JP6393460B2 - Electrical stimulator - Google Patents

Description

  The present invention relates to a method for stimulating the oral cavity and pharynx, and in particular, it is possible to effectively apply electrical stimulation to the oral cavity and pharyngeal area of a patient to enhance the effect of treating oral and pharyngeal dysfunction. The present invention relates to a pharyngeal larynx stimulation method.

  It is known that oral and pharyngeal dysfunctions such as swallowing dysfunction and sleep apnea syndrome occur due to dull reflexes to sensory stimulation in the patient's oral and pharyngeal regions due to cerebral infarction etc. .

  As a treatment method for a patient having a swallowing dysfunction, a method of applying electrical stimulation to the oral cavity / pharynx region of the patient is known. According to this method, the sensory nerve is activated by electrical stimulation to make it more sensitive, thereby promoting the swallowing reflex of the patient and promoting the recovery of the swallowing function.

  For example, Patent Document 1 discloses a pharyngeal stimulation method using a pharyngeal stimulation device, in which an electrode of the pharyngeal stimulation device is inserted into a pharyngeal region via a catheter, and electrical stimulation is directly applied to the pharyngeal region. Have been described. Patent Document 2 describes a dysphagia treatment method including a step of attaching a plurality of electrodes to the neck and a step of applying a pulse current to a patient.

US Pat. No. 8,092,433 US Pat. No. 7,039,468

  However, in the method described in Patent Document 1, when electrical stimulation is applied to the oral cavity / pharyngeal region, the operation of inserting the catheter is required, and the physical pain associated with the insertion of the catheter is caused to the patient. There was a problem of being forced. Further, in the method described in Patent Document 2, since the electrodes are arranged close to the neck, electrical stimulation is given only to a limited area between the electrodes, and it is difficult to reach the deep part of the living body. There is a possibility that the electrical stimulation given to the oral cavity / pharyngeal region is not sufficient, and the effect of treating oral / pharyngeal dysfunction is not sufficient.

  Therefore, the present invention aims to increase the effect of treating oral / pharyngeal dysfunction by effectively applying electrical stimulation to the oral cavity / pharyngeal region of the patient (particularly the tongue, pharyngeal wall, palatine). To do.

The gist of the present invention is as follows.
The oral cavity / pharyngopharyngeal stimulation method of the present invention includes the oscillator that oscillates an electrical stimulation current and an electrode that transmits the electrical stimulation current generated by the oscillator to the oral cavity / pharyngeal region of a living body. An oral and pharyngeal laryngeal stimulation method using an electrical stimulation device for applying electrical stimulation to a region, wherein the electrode is positioned on the lower jaw and / or front neck and cheek of the living body And an oscillating step of oscillating an electrical stimulation current for the living body. According to the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the electrical stimulation is effectively applied to the oral cavity / pharyngeal area of the patient (particularly the tongue, pharyngeal wall, palatine), and the effect of treating pharyngeal laryngeal dysfunction is achieved. Can be increased.
“Positioning an electrode at a living body part” refers to disposing the electrode on the skin surface closest to the living body part.

  Moreover, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the lower jaw is composed of the digastric muscle (anterior abdomen), the hyoid hyoid muscle, the hyoid hyoid muscle, the stylohyoid muscle, the bigastric muscle (posterior abdomen), And at least one muscle selected from the cervical muscles. With the above configuration, electrical stimulation can be effectively applied to the lower jaw.

  Further, in the oral and pharyngeal laryngeal stimulation method of the present invention, the anterior cervical region includes the thyroid hyoid muscle, the scapulohyoid muscle, the sternohyoid muscle, the cricoid thyroid muscle, the sternum thyroid muscle, the sternocleidomastoid muscle, and the broad muscle. Preferably it is at least one muscle selected from the cervical muscles. With the above configuration, electrical stimulation can be effectively applied to the front neck.

  Further, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the cheek portion is located on the lower jaw side from the line extending from the upper edge of the zygomatic arch to the lower edge of the orbit, and from the line extending from the lower edge of the orbit to the lower end of the nasal bone. It is preferably at least one bone portion selected from the maxillary bone portion located on the mandibular side and the mandibular bone portion located on the cervical vertebra side from the line connecting the mental nodule and the lower end of the nasal bone. With the above configuration, electrical stimulation can be effectively applied to the cheek.

  Furthermore, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, it is preferable that the cheek portion is at least one portion selected from a wing protrusion mandibular raphe, a mandibular notch, and a suborbital foramen. With the above configuration, electrical stimulation can be effectively applied to the cheek.

  Furthermore, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the electrode includes a first electrode and a second electrode of a first channel, and the positioning step includes the step of positioning each of the first electrode and the second electrode in the lower jaw. And / or positioning in the front neck and cheeks. With the above configuration, electrical stimulation can be effectively applied to the lower jaw and / or the front neck and the cheek.

  Furthermore, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the electrode includes a first electrode and a second electrode of a first channel, and a first electrode and a second electrode of a second channel, and the positioning step includes the step of Positioning the first electrode of the first channel and the first electrode of the second channel in the lower jaw and / or the front neck, and the second electrode of the first channel and the second electrode of the second channel And positioning to the cheek. With the above configuration, electrical stimulation can be particularly effectively applied to the lower jaw and / or the front neck and the cheek.

  Further, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the positioning step includes a step of positioning the first electrode of the first channel and the first electrode of the second channel in the lower jaw, A step of positioning the second electrode and the second electrode of the second channel on the cheek. Preferably, the electrical stimulation current is a unipolar pulse current including a pulse having one polarity. With the above configuration, electrical stimulation can be particularly effectively applied to the tongue, the laryngeal elevation muscle group, and the like, particularly in the oral cavity / pharyngeal larynx region on the oral cavity side.

  Further, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the positioning step includes a step of positioning the first electrode of the first channel and the first electrode of the second channel in the lower jaw, And positioning the second electrode and the second electrode of the second channel on the cheek. Preferably, the electrical stimulation current is a bipolar pulse current including a pulse having both polarities. If it is set as the said structure, electrical stimulation can be efficiently given widely to a tongue part etc. and a laryngeal elevation muscle group.

  Furthermore, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the positioning step includes a step of positioning the first electrode of the first channel and the first electrode of the second channel on the front neck, and the first channel. And positioning the second electrode of the second channel and the second electrode of the second channel on the cheek, and the electric stimulation current is preferably a unipolar pulse current including a pulse having one polarity. With the above configuration, electrical stimulation can be particularly effectively applied to the hypopharyngeal constrictor muscle, the nasopharyngeal constrictor muscle, etc., particularly in the oral cavity / pharyngeal region on the cervical side.

  Furthermore, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the positioning step includes a step of positioning the first electrode of the first channel and the first electrode of the second channel on the front neck, and the first channel. And the second electrode of the second channel is positioned on the cheek, and the electric stimulation current is preferably a bipolar pulse current including a pulse having both polarities. With the above configuration, electrical stimulation can be efficiently applied widely to the nasopharyngeal constrictor muscle, the oropharyngeal constrictor muscle, the hypopharyngeal constrictor muscle, and the like.

Furthermore, in the oral cavity / pharyngeal laryngeal stimulation method of the present invention, the electrical stimulation current is a pulse current having a waveform including a plurality of pulses. Preferably, a composite wave having a composite pulse longer than the pulse duration of the current pulse is formed. If it is the said structure, the electrical stimulation to the deep part of a biological body can be performed efficiently.
The electrical stimulation device of the present invention is an electrical stimulation device for applying electrical stimulation to a living body,
An oscillator that oscillates an electrical stimulation current, and a plurality of electrodes that transmit the electrical stimulation current oscillated by the oscillator to the oral cavity / pharynx of the living body,
The plurality of electrodes includes a first electrode and a second electrode of a first channel, and a first electrode and a second electrode of a second channel,
Here, the plurality of electrodes are arranged at crossed positions, and a current for electrical stimulation is applied to the surface of the living body,
The electrical stimulation current is a pulse current having a waveform including a plurality of pulses,
When the pulse current waveform is superimposed, a composite wave having a composite pulse having a pulse duration longer than the pulse duration of the pulse of the pulse current is formed,
The pulse current has a pulse wave portion having one or more pulses having the same polarity, and has a weak pulse between each of a plurality of consecutive pulse wave portions,
Each weak pulse has the same polarity and an amplitude smaller than the amplitude of the pulse of the pulse wave section,
The synthesized wave has a synthesized weak pulse applied from the end point of the synthesized pulse to the start point of the next synthesized pulse between the synthesized pulses.
The electrical stimulation device of the present invention is an electrical stimulation device for applying electrical stimulation to a living body,
An oscillator that oscillates an electrical stimulation current, and a plurality of electrodes that transmit the electrical stimulation current oscillated by the oscillator to the oral cavity / pharynx of the living body,
The plurality of electrodes includes a first electrode and a second electrode of a first channel, and a first electrode and a second electrode of a second channel,
Here, the plurality of electrodes are arranged at crossed positions, and a current for electrical stimulation is applied to the surface of the living body,
The electrical stimulation current is a pulse current having a waveform including a plurality of pulses,
When the pulse current waveform is superimposed, a composite wave having a composite pulse having a pulse duration longer than the pulse duration of the pulse of the pulse current is formed,
The amplitude of the composite pulse is maximum at the center in the width direction.
In the electrical stimulation device of the present invention, the electrode arranged on the foot side of the living body among the first electrode and the second electrode has a negative polarity, and the living body out of the first electrode and the second electrode. It is preferable that the electrode arranged on the head side of the positive polarity .
Furthermore, in the electrical stimulation device of the present invention, the pulse current has a pulse duration of 25 to 10000 μsec,
The synthetic pulse of the synthetic wave preferably has a pulse duration of more than 25 and not more than 15000 μsec.

  According to the oral cavity / pharyngeal laryngeal stimulation method of the present invention, electrical stimulation is effectively applied to the oral cavity / pharyngeal region of the patient (particularly the tongue, pharyngeal wall, palatine) to treat oral / pharyngeal dysfunction. The effect can be enhanced.

