再把所选的波形传播到人体内部的器官。
波形可以从计算机(比如科学计算机)中的存储区域中选择。所选波形的传输过程可以远程完成,或者可以通过连接到一个控制模块的治疗部件完成。传输可以是震动的、电子的,或者通过任何其它合适的方法。
本发明还提供了一种用于治疗哮喘和呼吸疾病的设备。该设备包括一个所收集的波形源,其中所收集的波形表示人体器官的功能;一个与人体直接接触的治疗部件;将波形传输到治疗部件的装置;从治疗部件传播所收集的波形到人体器官的装置。
传输装置可以包括一个数模转换器。所收集的波形源最好包含一台计算机,其具有以数字格式存储的所收集到的波形。该计算机可以包含分离的存储区域,用于不同类别的所收集的波形。
治疗部件可以包含天线或电极,或任何其它能够把一个或多个波形直接传播到人体的设备。
附图说明
在以下连同附图实现本发明最佳模式的例子的描述中,将更详细地说明本发明,在附图中:
图1是用于实践根据本发明的方法的设备的一种形式的示意图。
图2是用于实践根据本发明的方法的设备的另一种形式的示意图。
图3是根据本发明的方法的流程图。
本发明最佳实施例的描述
为了增进对本发明原理的理解,将参照附图中举例说明的实施例。尽管如此,应该理解并未由此而意图对本发明的范围做出任何限定,对图解设备的变更和进一步改进,以及对这里所示出的本发明原理的进一步应用,被认为对于本发明相关技术领域的人员来说是正常出现的。
呼吸系统医疗疾病的治疗可能要求发送电波形到一条或多条神经,最多可同时发送到五条神经。哮喘或其它呼吸障碍或疾病的校正涉及横隔膜和肋间肌的有节律的工作,来吸入和呼出空气,以便提取氧和排出废气化合物如二氧化碳。
支气管网的张开(扩张)使得在肺内有更多的空气被交换,以及对其所含氧气进行更多的处理。扩张过程可以通过编码的波形信号来以电子的方式进行控制。支气管也可以被关闭以限制通到肺里的空气量。通过本发明可以达到用于扩张和/或收缩的神经控制的平衡。
产生过多的粘液可能形成限制穿过支气管流动的空气量的粘液样栓塞。除了支气管内腔和气管外,肺部并不产生粘液。粘液的产生可以通过编码信号来增加或减少。信号可以平衡粘液的质量和数量。
自然地,所有编码的信号在低于1伏特下工作。考虑到所需编码信号的传输或者传导期间的电压损失,根据本发明所时间的电压可以增加到20伏特。对本发明电流应该始终小于2安培输出。通过直接连到神经的电极,进入到这些神经的直接传导将可能具有小于3伏特的电压和小于十分之一安培的电流的输出。
本发明通过控制传输到人体中的波形,能够控制呼吸频率和强度以及支气管扩张和支气管中的粘液作用。这种张开支气管的能力对急诊室内急性支气管炎的治疗是有用的。也可解决慢性气管梗阻病症如肺气肿等。
急性烧伤或化学吸入性损伤的治疗可以通过使用机械性的呼吸支持而得到加强。损伤间接引起的粘液分泌也会导致气管的梗阻,并且对于紧急治疗来说是很难控制的,并会造成生命危险。气管或支气管内的水肿(肿胀)往往限制了孔的大小并引起缺氧。在治疗期间,增大孔的能力是必需的或者至少是所希望的。
本发明通过对膈神经的调制后的激活可以减轻肺炎病人的呼吸努力。其它许多威胁生命情况下的治疗都涉及到一个功能良好的呼吸系统。因此,本发明给医生提供了一种方法来打开支气管和调整好呼吸频率以增加病人的供氧。这种电治疗方法包括传播激发或抑制波形到选定的神经来改善呼吸。这种治疗通过给氧以及使用现有的呼吸药物可以得到增强。
本发明同时包括利用神经可接收的波形来治疗哮喘和呼吸疾病的一种装置和一种方法。如图1所示,用于治疗哮喘和呼吸疾病的装置10的一种形式,由至少一个治疗部件12,和一个控制模块14构成。治疗部件12直接跟人体接触并从控制模块14接收编码的电波形。治疗部件12可以是电极、天线、震动变换器,或任何其它合适的用来传播调整或操作人或动物的呼吸功能的呼吸信号的传导附件。治疗部件12可以在一外科手术过程中被附加至合适的神经。这种外科手术可以在胸腔体视镜(thoriac-stereo-scope)步骤中通过“钥孔”(key-hole)入口来完成。如果有必要也可以用花费更高的胸廓切开术的方法以便更正确地放置治疗部件12。此外,如果有必要的话,治疗部件12可以插入体腔如鼻或口,并可以刺穿粘蛋白或其它薄膜以便紧密接近延髓和/或脑桥。于是已知用于调节呼吸功能的波形信号可以被发送到紧密接近脑干的神经。
控制模块14由至少一个控制器16和天线18构成。控制器16使该装置可以调整要传输到人体中的信号。如图1所示,控制模块14和治疗部件12可以是完全分离的元件,使得装置10可以远程操作。控制模块14可以是专有的,也可以是任何常规的能提供波形信号以传送给治疗部件12的装置。
在装置10的一替换实施例中,如图2所示,控制模块14’和治疗部件12’是相连接的。该图中相似的部件保留了相同的编号。此外,图2进一步显示了装置10’的另一个实施例,它是与计算机20相连接的,提供了更大的存储容量来存储波形信号。治疗期间装置10’提供的每个信号的输出电压和电流强度应不超过20伏特和2安培。
计算机20用来存储唯一的波形信号,这些信号对每个器官和器官功能来说是复杂的以及独特的。传送到控制模块14’并用来治疗病人的波形信号是从计算机20中的所存储的波形库中选出的。波形信号和它们的产生,在2001年11月20日提交的名称为“记录、存储和传播特定脑波形来调节人体器官功能的装置和方法”(Device andMethod to Record,Store,and Broadcast Specific Brain Waveforms toModulate Body Organ Functioning)的美国专利申请序列号____,中有更详细的描述,其公开内容在此合并作为参考。
如图3所示,本发明还包括一个用于使用装置10、10’来治疗哮喘和其它呼吸疾病的方法。该方法从步骤22开始,在该步骤中从分类波形信号菜单中选择一个或多个存储的编码电波形信号。被选择的波形信号激活、减活或调节呼吸系统。这种波形信号与脑干组织自然产生的用于平衡和控制呼吸过程的那些信号类似。一旦被选中,在步骤24波形信号可以被调整以便在人体内执行特定功能。可选择地,如果判定波形信号不需要被调整,则跳过步骤24并且使过程直接进行到步骤26。在步骤26,波形信号传输给装置10、10’的治疗部件12,12’。
在接收到波形信号之后,治疗部件12,12’传播信号到合适的位置,如步骤28所示。装置10、10’利用合适的波形信号,通过将电信号传导或传播到所选择的神经,来调整或调节呼吸活动。据信目标器官只能唯一地“听见”它自己单个的波形。结果就是,人体不会产生这种危险,即一个器官仅仅因为接收到另一个器官的波形而去执行该第二个器官的功能。
在本发明的一个实施例中,治疗部件12,12’的传播过程是通过在颈、头或胸部选定的合适区域中通过未破损的皮肤的直接传导或传输来完成的。这种区域紧邻靠近要施加信号的神经或神经从的位置。治疗部件12,12’在选定的目标区域与皮肤接触使得可以传送信号到目标神经。
在本发明的另一个实施例中,波形的传播过程通过经由附加一个电极以接收神经或神经从的直接传导来完成。必要时,这需要一个外科手术来将电极物理地连接到所选的目标神经。
在本发明的再一个实施例中,传播过程通过将波形变换成一种震动的形式来完成,其中其以一种方式被发送到头、颈或胸的某些区域,使得合适的“神经”能够接收并遵从这种震动信号里的编码指令。治疗部件12,12’使用导电凝胶或者粘贴介质压在未破损的皮肤表面以增加传导率。
本发明的各种特征已经结合本发明的举例说明的实施例进行了特别的揭示和描述。然而,必须理解的是,这些特定的产品,以及它们的制造方法,并非是限制性的而仅仅是举例说明,并且本发明的最完整解释将在所附的权利要求之中给出。