(A) is a figure which shows an example of the electrical stimulation apparatus used in the oral cavity and pharynx laryngeal stimulation method which concerns on embodiment of this invention, (b) is the oral cavity and pharyngeal stimulation method which concerns on embodiment of this invention. It is a figure which shows another example of the electrical stimulation apparatus used in in. (C) is a view showing the lower jaw, the front neck, and the cheek, which are positions for positioning the electrodes of the electrical stimulation device, in a front view near the patient's head, and (d) FIG. 2 is a diagram showing the lower jaw, the front neck, and the cheeks in the left side view near the patient's head. It is a figure which shows in the front view the biological part from a chest part including a lower jaw and an anterior neck part to a head, especially paying attention to a muscle. It is a figure which shows the head containing a cheek part in a front view especially paying attention to a bone. (A) is a view showing the head including the cheek in the left side view, particularly focusing on the bone, and (b) is an enlarged view in the left side view, focusing on the cheek, particularly the bone. It is a figure shown. (A) is a view showing the head including the cheek in the left side view, particularly focusing on the muscle, and (b) is a left side view focusing on the lower jaw including the cheek, particularly the muscle. (C) is an enlarged view of the cheek, particularly focusing on muscles, and is an enlarged view of the left side view. (D) is the body axis of the oral cavity / pharyngeal region. It is a figure which shows a cross section. (A) is a figure which shows the position of the electrode in the 1st example of the positioning process of the oral cavity and pharyngeal laryngeal stimulation method based on embodiment of this invention which uses an example of an electrical stimulation apparatus in the front view of a patient's head vicinity. (B) is a diagram showing the position of the electrode shown in (a) in the left side view near the patient's head. (A) shows the position of the electrode in the second example of the positioning step of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention using another example of the electrical stimulation device in a front view near the head of the patient. (B) is a figure which shows the position of the electrode shown to (a) in the left view near a patient's head. (A) shows the position of the electrode in the third example of the positioning step of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention using another example of the electrical stimulation device in a front view near the patient's head. (B) is a figure which shows the position of the electrode shown to (a) in the left view near a patient's head. (A) shows the position of the electrode in the fourth example of the positioning step of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention using another example of the electrical stimulation device in a front view near the head of the patient. (B) is a figure which shows the position of the electrode shown to (a) in the left view near a patient's head. (A) shows the position of the electrode in the fifth example of the positioning step of the oral cavity / pharyngeal stimulation method according to the embodiment of the present invention using another example of the electrical stimulation device in a front view near the head of the patient. (B) is a figure which shows the position of the electrode shown to (a) in the left view near a patient's head. (A) shows the position of the electrode in the sixth example of the positioning step of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention using another example of the electrical stimulation device in a front view near the head of the patient. (B) is a figure which shows the position of the electrode shown to (a) in the left view near a patient's head. FIGS. 1A and 1B are diagrams illustrating a pulse current output from each pulse generation unit and a waveform of a combined wave when the electrical stimulation apparatus illustrated in FIGS. 1A and 1B includes a first pulse generation unit and a second pulse generation unit. is there. It is the graph which showed the relationship between the pulse duration of an electrical stimulation and the value (threshold value) of the electric current which a nerve ignites about each nerve. (A)-(d) is a figure which shows the modification of the pulse of the pulse current shown in FIG. 12, and the shape of the synthetic | combination pulse which overlap | superposed the pulse. It is a figure which shows the 1st modification of the pulse current shown in FIG. 12, and the waveform of the synthetic wave. It is a figure which shows the 2nd modification of the pulse current shown in FIG. 12, and the waveform of the synthetic wave. It is a figure which shows the 3rd modification of the pulse current shown in FIG. 12, and the waveform of the synthetic wave. It is a figure which shows the 4th modification of the pulse current shown in FIG. 12, and the waveform of the synthetic wave. It is a figure which shows the 5th modification of the pulse current shown in FIG. 12, and the waveform of the synthetic wave. It is a figure which shows the other form of the pulse current shown in FIG. 19, and the waveform of the synthetic wave. (A) And (b) is a figure which shows another form of the pulse current shown in FIG. 19, respectively, and the waveform of the synthetic wave. It is a figure which shows the waveform of the 6th modification of the pulse current shown in FIG. 12, and its synthetic wave. It is a figure which shows the waveform of the 7th modification of the pulse current shown in FIG. 12, and its synthetic wave. It is a figure which shows the 8th modification of the pulse current shown in FIG. 12, and the waveform of the synthetic wave. When the electrical stimulation apparatus shown to Fig.1 (a), (b) is further provided with the 3rd pulse generation part, it is a figure which shows the waveform of the pulse current which each pulse generation part outputs, and its synthetic wave. It is a figure which shows the modification of the pulse current shown in FIG. 25, and the waveform of the synthetic wave. FIG. 5 is a diagram schematically showing that the position of interference is changed by changing the mounting position and size of the electrode in the case where electrical stimulation is applied by interfering with the electrical stimulation current from the electrode of each channel of the electrical stimulation device. (A) is a figure showing the position of an electrode when the position where an electric current interferes contains the desired position in the living body, (b) changed the position of the electrode of (a) It is a figure which shows the position where the electric current in a case interferes, (c) is a figure which shows the position where an electric current interferes when an energization area change mechanism is made to function about the electrode of (b). It is a figure which shows 1st embodiment of a size variable electrode, (a) is a figure which shows the whole, (b) is a figure which shows an attachment surface, (c) is aa of (b). It is a figure which shows the cross section which follows a line. (A)-(e) is a figure which shows the modification of the electrode shown in FIG. 28, (a) is a figure which shows the whole, (b) is a figure which shows an attachment surface, (c) (B) is a figure which shows the cross section which follows the bb line of (b), (d) is a figure which shows the cross section which follows the cc line of (c), (e) is a periphery of a hole. FIG. (A)-(d) is a figure which shows another modification of the electrode shown in FIG. 28, (a) is a figure which shows the whole, (b) is a figure which shows an attachment surface, (c) is a figure which shows the cross section which follows the dd line of (b), (d) is a figure which shows the cross section which follows the ee line of (c). It is a figure which shows 2nd embodiment of a size variable electrode, (a) is a figure which shows the whole, (b) is a figure which shows an attachment surface, (c) is f- of (b). It is a figure which shows the cross section which follows f line. It is a figure which shows 3rd embodiment of a size variable electrode, (a) is a figure which shows the whole, (b) is the attachment surface of the said electrode in the state before pressing an elastic electricity supply member with a pressing member. It is a figure which shows the cross section in the direction orthogonal to (c), and (c) is a figure which shows the cross section in the direction orthogonal to the attachment surface of the said electrode in the state which pressed the elastic electricity supply member with the press member. (A) is a figure which shows the modification of an example of the electrical stimulation apparatus shown to Fig.1 (a), (b) shows the modification of another example of the electrical stimulation apparatus shown in FIG.1 (b). FIG. (A) is a figure which shows the position which positioned the electrode of the electrical stimulation apparatus in the test example which gives electrical stimulation to the oral cavity and the pharyngeal region of a test subject using an electrical stimulation apparatus, (b) is this test example. It is a figure which shows intraoral position A-I which measured the electric potential (mV) in (c), each pulse current and each pulse current are transmitted to a test subject, and it reaches a pain threshold value, an exercise threshold value, and a sensory threshold value. It is a figure which shows the relationship with the electrical intensity measured on the pharyngeal wall surface when it was done.

(Oral and pharyngeal stimulation methods)
The oral cavity / pharyngeal larynx stimulation method of the present invention is a method for treating oral cavity / pharyngeal dysfunction by applying electrical stimulation to the oral cavity / pharyngeal area. Here, oral and pharyngeal dysfunction refers to pneumonia that accompanies swallowing dysfunction, sleep apnea syndrome, and oral and pharyngeal dysfunction (cannot produce cough, and is caused by foreign matter mixed in the lungs) ) And the like.

  The oral cavity / pharyngeal laryngeal stimulation method of the present invention includes an oscillator that oscillates an electrical stimulation current and an electrode that transmits the electrical stimulation current generated by the oscillator to the oral cavity / pharyngeal area of a living body. An electrical stimulation device is used to apply electrical stimulation to the body. The oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention needs to include a positioning step of positioning the electrode on the living body, and an oscillation step of oscillating a current for electrical stimulation to the living body. Here, the electrodes need to be positioned in the lower jaw and / or the front neck and the cheeks.

According to the positioning of the electrodes by the positioning step, electrical stimulation can be effectively applied to the oral cavity / pharyngeal region of the patient, particularly to the region related to the oral cavity / pharyngeal region such as the tongue, pharyngeal wall, and palatal canal. . In particular, by increasing the current density of the current flowing through this region, the pharyngeal plexus and superior laryngeal nerve are electrically connected to the pharyngeal plexus and the superior laryngeal nerve, which are present in the pharyngeal region and are responsible for input to the sensory nerves necessary to induce the swallowing reflex. Stimulation can be effectively applied, and electrical stimulation can be effectively applied to the sublingual nerve that is present in the oral cavity region and governs the movement of the tongue that plays an important role in swallowing movements.
Therefore, according to the oral cavity / pharyngeal laryngeal stimulation method of the present invention that can effectively apply electrical stimulation to the oral cavity / pharyngeal area, the effect of treating oral cavity / pharyngeal dysfunction can be enhanced.

Hereinafter, embodiments of the oral cavity / pharyngeal laryngeal stimulation method of the present invention will be described in detail with reference to the drawings.
FIG. 1 (a) shows an example 1a of an electrical stimulation device having an electrode 3 composed of a first electrode 3C1-1 and a second electrode 3C1-2 of one channel (first channel 3C1), and FIG. ) And the electrode 3 including the first electrode 3C1-1 and the second electrode 3C1-2 of the first channel 3C1 and the first electrode 3C2-1 and the second electrode 3C2-2 of the second channel 3C2. Another example 1b of the device is shown. The electrical stimulation device 1 is configured to be able to transmit an electrical stimulation current oscillated by an oscillator, for example, a pulse current to a living body via the lead wire 4 and the electrode 3.
Details of the electrical stimulation apparatuses 1a and 1b shown in FIGS. 1 (a) and 1 (b) will be described later.

  FIG. 1 (c) shows the lower jaw part 10, the front neck part 20, and the cheek part 30 which are positions for positioning the electrodes 3 of the electrical stimulation device 1 used in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention. Is shown in a front view in the vicinity of the head 60 of the patient, and the lower jaw 10, the front neck 20 and the cheek 30 shown in FIG. It is shown in the surface view.

Details of the oral cavity / pharyngeal laryngeal stimulation method will be described below.
<Positioning process>
Hereinafter, the details of the positioning step of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
First, details of the lower jaw 10, the front neck 20, and the cheek 30 where the electrode 3 is positioned will be described.
FIG. 2 is a front view showing a living body portion including the lower jaw 10 and the front neck 20 from the chest 70 to the head 60, particularly focusing on muscles.

  Examples of the lower jaw 10 include the bigastric muscle (anterior abdominal muscle) 11, the hyoid hyoid muscle 12, the hyoid hyoid muscle 13, the stylohyoid muscle 14, the bigastric muscle (posterior abdominal muscle) 15, and the cervical muscle 16 and the like. In particular, from the viewpoint of avoiding irritation to the carotid sinus, the bigastric muscle (anterior abdomen) 11, the hyoid hyoid muscle 12, and the hyoid hyoid muscle 13 are preferable. The muscles may be a single type or a combination of two or more types.

  Examples of the front neck 20 include the thyroid hyoid muscle 21, the scapulohyoid muscle 22, the sternohyoid muscle 23, the cricoid thyroid muscle 24, the sternum thyroid muscle 25, the sternocleidomastoid muscle 26, and the cervical muscle 16 and the like. Particularly, the thyroid hyoid muscle 21, the scapulohyoid muscle 22, the sternohyoid muscle 23, the ring-shaped thyroid muscle 24, and the sternum thyroid muscle 25 are particularly preferable. The muscles may be a single type or a combination of two or more types.

  Here, it is important that the position for positioning the electrode 3 in the neck including the front neck 20 and the back neck is the front neck 20. When the electrode 3 is positioned on the front neck 20, stronger electrical stimulation is applied to the oral cavity / pharyngeal region 90 than when the electrode 3 is positioned on the rear neck including the cervical paraspinal and trapezius muscles. Therefore, it is possible to obtain a higher effect of treating oral / pharyngeal dysfunction.

FIG. 3 shows the head 60 including the cheek 30 in a front view with particular attention to the bone.
The cheek 30 is, for example, a portion of the zygomatic bone 31 located on the lower jaw 36 side from a line (shown by a dotted line in FIG. 3) continuous from the upper edge 34 of the zygomatic arch to the lower edge of the orbit, and from the lower edge 35 of the orbit to the lower end 37 of the nasal bone. A cervical vertebra 39 (shown by a dotted line in FIG. 3) than a continuous line (shown by a dotted line in FIG. 3), a portion of the maxilla 32 located on the mandible 36 side, and a line (shown by a dotted line in FIG. 3) connecting the genital node 38 and the lower nasal bone 37. For example, a portion of the mandible 33 located on the side (not shown in FIG. 3). In addition, the said part may be single 1 type, and is good also as 2 or more types of combinations.

4A shows the head 60 including the cheek 30 in the left side view with particular attention to the bone, and FIG. 4B shows the cheek 30 in the left side with particular attention to the bone. Enlarged in the plan view.
The cheek 30 is a portion shown in FIG. 3, and particularly from the viewpoint of efficiently applying electrical stimulation to the oral cavity / pharyngeal region 90, the wing-projected mandibular raphe 41, the mandibular notch 42, and the orbital hole 43 etc. are preferable. In addition, the said site | part may be single 1 type, and is good also as 2 or more types of combinations.

FIG. 5 (a) shows the head 60 including the cheek 30 in the left side view with particular attention to muscles, and FIG. 5 (b) shows the lower jaw 36 including the cheek 30 in particular to muscles. And it expands and shows in the left view. FIG. 5C shows the cheek 30 in an enlarged manner in the left side view, particularly focusing on muscles, and FIG. 5D shows a cross section of the body axis of the oral cavity / pharyngeal region 90.
Further, the cheek portion 30 includes, for example, the masseter muscle 44, the cheek muscle 45, the upper lip levator muscle 46, the large zygomatic muscle 47, the small zygomatic muscle 48, the lower antrum muscle 49, the lower lower lip muscle 50, the broad jaw muscle 51, the chin guy Examples include the deltoid muscle 52, the genital muscle 53, the outer pterygoid muscle 54, the inner pterygoidal muscle 55, the nasopharyngeal constrictor muscle 56, and the like. 44, cheek muscles 45, outer pterygoid muscles 54, inner pterygoidal muscles 55, and nasopharyngeal constrictor muscles 56 are preferred. The muscles may be a single type or a combination of two or more types.

  When the current flows on the living body surface side of the muscle, the current does not flow to the muscle located in the deep part of the living body, and the oral cavity / pharyngeal region 90 of the patient (particularly the tongue, pharyngeal wall, palatine) There is a risk that sufficient electrical stimulation may not be applied to the device. Therefore, when applying electrical stimulation to the cheek 30, the cheek 30 having a relatively high electrical resistance from the viewpoint of reducing the electrical distance to the oral cavity / pharyngeal region 90 located inside the living body. Considering the anatomical positional relationship between the bone portion related to the above and the muscle related to the cheek 30 having a relatively low electrical resistance, a strong current is applied to the muscle tissue closest to the oral cavity / pharyngeal region 90 It is preferable to arrange the electrodes so as to flow. Since the oral cavity / pharyngeal region 90 is located inside the living body covered with bones such as the mandible 33, an electrode is disposed at a position located between the bone and the muscle tissue adjacent to the oral cavity / pharyngeal region 90. It is preferable.

Next, a specific example of the positioning step of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
The first example of the positioning step in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
As shown in FIG. 6, in this example, an example 1a of the electrical stimulation device shown in FIG. 1 (a) is used. Here, the electrode 3 includes a first electrode 3C1-1 and a second electrode 3C1-2 of one channel (first channel 3C1). As shown in FIG. 6A, the first electrode 3C1-1 includes a first A electrode portion 3C1-1A and a first B electrode portion 3C1-1B that are electrically connected by a conducting wire 4, and the second electrode 3C1-2 includes a second A electrode portion 3C1-2A and a second B electrode portion 3C1-2B that are electrically connected by the conducting wire 4.
FIG. 6 (a) shows the position of the electrode 3 in the first example of the positioning step in a front view near the patient's head 60, and FIG. 6 (b) shows the position of the electrode 3 shown in FIG. 6 (a). Is shown in the left side view near the head 60 of the patient.
In the first example of the positioning step, the first B electrode portion 3C1-1B is placed on the front neck 20 on the right side of the living body (right side when viewed from the patient side, left side on the drawing, the same applies hereinafter) to the first A electrode portion 3C1-1A. It is positioned by sticking to the cheek 30 on the right side of the living body, and the second A electrode portion 3C1-2A is placed on the front neck 20 on the left side of the living body (left side when viewed from the patient side, right side on the drawing, the same applies hereinafter) The second B electrode portion 3C1-2B is positioned by sticking to the cheek 30 on the left side of the living body.
In particular, according to the first example of the positioning step, uniform stimulation can be given to the oral cavity / pharyngeal region.

  In addition, the positioning process in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention is not limited to this, and the first electrode 3C1-1 and the second electrode 3C1-2 are respectively connected to the lower jaw 10 and / or Or what is necessary is just to be able to position to the front neck part 20 and the cheek part 30. FIG.

A second example of the positioning step in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
As shown in FIG. 7, in this example, another example 1b of the electrical stimulation device shown in FIG. 1B is used. Here, the electrode 3 includes two channels (a first channel 3C1 and a second channel 3C2). As shown in FIG. 7A, the first channel 3C1 includes a first electrode 3C1-1 and a second electrode 3C1-2, and the second channel 3C2 includes the first electrode 3C2-1 and the second electrode. It consists of 3C2-2.
FIG. 7A shows the position of the electrode 3 in the second example of the positioning step in a front view near the head 60 of the patient, and FIG. 7B shows the position of the electrode 3 shown in FIG. Is shown in the left side view near the head 60 of the patient.
In the second example of the positioning step, the first electrode 3C1-1 of the first channel 3C1 is attached to the front neck portion 20 on the left side of the living body, and the second electrode 3C1-2 of the first channel 3C1 is attached to the cheek portion 30 on the right side of the living body. The first electrode 3C2-1 of the second channel 3C2 is attached to the front neck 20 on the right side of the living body, and the second electrode 3C2-2 of the second channel is attached to the cheek 30 on the left side of the living body. Position by.
In particular, according to the second example of the positioning step, it is possible to apply relatively strong electrical stimulation to the oral cavity / pharyngeal region on the neck side.

A third example of the positioning process in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
As shown in FIG. 8, in this example, another example 1b of the electrical stimulation device shown in FIG. 1B is used. Here, the electrodes are the same as in the second example of the positioning step shown in FIG. Below, the same code | symbol is attached | subjected to the element similar to the electrical stimulator used in the 2nd example of the positioning process shown in FIG. 7, and the description is abbreviate | omitted.
FIG. 8A shows the position of the electrode 3 in the third example of the positioning step in a front view near the head 60 of the patient, and FIG. 8B shows the position of the electrode 3 shown in FIG. Is shown in the left side view near the head 60 of the patient.
In the third example of the positioning step, the first electrode 3C1-1 of the first channel 3C1 is attached to the lower jaw portion 10 on the left side of the living body, and the second electrode 3C1-2 of the first channel 3C1 is attached to the cheek portion 30 on the right side of the living body. By positioning the first electrode 3C2-1 of the second channel 3C2 on the lower jaw portion 10 on the right side of the living body and the second electrode 3C2-2 of the second channel on the cheek portion 30 on the left side of the living body, Position.
In particular, according to the third example of the positioning step, it is possible to apply relatively strong electrical stimulation to the oral cavity / pharyngeal region on the oral cavity side.

A fourth example of the positioning step in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
As shown in FIG. 9, in this example, another example 1b of the electrical stimulation device shown in FIG. 1B is used. Here, the electrode 3 includes two channels (a first channel 3C1 and a second channel 3C2). As shown in FIG. 9A, the first channel 3C1 includes a first electrode 3C1-1 and a second electrode 3C1-2, and the second channel 3C2 includes the first electrode 3C2-1 and the second electrode. It consists of 3C2-2. Here, the first electrode 3C1-1 of the first channel is composed of a first first A electrode portion 3C1-1A and a first first B electrode portion 3C1-1B electrically connected by the conducting wire 4, and the second The first electrode 3C2-1 of the channel includes a second first A electrode portion 3C2-1A and a second first B electrode portion 3C2-1B that are electrically connected by the conducting wire 4. Below, the same code | symbol is attached | subjected to the element similar to the electrical stimulator used in the 2nd example of the positioning process shown in FIG. 7, and the description is abbreviate | omitted.
FIG. 9A shows the position of the electrode 3 in the fourth example of the positioning step in a front view near the head 60 of the patient, and FIG. 9B shows the position of the electrode 3 shown in FIG. 9A. Is shown in the left side view near the head 60 of the patient.
In the fourth example of the positioning step, the first first A electrode part 3C1-1A is attached to the front neck 20 on the left side of the living body, and the first first B electrode part 3C1-1B is attached to the lower jaw part 10 on the left side of the living body. By positioning the second electrode 3C1-2 of one channel on the cheek 30 on the right side of the living body, the second first A electrode portion 3C2-1A is placed on the front neck 20 on the right side of the living body, and the second first B Positioning is performed by attaching the electrode portion 3C2-1B to the lower jaw portion 10 on the right side of the living body and attaching the second electrode 3C2-2 of the second channel to the cheek portion 30 on the left side of the living body.
In particular, according to the fourth example of the positioning step, it is possible to give a stronger electrical stimulation to the upper part of the pharynx than in the second and third examples.