Claims (10)

1.一种治疗哮喘和呼吸疾病的方法,包括下列步骤:
a.从一存储区选择一个或多个在人体内产生并由人体内神经元传送的波形;
b.传输或传导所选择的波形到一与人体接触的治疗部件;以及
c.从治疗部件传播所选择的波形到一人体内的器官。
2.根据权利要求1的方法,其中步骤“a”还包括从一计算机的一存储区中选择所述的波形。
3.根据权利要求1的方法,其中步骤“b”还包括远程地传输所选择的波形到所述治疗部件。
4.根据权利要求1的方法,其中步骤“b”还包括震动传输所选择的波形。
5.一种治疗哮喘和呼吸疾病的设备,包括:
a.一所收集的波形的源,其中所收集的波形表示人体器官的功能;
b.一与人体直接接触的治疗部件;
c.用于传输一个或多个所收集的波形到所述治疗部件的装置;
d.用于将所收集的波形从治疗部件传播到一人体器官以刺激器官功能的装置。
6.根据权利要求5的设备,其中所述的传输装置包括一数模转换器。
7.根据权利要求5的设备,其中所述的源还包括具有以数字格式存储的所收集的波形的计算机。
8.根据权利要求7的设备,其中所述的计算机包括分开的存储区域,用于收集不同呼吸功能类别的波形。
9.根据权利要求5的设备,其中所述治疗部件包括一用于传播呼吸信号的天线。
10.根据权利要求5的设备,其中所述治疗部件包括一电极。
CNA028275756A 2001-11-27 2002-11-25 通过可被神经接收的电波形治疗哮喘和呼吸疾病 Pending CN1620323A (zh)

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