A fifth example of the positioning step in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
As shown in FIG. 10, in this example, another example of the electrical stimulation device shown in FIG. 1B is used. Here, the electrodes are the same as in the case of the fourth example of the positioning step shown in FIG. Below, the same code | symbol is attached | subjected to the element similar to the electrical stimulator used in the 4th example of the positioning process shown in FIG. 9, and the description is abbreviate | omitted.
FIG. 10A shows the position of the electrode 3 in the fifth example of the positioning step in a front view near the head 60 of the patient, FIG. 10B shows the position of the electrode 3 shown in FIG. The position is shown in a left side view near the patient's head 60.
In the fifth example of the positioning step, the first first A electrode part 3C1-1A is attached to the front neck 20 on the left side of the living body, and the first first B electrode part 3C1-1B is attached to the lower jaw part 10 on the right side of the living body. By positioning the second electrode 3C1-2 of one channel on the cheek 30 on the right side of the living body, the second first A electrode portion 3C2-1A is placed on the front neck 20 on the right side of the living body, and the second first B Positioning is performed by attaching the electrode portion 3C2-1B to the lower jaw portion 10 on the left side of the living body and attaching the second electrode 3C2-2 of the second channel to the cheek portion 30 on the left side of the living body.
In particular, according to the fifth example of the positioning step, it is possible to apply a relatively strong electrical stimulation to the lower part of the larynx.
The second electrode 3C1-2 of the first channel is attached to the cheek 30 on the left side of the living body while the positioning of the electrodes in the lower jaw 10 and the front neck 20 is maintained, and the second electrode 3C2-2 of the second channel is attached. The effect similar to the above can be obtained also when pasted on the cheek 30 on the right side of the living body.

A sixth example of the positioning step in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
As shown in FIG. 11, in this example, another example of the electrical stimulation apparatus shown in FIG. 1B is used. Here, the electrodes are the same as in the case of the fourth example of the positioning step shown in FIG.
FIG. 11A shows the position of the electrode 3 in the sixth example of the positioning step in a front view near the patient's head 60, and FIG. 11B shows the position of the electrode 3 shown in FIG. The position is shown in a left side view near the patient's head 60. Below, the same code | symbol is attached | subjected to the element similar to the electrical stimulator used in the 4th example of the positioning process shown in FIG. 9, and the description is abbreviate | omitted.
In the sixth example of the positioning step, the first first A electrode part 3C1-1A is attached to the cheek 30 on the left side of the living body, and the first first B electrode part 3C1-1B is attached to the cheek part 30 on the right side of the living body. The second electrode 3C1-2 of the channel is positioned by sticking to the front neck 20 on the left side of the living body, and the second first A electrode portion 3C2-1A is placed on the cheek 30 on the right side of the living body, and the second first B electrode Positioning is performed by attaching the part 3C2-1B to the cheek 30 on the left side of the living body and attaching the second electrode 3C2-2 of the second channel to the front neck 20 on the right side of the living body.
In particular, according to the sixth example of the positioning step, it is possible to apply a relatively strong electrical stimulation to the upper pharynx.

  In the positioning step in the oral cavity / pharyngopharyngeal stimulation method according to the embodiment of the present invention when another example 1b of the electrical stimulation device shown in FIG. 1B is used, in particular, the electrode 3 is connected to the lower jaw portion 10 of the living body. Positioning on the front neck 20 and the cheek 30 is preferable. If the electrode 3 is positioned at a combination of these living body parts, a particularly strong electrical stimulation can be applied to the oral cavity / pharyngeal region 90, and therefore, a particularly high therapeutic effect on the oral cavity / pharyngeal function disorder can be obtained.

  As in the second to sixth examples of the positioning steps shown in FIGS. 7 to 11, the electrodes 3 of the first channel 3C1 and the second channel 3C2 are connected to the positions of the first electrode 3C1-1 of the first channel and A virtual line (not shown) connecting the position of the second electrode 3C1-2, and a virtual line (not shown) connecting the position of the first electrode 3C2-1 and the position of the second electrode 3C2-2 of the second channel By positioning so that the crossing (cross), electrical current for electrical stimulation from each of the channels 3C1, 3C2 interferes in the deep region of the living body, with respect to nerves and muscles existing in that region, It becomes possible to give a stronger electrical stimulus.

  For example, in the second example of the positioning step shown in FIG. 7, when the position of the first electrode 3C1-1 of the first channel and the position of the first electrode 3C2-1 of the second channel are replaced, An imaginary line (not shown) connecting the position of the first electrode 3C1-1 and the second electrode 3C1-2 of one channel, the position of the first electrode 3C2-1 and the second electrode 3C2-2 of the second channel Even when a virtual line (not shown) connecting the positions of the two does not intersect (straight), it can be included in the positioning step in the oral cavity / pharyngeal stimulation method according to the embodiment of the present invention.

  The positioning step in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention is not limited to the second to sixth examples of the positioning step shown in FIGS. Positioning the first electrode 3C1-1 and the second channel first electrode 3C2-1 on the lower jaw 10 and / or the front neck 20, the first channel second electrode 3C1-2, It is only necessary that the two-channel second electrode 3 </ b> C <b> 2-2 can be positioned on the cheek 30.

<Oscillation process>
Hereinafter, the details of the oscillation process of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
Examples of the electrical stimulation current oscillated with respect to the living body include a continuous current and an intermittent current. Examples of the continuous current include a direct current and an alternating current, and an alternating current is preferable. Examples of the intermittent current include a current having a waveform of a rectangular wave, a sine wave, a triangular wave, a sawtooth wave, and the like.

  In the case where the electrical stimulation device 1 has one channel (first channel 3C1), an electrical stimulation current having one frequency can be used. For example, in the case of the first example of the positioning step shown in FIG. 6, an electrical stimulation current of one frequency can be passed through the first channel 3C1 (straight).

When the electrical stimulation apparatus 1 has a plurality of channels, electrical stimulation currents having a plurality of frequencies with different frequencies can be used. For example, in the case of the second example of the positioning step shown in FIG. 7, an electrical stimulation current having a frequency in the first channel 3C1 can be passed, and an electrical stimulation current having a different frequency can be passed in the second channel 3C2 (cross). ).
For example, in FIG. 7, when the position of the first electrode 3C1-1 of the first channel and the position of the first electrode 3C2-1 of the second channel are replaced, the electric stimulation current is Can flow (straight).

As the current stimulation frequency, the low frequency band can be 1 Hz to 999 Hz (less than 1000 Hz), preferably 1 Hz to 200 Hz, and the rectangular wave width is preferably 1.0 μsec to 5.0 msec. Note that the current waveform can be appropriately modulated.
The stimulation frequency refers to the frequency of stimulation given to nerves and muscle tissue, and does not limit the carrier frequency.

In the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention, in particular, as the electrical stimulation current, a pulse current having a waveform having a plurality of pulses is preferable. In this case, it is preferable that a composite wave having a composite pulse having a pulse duration longer than the pulse duration of the pulse of the pulse current is formed.
In this case, the electrical stimulation apparatus 1b shown in FIG.1 (b) is used. Here, the electrical stimulation apparatus 1b includes an operation unit 500. The operation unit 500 includes at least two pulse generation units (a first pulse generation unit and a second pulse generation unit) that output a pulse current as an oscillator. Unit; not shown) and a control unit for controlling the operation of the pulse generation unit. Furthermore, the operation unit 500 includes therein a power supply unit (not shown), an input unit 500a, a display unit 500b, and an amplification unit (not shown).

The pulse current output from the first pulse generation unit and the second pulse generation unit of the electrical stimulation device 1 has, for example, one or more pulses having the same waveform and one polarity as shown in FIG. A first pulse wave part P1 having (three in the figure) and a second pulse wave part having one or more (three in the figure) pulses having a polarity opposite to the polarity of the pulse of the first pulse wave part P1 It has a waveform that alternately and repeatedly includes P2. In the illustrated example, the upper side is one polarity (one side polarity), and the lower side is the opposite polarity (the other side polarity). And in the electrical stimulation apparatus 1, the pulse which has one side polarity among the pulses which the 1st pulse generation part produced | generated is oscillated from the 1st electrode 3C1-1 of the 1st channel 3C1, and the pulse which has the other side polarity is Oscillated from the second electrode 3C1-2 of the first channel 3C1. Of the pulses generated by the second pulse generator, a pulse having one side polarity is oscillated from the first electrode 3C2-1 of the second channel 3C2, and a pulse having the other side polarity is the second channel 3C2. Oscillated from the two electrodes 3C2-2.
Each pulse of the pulse current output from each pulse generator is a rectangular wave pulse having a pulse duration Tp and a peak current value Cp. Further, the non-application period Sn in which no current is applied between adjacent rectangular waves (that is, the time in which the current value is 0 mA) is the non-application time Tn. In this embodiment, the non-application time Tn has the same time as the pulse duration Tp (Tn = Tp). Further, a non-application period in which the current value is 0 mA is provided between the first pulse wave part P1 and the second pulse wave part P2, and the time of this non-application period is the same as the pulse duration Tp. is there.

  And in this embodiment, as shown in FIG. 12, the phase difference D of the pulse current of the same waveform output from the 1st pulse generation part and the 2nd pulse generation part becomes the same time as pulse duration Tp (that is, The end point of the pulse current pulse generated by the first pulse generation unit overlaps the start point of the pulse current pulse generated by the second pulse generation unit, and the pulse current pulse generated by the second pulse generation unit is generated. The control unit controls each pulse generation unit so that the end point of the pulse and the start point of the pulse of the pulse current generated by the first pulse generation unit overlap. As a result, when the pulse currents output from the first pulse generation unit and the second pulse generation unit are superimposed on each other, as shown in FIG. A synthesized wave having a synthesized pulse whose time is longer than the pulse duration Tp of the pulse of the pulse current is formed. The formed composite wave is provided with a composite pulse having a pulse duration of 6 Tp alternately and repeatedly without passing through the non-application period Sn.

  Therefore, according to this embodiment, for example, each electrode 3 is connected to a virtual line (not shown) connecting the position of the first electrode 3C1-1 of the first channel and the position of the second electrode 3C1-2, and the second Each pulse current is attached to the surface of the living body so that a virtual line (not shown) connecting the position of the first electrode 3C2-1 and the position of the second electrode 3C2-2 of the channel intersects (cross). By causing the living body to oscillate, an interference wave in which the pulse currents interfere with each other can be formed in the deep part of the living body. In the deep part of the living body where more nerve fibers exist than the surface of the living body, electrical stimulation can be applied to many nerve fibers by the interference wave.

  Further, since the control unit controls the pulse generation unit so that a synthetic wave having a synthetic pulse having a pulse duration longer than the pulse duration Tp of the pulse of the pulse current is formed, the pulse current output from the pulse generation unit The interference wave obtained by actually interfering with each other in the living body has an interference pulse having a pulse duration longer than the pulse duration Tp of the pulse of the pulse current, like the synthesized wave.

In order for the treatment by the electrical stimulation current generated by the electrical stimulation device 1 to have a sufficient effect, many nerve nerves related to the tissue that is the target of the treatment of the body function is electrical stimulation by the device. It needs to be given to fibers, especially nerve fibers of sensory nerves. That is, it is necessary to generate an action potential in many nerve fibers by applying an electrical stimulus that exceeds the threshold value at which the action potential is generated (also referred to as “firing” of the nerve). This is because when the nerve fiber of the sensory nerve fires, the brain can recognize the sensation, and when the nerve fiber of the motor nerve fires, the muscle contracts.
Here, for each nerve, the threshold value at which nerve firing is caused by electrical stimulation is shown in a curve so that the relationship between the pulse duration of electrical stimulation and the current value (threshold value) fired by the nerve is shown as a curve. And the higher the shorter the pulse duration. Furthermore, since the pulse current is attenuated while being transmitted through the inside of the living body, the current value of the interference wave formed by the interference of the pulse current in the deep part of the living body is the current value of the synthesized wave (the pulse oscillated from the electrode). Lower than the sum of the current values). However, according to the pulse current output from the pulse generation unit of the electrical stimulation device 1, as described above, the pulse duration of the interference pulse of the obtained interference wave is longer than the pulse duration Tp of the pulse of the pulse current. Become. Therefore, according to the pulse current output from the pulse generation unit of the electrical stimulation apparatus 1, even if the pulse current attenuates while being transmitted through the inside of the living body, many nerve nerves are generated by the interference wave having a long pulse duration. An electrical stimulation exceeding a threshold value can be applied to the fiber to obtain an effect such as sufficient treatment.

  This point will be described in more detail with reference to FIG. 13. For example, when only a pulse duration and a pulse current having a current value indicated by point A in FIG. An electrical stimulus having a size indicated by B is applied. As a result, in the deep part of the living body, the Aα nerve cannot be ignited. Further, in the prior art that causes sine waves having different frequencies to interfere with each other, when a pulse current having a pulse duration and a current value indicated by point A interferes with a pulse current having a shorter pulse duration than the pulse current. Since the pulse duration time of the interference pulse of the interference wave is shortened and the electrical stimulation having the magnitude indicated by the point C is applied, similarly, the Aα nerve cannot be fired deep in the living body. On the other hand, according to the pulse current, the pulse duration time of the interference pulse of the interference wave is increased, and the electrical stimulation having the magnitude indicated by the point D is applied, so that the Aα nerve is also ignited in the deep part of the living body. Can be made.

  That is, according to the pulse current output from the pulse generation unit of the electrical stimulation apparatus 1, electrical stimulation to the deep part of the living body can be performed efficiently.

  Further, in this pulse current, the waveform of the pulse current output from the first pulse generation unit and the second pulse generation unit is the same, and the end point of the pulse of the pulse current generated by the first pulse generation unit, Since the start point of the pulse generated by the two-pulse generation unit overlaps, the end point of the pulse current generated by the second pulse generation unit overlaps the start point of the pulse generated by the first pulse generation unit. Becomes a continuous rectangular wave with constant amplitude and pulse duration. Therefore, a constant stimulus can be continuously given to the user. Furthermore, since the waveforms of the pulse currents output from the first pulse generation unit and the second pulse generation unit are the same, the operation of the pulse generation unit can be easily controlled.

  Furthermore, since the polarity of the synthetic pulse of the synthetic wave formed is alternately switched, the in-vivo electrolyte attracted to the polarity of the synthetic pulse is not biased toward each electrode. Treatment by electrical stimulation can be performed while suppressing changes in liquid properties in the living body, such as bias in the body. On the other hand, when the polarities of the synthesized pulses are the same as shown in FIG. 15, which will be described later, contrary to the above, the change in the liquid property in the living body is used, or the electrode flow action is performed. It is possible to perform treatment by electrical stimulation while using the device. In addition, by changing the fluidity in the living body, for example, accumulation of specific cells can be induced to promote wound healing and the like. Here, the electrode flow action is an action in which the generation of polarization changes when a current is applied to the living body for a relatively long time or a slightly large current, and as a result, the threshold value changes.

Here, as described above, in order for the treatment with the electrical stimulation current to have a sufficient effect, it is preferable to apply an interference wave having a current value exceeding the threshold value to many nerve fibers located in the deep part of the living body. . On the other hand, there are sensory nerves that feel pain. And when the electric current value of an interference wave exceeds the threshold value of the sensory nerve which feels pain, the user who uses the electrical stimulation apparatus 1 feels pain. Therefore, from the viewpoint of sufficiently obtaining the effect of treatment while reducing the pain of the user who uses the electrical stimulation apparatus 1, thresholds of sensory nerves that feel pain (for example, thresholds of Aδ nerve and C nerve shown in FIG. 13) It is preferable not to apply electrical stimulation using an interference wave that greatly exceeds.
Therefore, it is preferable that the composite pulse of the synthetic wave formed by the pulse current oscillated by the electrical stimulation device 1 does not greatly exceed the threshold of sensory nerves that feel pain, and preferably does not exceed the threshold of sensory nerves that feel pain. .
Here, the pulse duration of the composite pulse of the composite wave is not limited. However, in the field of rehabilitation using an electrical stimulation device, as shown in FIG. 13, when electrical stimulation of high intensity (strong current value) is used, the pulse duration is 25 to 300 μsec, and low intensity (weak current value). ) Is used, the pulse duration is 1000 to 10000 μsec. Therefore, it is preferable that the synthetic pulse of the synthetic wave has a pulse duration of 10 to 15000 μsec. More preferably, the pulse duration is 25 to 300 μsec or 1000 to 10,000 μsec.

Further, from the viewpoint of reducing the pain of the user who uses the electrical stimulation device 1, it is preferable that the pulse current does not greatly exceed the threshold value of the sensory nerve that senses pain located on the surface (or surface layer) of the living body. The pulse duration Tp of the pulse current is preferably less than 600 μsec, and more preferably less than 300 μsec.
According to this, by setting the pulse duration Tp of the pulse to less than 600 μsec, particularly less than 300 μsec, the pulse current is within a range that does not greatly exceed the threshold of sensory nerves that feel pain located on the surface (or surface layer) of the living body. It is possible to provide a pulse current having an intensity in consideration of the attenuation in the living body. As a result, it is possible to generate an interference wave having a desired current value necessary for nerve firing in the deep part of the living body while reducing the user's pain.

  Here, in this embodiment, the waveform of each pulse current is the same as shown in FIG. 12, but in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention, the waveform of each pulse current is overlapped. As long as a combined wave having a combined pulse having a pulse duration longer than the pulse duration Tp of the pulse of the pulse current is formed, the waveforms of the pulse currents can be different from each other. For example, in FIG. 12, the pulse duration Tp of each pulse of the pulse current output from the first pulse generation unit is set to t, the non-application time Tn is set to 1 / 2t, and is output from the second pulse generation unit. The pulse duration Tp of each pulse of the pulse current is set to 1 / 2t, the non-application time Tn is set to t, and the phase difference D is set to t. The current waveforms can be different from each other.

  The synthesized wave shown in FIG. 12 is formed only from the synthesized pulse. However, in the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention, the synthesized wave includes the first pulse generation unit of the electrical stimulation device 1. In addition, when the pulse currents output from the second pulse generation unit are superimposed on each other, a pulse that is not synthesized, that is, a pulse in which pulses of other pulse currents are not superimposed or connected may be included.

Furthermore, in the waveform shown in FIG. 12, the non-application time Tn between the pulses and the phase difference D for superimposing the pulses are the same as the pulse duration Tp. In the laryngeal stimulation method, the non-application time Tn and the phase difference D can be changed. Specifically, for example, as shown in FIG. 14A, the phase difference D and the non-application time Tn are set to half the pulse duration Tp, or although not shown, the phase difference D is pulse duration. It is also possible to set the non-application time Tn to half the pulse duration Tp while keeping the same time as the time Tp.
In FIG. 14A, the pulse duration of the combined pulse of the combined wave becomes longer, while a portion where the current value protrudes is generated in the combined pulse. In addition, the time during which the current value of the protruding portion lasts is shorter than the pulse duration Tp of the pulse of the pulse current. However, since the pulse duration of the synthesized pulse is longer than the pulse duration Tp of the pulse current of the synthesized pulse as a whole, the deeper part of the living body is caused by the interference pulse of the interference wave that actually causes the pulse current to interfere in the living body. Can be fired at a low threshold. In addition, since the composite pulse has a protruding portion, electrical stimulation with a short pulse duration and a large current value can be simultaneously given to the deep nerves of the living body.

  The waveform shown in FIG. 12 is a rectangular wave in which the non-application time Tn between the pulses and the phase difference D for superimposing the pulses are the same as the pulse duration Tp, according to the embodiment of the present invention. In the oral cavity / pharyngeal stimulation method, the pulse shape, non-application time Tn, and phase difference D can be changed. Specifically, for example, as shown in FIGS. 14B to 14D, the pulse included in the pulse current may be a sine half-wave pulse. Further, as shown in FIG. 14B, the non-application time Tn between the pulses may be set to 0, and the phase difference D may be set to a half time of the pulse duration Tp. Furthermore, as shown in FIG. 14C, the non-application time Tn may be set to 0, and the phase difference D may be set to 1/3 of the pulse duration Tp. Further, as shown in FIG. 14D, the non-application time Tn may be half the pulse duration Tp, and the phase difference D may be 3/4 of the pulse duration Tp. Thus, by making the pulse included in the pulse current a sine half-wave pulse, it is possible to make the sense of stimulation felt when the user uses the electrical stimulation device mild. In addition, by controlling the phase difference D of the pulse current, the current value of the protruding portion where the current value in the composite pulse protrudes can be adjusted. Therefore, the pulse duration due to the protruding portion is short and the current value is Large electrical stimulation can be effectively applied to nerves deep in the living body.

Next, a pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and a first modification of the synthesized wave will be described with reference to FIG.
The pulse current output from the first pulse generator and the second pulse generator shown in FIG. 15 is a first pulse having one or more pulses having one polarity (three pulses having one polarity in the drawing). The point having only the wave part P1 and the time between the first pulse wave part P1 (the non-application period from the last pulse of the first pulse wave part P1 to the first pulse of the next first pulse wave part P1) 12 is different from the pulse current shown in FIG. 12 in that the time is longer than the non-application time Tn in the first pulse wave part P1. In the illustrated example, the time between the first pulse wave parts P1 is twice the non-application time Tn and the pulse duration Tp.

  In this modification, when the pulse currents are superimposed on each other, a composite wave having a composite pulse as shown in FIG. 15 is formed. Specifically, each pulse current has the same waveform in which the non-application time Tn has the same time as the pulse duration Tp, and the phase difference D has the same time as the pulse duration Tp. When the respective pulse currents are superposed on each other, as shown in the figure, the pulse of the first pulse wave part P1 of the pulse current from the second pulse generation part becomes the first pulse wave of the pulse current from the first pulse generation part. It is located in the non-application period Sn after the pulse of the part P1, and a synthetic wave is formed by mutually complementing the non-application period Sn. Therefore, the composite wave is a first pulse wave part having a one-side polarity composite pulse having a pulse duration 6Tp that is the sum of all pulse durations Tp of the first pulse wave part P1 of the pulse current of each pulse generator. A non-application period having a time obtained by subtracting the pulse duration Tp from the time between P1 is alternately provided.

Therefore, in this embodiment, since the composite pulses are composed of the same polarity, compared to the case where the composite pulses are alternately switched as shown in FIG. Will be repeated, and an electrode flow action or the like can be obtained.
Further, in this modified example, a non-applied section in which a current value is 0 mA is formed between the combined pulses of the combined wave, so that the pulse currents interfere with each other in the deep part of the living body. Also in the formed interference wave, a non-application period is formed between the interference pulses as in the combined wave. Then, nerve firing occurs during the duration of the interference pulse, and nerve firing does not occur in the non-application interval between each interference pulse. Therefore, unlike the case where no non-application period is formed between each interference pulse, the user of the electrical stimulation device can recognize the input of the interference pulse and grasp how much electrical stimulation has been given. can do. That is, the user or the like can recognize the number of times of input of the interference pulse, and the user or the like can easily grasp the usage amount of the electrical stimulation. In particular, when the fired nerve is a motor nerve that contracts muscles, the non-application interval Sn is formed between the interference pulses, so that the contraction and relaxation of the muscles can be confirmed. Thus, it is possible to easily confirm the portion receiving the electrical stimulation and the degree thereof.

Next, a pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and a second modification of the combined wave will be described with reference to FIG.
The pulse currents output from the first pulse generation unit and the second pulse generation unit shown in FIG. 16 have the same waveform as each of the pulse currents shown in FIG. A first pulse wave part P1 having a pulse (three in the figure) and a second pulse wave having one or more (three in the figure) pulse having a polarity opposite to the polarity of the pulse of the first pulse wave part P1 It is a waveform provided with part P2 alternately and repeatedly.
However, in the pulse current shown in FIG. 16, each pulse is a sine half-wave pulse having a pulse duration Tp and a peak current value Cp, and a non-application period Sn where no current is applied between adjacent sine half-wave pulses. Is a non-application time Tn (in the drawing, the non-application time Tn is 0) shorter than the pulse duration Tp, and the phase difference D of each pulse current is smaller than the pulse duration Tp. 12 is different from the pulse current shown in FIG. 12 in the point (in the drawing, the time is half of Tp).
In this modified example, the non-application period between the first pulse wave part P1 and the second pulse wave part P2 is also zero, as is the non-application time Tn between the pulses in each pulse wave part.

  In this modification, when the pulse currents are overlapped with each other, a composite wave having a composite pulse as shown in FIG. 16 is formed. Specifically, each pulse current has a sine half-wave pulse having the same waveform and the same pulse duration Tp, and the phase difference D is half the pulse duration Tp. Has a waveform in which one-side polarity composite pulse having a pulse duration of 3 Tp and the other-side polarity composite pulse having a pulse duration of 3 Tp are alternately repeated without passing through the non-application period Sn. Each composite pulse has a shape in which the current value varies within the pulse duration.

  Therefore, in this modification, the composite pulse is formed by superimposing sine half-wave pulses as shown in FIG. 16, so the composite pulse shown in FIG. 12 is formed by superposing rectangular wave pulses. Compared with, it is possible to make the electrical stimulation feeling felt when the user uses the electrical stimulation device milder.

Next, a pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and a third modification of the synthesized wave will be described with reference to FIG.
The pulse current output from the first pulse generation unit and the second pulse generation unit shown in FIG. 17 is a first pulse having one or more pulses having one polarity (in the drawing, three pulses having one polarity). A point having only the wave portion P1, a point where each pulse is a sine half wave having a pulse duration Tp and a peak current value Cp, and a time of a non-application period Sn in which a current between adjacent sine half waves is not applied, It is a non-application time Tn shorter than the pulse duration Tp (in the figure, there is only a moment of 0 mA between adjacent pulses), and a time between the first pulse wave parts P1 (of the first pulse wave part P1) The time during which the non-application period from the last pulse to the first pulse of the next first pulse wave part P1 is longer than the phase difference D between the pulse currents (in the figure, twice the phase difference D). And pulse duration T 12), and the phase difference D of the pulse current is smaller than the pulse duration Tp (in the figure, it is half the time of Tp), it differs from the pulse current shown in FIG. .

  In this modification, when the pulse currents are superimposed on each other, a composite wave having a composite pulse as shown in FIG. 17 is formed. Specifically, each pulse current has the same waveform, a pulse duration Tp and a non-application time Tn that have the same sine half-wave pulse, and a phase difference D that is half the pulse duration Tp. The wave has a waveform including a plurality of one-sided composite pulses having a pulse duration of 3Tp + D through a non-application period having a time obtained by subtracting the time of the phase difference D from the time between the first pulse wave parts P1. Each composite pulse has a shape in which the current value varies within the pulse duration.

Accordingly, in this modification, the composite pulse is formed by superimposing sine half-wave pulses having one polarity as shown in FIG. 17, so that the composite pulse shown in FIG. Compared to the case where the polarity of the composite pulse is alternately changed, the electrical stimulation feeling felt when the user uses the electrical stimulation device is made milder and the electrode flow-through effect is obtained. be able to.
In addition, since a non-application period in which a current is not applied and a current value is 0 mA is formed between the composite pulses of the composite wave, the user or the like performs electrical stimulation in the same manner as in the first modification. The receiving part and its degree can be easily confirmed.

Next, a pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and a fourth modification of the synthesized wave will be described with reference to FIG.
The pulse current output from the first pulse generation unit and the second pulse generation unit shown in FIG. 18 is a rectangular wave, and has the same waveform as the pulse current shown in FIG. The phase difference D of the pulse current is the same as the pulse duration Tp.
However, the pulse current shown in FIG. 18 includes the third pulse wave part P3 having one or more pulses having both polarities (in the figure, three pairs of bipolar pulses) and one or more pulses having both polarities ( In the figure, it is different from the pulse current shown in FIG. 12 in that it has a waveform that repeatedly includes a fourth pulse wave part P4 having three pairs of bipolar pulses. The pulse current shown in FIG. 18 is similar to the non-application period where the current value is 0 mA between the first pulse wave part P1 and the second pulse wave part P2 shown in FIG. A non-application period in which the current value is 0 mA is provided between the third pulse wave part P3 and the fourth pulse wave part P4. Here, the bipolar pulse of the third pulse wave part P3 has a peak current value smaller than that of the one-side polarity pulse of the peak current value Cp and the one-side polarity pulse (in the illustrated example, the peak current value Cp / 3). Of the other side polarity). Further, the bipolar pulse of the fourth pulse wave part P4 has a smaller peak current value than the pulse of the other side polarity of the peak current value Cp and the pulse of the other side polarity (in the illustrated example, the peak current value Cp / 3). ) It consists of a pulse of one side polarity. Further, the non-application period between the third pulse wave part P3 and the fourth pulse wave part P4 is the same as the pulse duration Tp.

  In this modification, when the pulse currents are superimposed on each other, a composite wave as shown in FIG. 18 is formed. Specifically, when the respective pulse currents are superposed on each other, as shown in the figure, the synthesized wave is composed of a synthesized pulse having one side polarity with a pulse duration of 7 Tp and a synthesized pulse having the other side polarity with a pulse duration of 7 Tp. The waveform is alternately provided without passing through the non-application period. Each composite pulse has a shape in which the current value fluctuates within the pulse duration, specifically, a shape in which the current value decreases after rising rapidly from a low value and becomes constant.

  Therefore, in this modification, the composite pulse is formed by superimposing bipolar pulses as shown in FIG. 18, so the composite pulse shown in FIG. 12 overlaps one polarity pulse (unipolar pulse). Compared to the case of forming together, since electrical stimulation can be performed while releasing the electrical energy stored in the living body, stronger electrical stimulation input can be performed.

Next, a fifth modification of the pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and the synthesized wave thereof will be described with reference to FIGS. 19, 20, 21 (a), and (b).
The pulse currents output from the first pulse generation unit and the second pulse generation unit shown in FIGS. 19 and 20 are not applied in the non-application period between the first pulse wave unit P1 and the second pulse wave unit P2. Is different from the pulse current shown in FIGS. 12 and 16 in that the time is larger than the phase difference D. In addition, the pulse current output from the first pulse generation unit and the second pulse generation unit shown in FIG. 21A is a non-application period between the third pulse wave unit P3 and the fourth pulse wave unit P4. It differs from the pulse current shown in FIG. 18 in that the non-application time is a time longer than the phase difference D. Furthermore, the pulse current output from the first pulse generation unit and the second pulse generation unit shown in FIG. 21B is a waveform that repeatedly includes only the third pulse wave part P3 of the pulse current shown in FIG. This is different from the pulse current shown in FIG.
19, 20, 21 (a) to (b), the non-application time between the pulse wave portions is a time obtained by adding the pulse duration Tp to the phase difference D.

  In these modified examples, when the pulse currents are superimposed on each other, a composite wave having a composite pulse as shown in FIGS. 19, 20, 21 (a) and (b) is formed, and each composite pulse is formed. An interval in which no current is applied can be formed between them. Specifically, since the non-application time in the non-application period between each pulse wave part of each pulse current is a time larger than the phase difference D, from the non-application time between each pulse wave part, FIG. , 21 (a) and (b), the pulse duration Tp is reduced between the combined pulses and the pulse duration shown in FIG. 20 is reduced by half the pulse duration Tp. Become.

Accordingly, in the modified examples shown in FIGS. 19, 20, and 21 (a), the same effect as that obtained when the pulse current and the synthesized wave shown in FIGS. Since a non-application period in which no current is applied and the current value is 0 mA is formed between the combined pulses, as in the first modified example, the user etc. The degree can be easily confirmed. In the modification shown in FIG. 21 (b), a non-application period in which a current is not applied and a current value is 0 mA is formed between the combined pulses of the combined wave, and the same polar stimulation is repeated. Similar to the first modified example, an electrode flow action or the like can be obtained.

Next, a pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and a sixth modification of the synthesized wave will be described with reference to FIG.
The pulse currents output from the first pulse generation unit and the second pulse generation unit shown in FIG. 22 vary in pulse amplitude within the pulse wave unit, and the first pulse wave unit P1 and the second pulse wave unit P2 Of the pulse wave portion has a maximum amplitude in the central portion in the width direction of the pulse wave portion, decreases after the amplitude increases in the pulse wave portion, and the number of pulses in each pulse wave portion is eight. This is different from the pulse current shown in FIG.
Specifically, the first pulse wave part P1 and the second pulse wave part P2 of the pulse current shown in FIG. 22 are each formed from eight rectangular wave pulses, and are located in the center in the width direction of each pulse wave part. The fourth and fifth pulses of each pulse wave section have a current value Cp with the maximum amplitude. Further, the pulse at the left end in the width direction and the pulse at the right end in the width direction of each pulse wave part, that is, the first pulse and the last pulse in each pulse wave part have the current values with the minimum amplitude. Further, the amplitude of each pulse gradually increases from the pulse at both ends in the width direction, which has the minimum amplitude, to the pulse in the central portion in the width direction, which has the maximum amplitude.

  In this modification, when the pulse currents are overlapped with each other, a synthesized wave having a synthesized pulse as shown in FIG. 22 is formed, and the amplitude of the synthesized pulse of the synthesized wave is the center in the width direction of the synthesized pulse. The largest in the department. Specifically, the amplitude of the composite pulse of the composite wave increases and then decreases. More specifically, each pulse current has the same waveform with the same pulse duration Tp and non-application time Tn, and has a phase difference D equal to the pulse duration Tp. When superimposed, a composite pulse as shown in the figure is formed, and the maximum amplitude of the composite pulse gradually increases from both ends of the composite pulse in the width direction toward the center in the width direction.

  Therefore, in this modified example, the pulse amplitude of the pulse wave portion is maximized at the central portion in the width direction of the pulse wave portion, so that a pulse current having a large current value is not suddenly applied to the surface of the living body. Therefore, the invasiveness of the user of the electrical stimulation device due to electrical stimulation can be suppressed, and the user's feeling of electrical stimulation can be eased. In addition, when the amplitude of the pulse of the pulse wave part does not change in the pulse wave part, the electric charge stored in the living body by using the electrical stimulation device is suddenly released after the pulse wave part, and the back electromotive force ( Reverse current) may occur, and as a result, an unintended electrical stimulation may be given to the living body. As the pulse of the pulse wave part decreases after the amplitude increases in the pulse wave part, it is stored in the living body. Unintentional irritation caused by sudden release of charge can be suppressed. Furthermore, in this modified example, the amplitude of the synthesized pulse also becomes the maximum at the central portion in the width direction of the synthesized pulse for the synthesized wave. Similarly, for the interference wave, the amplitude of the interference pulse also becomes larger in the width direction of the interference pulse. Maximum in the center. Accordingly, the user's feeling of electrical stimulation can be eased. In addition, since the amplitude of the composite pulse also decreases after the amplitude increases in the pulse wave section, an unintentional irritation caused by a sudden release of charges stored in the living body can be suppressed.

  Next, a pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and a seventh modification of the synthesized wave will be described with reference to FIG.

  The pulse current output from the first pulse generation unit and the second pulse generation unit shown in FIG. 23 is a first pulse having one or more pulses having one polarity (three pulses having one polarity in the drawing). The point which has only the wave part P1 and the point which has a weak pulse in each between several continuous 1st pulse wave parts P1 differ. Note that the weak pulse shown in FIG. 23 has the same polarity as the pulse of the first pulse wave part P1 and the same polarity, and Cw having an amplitude smaller than the amplitude of the pulse of the first pulse wave part P1. ing.

  Specifically, in the example shown in FIG. 23A, the weak pulse duration Tw of the weak pulse is the same as the pulse duration Tp of the first pulse wave portion P1, and is the last of the first pulse wave portion P1. A weak pulse is applied with a non-application time equal to the pulse duration Tp from the first pulse, and after the weak pulse, the first pulse of the next first pulse wave part P1 is opened with a non-application time equal to the pulse duration Tp. Is applied. In the modification shown in FIG. 23A, when the pulse currents are superposed on each other, the phase difference D has the same time as the pulse duration Tp. Then, a synthetic weak pulse applied from the end point of the composite pulse to the start point of the next composite pulse is formed.

  In the example shown in FIG. 23B, the weak pulse is a weak pulse duration of time Tw from the last pulse of the first pulse wave part P1 to the first pulse of the next first pulse wave part. have. Further, the first pulse wave part P1 has an auxiliary pulse having the same polarity as the pulse and the same amplitude as the weak pulse between the pulses of the first pulse wave part P1. In the modification shown in FIG. 23B, when the pulse currents are superposed on each other, as shown in the figure, the pulse is applied from the end point of the combined pulse to the start point of the next combined pulse. A synthetic weak pulse is formed. Note that the amplitude of the composite weak pulse in FIG. 23B is twice the amplitude Cw of the weak pulse because the weak pulses of the pulse current output from the first pulse generation unit and the second pulse generation unit overlap each other. ing.

  The “weak pulse duration” refers to the time (pulse width) between the start point and end point of one weak pulse or composite weak pulse. The “synthetic weak pulse” is a composite pulse generated by superimposing or connecting the weak pulses of the superimposed pulse currents when the pulse current waveforms output from each pulse generator are superimposed. It refers to the waveform of the part other than.

Therefore, in this embodiment, since the composite pulses are composed of the same polarity, compared to the case where the composite pulses are alternately switched as shown in FIG. Will be repeated, and an electrode flow action or the like can be obtained. Further, the pulse current has a weak pulse between each of the plurality of continuous first pulse wave parts P1, and the weak pulse has the same polarity as the pulse of the first pulse wave part P1, and the first Since the amplitude is smaller than the amplitude of the pulse of the pulse wave part P1, weak electricity flows between the interference pulses having the same polarity with respect to the interference site, and an electrode flow action or the like can be obtained more effectively. it can.

Note that the weak pulse can be applied between two continuous pulse wave portions. As shown in FIGS. 23A and 23B, the weak pulse is converted into three or more continuous pulse wave portions. It is preferable from the viewpoint of obtaining a more effective electrode flow action and the like .

Further, as shown in FIG. 23A, by providing a non-application period before and after the weak pulse, it is possible to obtain an electrode flow action only at an interference portion where the pulse current interferes. Further, as shown in FIG. 23 (b), by providing a weak pulse applied between adjacent first pulse wave portions P1, it is possible to obtain an electrode flow action or the like in a wide area including under the electrode. it can. Furthermore, as shown in FIG. 23B, by providing a weak pulse applied between adjacent first pulse wave portions P1 and an auxiliary pulse having the same polarity as the pulse of the first pulse wave portion P1. , it can be obtained more effectively electrode through flow action and the like.

  Here, the weak pulse is preferably 50% or less of the amplitude of the pulse, and more preferably 25% or less, in relation to the pulse of the pulse wave part before and after the weak pulse is applied. . Alternatively, the amplitude of the weak pulse is preferably set to a current value at which the nerve is not ignited by the weak pulse when a pulse current is applied to the living body, or a current value in the range of −1 to 1 mA.

  Next, a pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and an eighth modification of the synthesized wave will be described with reference to FIG.

  The pulse currents output from the first pulse generation unit and the second pulse generation unit shown in FIG. 24 are a plurality of first pulse wave units P1 and P2 that are continuously repeated. The difference is that a weak pulse is present between each of the pulse wave part P1 and the second pulse wave part P2. Note that the weak pulse shown in FIG. 24 has the same polarity, and has a Cw with an amplitude smaller than the amplitude of the pulse of each pulse wave section, as in the weak pulse shown in FIG.

  Specifically, in the example shown in FIG. 24A, the weak pulse duration Tw of the weak pulse is the same as the pulse duration Tp of the first pulse wave portion P1 and the second pulse wave portion P2, A weak pulse is applied from the last pulse of one pulse wave part P1 or the second pulse wave part P2 with the same non-application time as the pulse duration Tp, and after the weak pulse, the same non-application time as the pulse duration Tp is applied. The first pulse of the next pulse wave part P1, P2 is applied. In the modification shown in FIG. 24 (a), when the pulse currents are superposed on each other, the phase difference D has the same time as the pulse duration Tp. A synthetic weak pulse is formed that is applied from the end point to the start point of the next synthetic pulse.

  In the example shown in FIG. 24B, the weak pulse is between the last pulse of the first pulse wave part P1 or the second pulse wave part P2 and the first pulse of the next pulse wave parts P1 and P2. It has a weak pulse duration of time Tw. Further, the first pulse wave part P1 has an auxiliary pulse having the same polarity as the pulse and the same amplitude as the weak pulse between the pulses of the first pulse wave part P1. Further, the second pulse wave part P2 has an auxiliary pulse having a polarity opposite to that of the pulse (the same polarity as the weak pulse) and the same amplitude as the weak pulse, between the pulses of the second pulse wave part P2. ing. In the modification shown in FIG. 24B, when the pulse currents are superposed on each other, as shown in the figure, the combined pulse is applied from the end point of the combined pulse to the start point of the next combined pulse. A synthetic weak pulse is formed. Note that the amplitude of the composite weak pulse in FIG. 24B is twice the amplitude Cw of the weak pulse because the weak pulses of the pulse current output from the first pulse generation unit and the second pulse generation unit are superimposed. It has become.

  Therefore, in this embodiment, since there are weak pulses in each of a plurality of composite pulses in which the polarities are alternately switched, compared with a case where the composite pulses have the same polarity as shown in FIG. The electrode flow action can be obtained by the weak pulse while suppressing the liquid property change in the living body due to the synthetic pulse.

  In addition, as shown in FIG. 24A, by providing a non-application period before and after the weak pulse, it is possible to obtain an electrode flow action only at the interference site where the pulse current interferes. Further, as shown in FIG. 24 (b), by providing a weak pulse applied between the first pulse wave part P1 and the second pulse wave part P2, the electrode flow in a wide area including under the electrode. The effect can be obtained. Furthermore, as shown in FIG. 24 (b), the weak pulse applied between the first pulse wave part and the second pulse wave part P2, and the pulse of the first pulse wave part P1 in each pulse wave part, By providing auxiliary pulses having the same polarity, the electrode flow action can be obtained more effectively.

  Note that the pulse current oscillated by the electrical stimulation device 1 (1a, 1b) and the synthesized wave of the pulse current are not limited to the pulse current and the synthesized wave of the above-described waveform, and the oral and pharyngeal stimulation of the present invention. In the method, when the waveform of the pulse current output from each pulse generator is overlapped, a composite wave having a composite pulse having a pulse duration longer than the pulse duration of the pulse of the pulse current is formed. The pulse currents of the waveforms can be used in combination.

  Furthermore, when the electrical stimulation apparatus 1 (1a, 1b) has an additional pulse generation unit such as a third pulse generation unit in addition to the first pulse generation unit and the second pulse generation unit, for example, FIG. As shown in the figure, a composite wave similar to the composite wave shown in FIG. 12 can be obtained by setting the time of the non-application period Sn between pulses of each pulse current to twice the pulse duration Tp.

  Further, the case where the electrical stimulation device 1 (1a, 1b) includes the third pulse generation unit and the case where the electrical stimulation device 1 (1a, 1b) includes only the first pulse generation unit and the second pulse generation unit are described above. Similarly to the above, it is possible to arbitrarily change the shape of each pulse, the non-application time Tn between the pulses, the phase difference D, and the like. As an example in which the phase difference D for superimposing the pulses is changed, as shown in FIG. 26A, the remaining two pulses are not overlapped with each other for one of the three pulses, As shown in FIG. 26 (b), a part of the remaining two pulses is overlapped with each other with respect to one of the three pulses, or, as shown in FIG. As shown in c), the two pulses all overlap, and a part of the remaining one pulse is overlapped. In the synthesized pulses shown in FIGS. 26A to 26C, the current value becomes the maximum value at the central portion in the width direction of the synthesized pulse, so that the user's feeling of electrical stimulation can be eased. In addition, in the composite pulse shown in FIGS. 26B and 26C, the maximum value of the current value of the composite pulse is three times the amplitude of the pulse, so that even if current decay occurs in the living body, sufficient Can give irritation.

Here, an embodiment of the oral cavity / pharyngeal laryngeal stimulation method of the present invention in which each example of the positioning step described above and each example of the pulse current are combined will be described.
A first example of an oral cavity / pharyngeal laryngeal stimulation method according to an embodiment of the present invention will be described.
The first example of the oral cavity / pharyngopharyngeal stimulation method according to the embodiment of the present invention uses a third example of the positioning step shown in FIG. 8 as the positioning step, and includes a pulse having one polarity as the electrical stimulation current. A unipolar pulse current is used.
Here, a pulse current including a pulse having a negative polarity (negative polarity) is applied to the cheek 30 on the right side of the living body on the first electrode 3C1-1 of the first channel 3C1 attached to the lower jaw portion 10 on the left side of the living body. The first electrode 3C2 of the second channel 3C2 that oscillates a pulse current including a pulse having a positive polarity (positive polarity) on the second electrode 3C1-2 of the first channel 3C1 and is attached to the lower jaw 10 on the right side of the living body. −1 includes a pulse current having a negative polarity (negative polarity) pulse and a second channel second electrode 3C2-2 attached to the cheek 30 on the left side of the living body has a positive polarity (positive polarity) pulse. By oscillating the pulse current, electrical stimulation can be applied particularly efficiently to the tongues such as the tongue muscles and the genioglossus muscles.
Further, here, a pulse current including a pulse having a positive polarity (positive polarity) is applied to the cheek 30 on the right side of the living body on the first electrode 3C1-1 of the first channel 3C1 attached to the lower jaw portion 10 on the left side of the living body. A pulse current comprising a pulse having a negative polarity (negative polarity) is oscillated in the second electrode 3C1-2 of the attached first channel 3C1, and the first of the second channel 3C2 attached to the lower jaw 10 on the right side of the living body. Pulse having a positive polarity (positive polarity) on the electrode 3C2-1 and a negative polarity (negative polarity) on the second electrode 3C2-2 of the second channel attached to the cheek 30 on the left side of the living body By oscillating a pulsed current comprising, electrical stimulation can be applied particularly efficiently to the laryngeal elevation muscle group (mainly the muscle of the lower jaw) and the like.

  According to the first example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention, electrical stimulation is particularly effective in the oral cavity / pharyngeal area 90 in particular on the oral cavity and the laryngeal elevation muscle group. In particular, the effect of treating oral / pharyngeal dysfunction can be particularly enhanced.

A second example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
The second example of the oral cavity / pharyngeal stimulation method according to the embodiment of the present invention uses a third example of the positioning step shown in FIG. 8 as the positioning step, and includes pulses having both polarities as the electrical stimulation current. A bipolar pulse current is used.
Here, between the first electrode 3C1-1 of the first channel 3C1 attached to the lower jaw portion 10 on the left side of the living body and the second electrode 3C1-2 of the first channel 3C1 attached to the cheek portion 30 on the right side of the living body. Oscillates a bipolar pulse current, and the second electrode 3C2-1 of the second channel 3C2 attached to the lower jaw 10 on the right side of the living body and the second of the second channel attached to the cheek 30 on the left side of the living body. By oscillating a bipolar pulse current between the electrode 3C2-2 and the first embodiment of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention, electrical stimulation is efficiently applied to the tongue and the like. Both the effect of giving and the effect of efficiently giving electrical stimulation to the laryngeal elevation muscle group and the like can be obtained together.

  In the second example using the bipolar pulse current, a pulse having negative polarity (minus) is given not only to the cheek 30 but also to the lower jaw 10, and there is a problem such as pain due to muscle contraction in the lower jaw 10. There is a possibility that a pulse having a negative polarity (minus) is applied not only to the lower jaw 10 but also to the cheek 30 and problems such as pain due to muscle contraction may occur in the cheek 30. On the other hand, in the first example using a unipolar pulse current, the above problem is unlikely to occur.

A third example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
The third example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention uses the second example of the positioning step shown in FIG. 7 as the positioning step, and includes a pulse having one polarity as the electrical stimulation current. A unipolar pulse current is used.
Here, a pulse current including a pulse having positive polarity (positive polarity) is applied to the cheek 30 on the right side of the living body on the first electrode 3C1-1 of the first channel 3C1 attached to the front neck portion 20 on the left side of the living body. In addition, the second electrode 3C1-2 of the first channel 3C1 oscillates a pulse current having a negative polarity (negative polarity) pulse, and the first of the second channel 3C2 attached to the front neck 20 on the right side of the living body. Pulse having a positive polarity (positive polarity) on the electrode 3C2-1 and a negative polarity (negative polarity) on the second electrode 3C2-2 of the second channel attached to the cheek 30 on the left side of the living body By oscillating a pulse current including the electrical stimulation can be applied to the nasopharyngeal constrictor muscles and the like particularly efficiently.
Here, a pulse current including a pulse having a negative polarity (negative polarity) is applied to the cheek 30 on the right side of the living body on the first electrode 3C1-1 of the first channel 3C1 attached to the front neck 20 on the left side of the living body. A pulse current including a pulse having positive polarity (positive polarity) is oscillated on the second electrode 3C1-2 of the first channel 3C1 pasted, and the second channel 3C2 pasted on the front neck 20 on the right side of the living body A pulse current including a pulse having a negative polarity (negative polarity) is applied to the first electrode 3C2-1, and a positive polarity (positive polarity) is applied to the second electrode 3C2-2 of the second channel attached to the cheek 30 on the left side of the living body. By oscillating a pulse current having a pulse, the electrical stimulation can be given particularly efficiently to the hypopharyngeal constrictor muscle or the like.

  According to the third example of the oral cavity / pharyngopharyngeal stimulation method according to the embodiment of the present invention, electrical stimulation is particularly applied to the hypopharyngeal constrictor muscle and the upper pharyngeal constrictor muscle among the oral cavity / pharyngeal area 90 on the cervical side. Can be particularly effectively applied to enhance the effect of treating oral / pharyngeal laryngeal dysfunction.

A fourth example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
The fourth example of the oral cavity / pharyngeal stimulation method according to the embodiment of the present invention uses a second example of the positioning step shown in FIG. 7 as the positioning step, and includes pulses having both polarities as the electrical stimulation current. A bipolar pulse current is used.
Here, the first electrode 3C1-1 of the first channel 3C1 attached to the front neck 20 on the left side of the living body and the second electrode 3C1-2 of the first channel 3C1 attached to the cheek 30 on the right side of the living body. A bipolar pulse current is generated between the first electrode 3C2-1 of the second channel 3C2 attached to the front neck 20 on the right side of the living body and the second channel attached to the cheek 30 on the left side of the living body. By oscillating a bipolar pulse current with the second electrode 3C2-2, electrical stimulation is performed on the nasopharyngeal constrictor muscle and the like obtained in the third example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention. It is possible to obtain both the effect of efficiently applying the electrical stimulation and the effect of efficiently applying electrical stimulation to the hypopharyngeal constrictor muscle and the like. Furthermore, according to the fourth example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention, electrical stimulation can also be applied to the oropharyngeal constrictor muscle.

  As in the case of the first and second examples, in the fourth example using the bipolar pulse current, a pulse having a negative polarity (minus) is given not only to the cheek 30 but also to the front neck 20. There is a possibility that problems such as pain due to muscle contraction may occur in the front neck 20, and a pulse having a negative polarity (minus) is given not only to the front neck 20 but also to the cheek 30. There is a possibility that problems such as pain due to contraction may occur. On the other hand, in the third example using a unipolar pulse current, the above problem is unlikely to occur.

  In the above first to fourth examples, one may be used alone or a plurality may be used in combination so as to enhance the therapeutic effect of the oral cavity / pharyngeal region.

A fifth example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention will be described.
The fifth example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention is particularly aimed at enhancing the therapeutic effect on dysphagia.
A plurality of living body sites in the oral cavity / pharyngeal region 90 are involved in the swallowing motion. That is, first, the laryngeal lift muscle group lifts the pharyngeal larynx region upward, and then the tongue in the oral region moves to the laryngeal region side by the tongue muscle, and the nasopharyngeal constrictor muscle, the oropharyngeal constrictor muscle, A swallowing reflex occurs when the hypopharyngeal constrictor muscles expand and contract in this order. In patients with dysphagia, some or all of these effects are impaired.

The fifth example of the oral cavity / pharyngeal laryngeal stimulation method of the present invention uses a fourth example of the positioning step shown in FIG. 9 as the positioning step, and a unipolar pulse current comprising a pulse having one polarity as the electrical stimulation current , And bipolar pulse currents with pulses of both polarities.
First, in the first stage and the second stage, a first example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention is performed.
That is, in the first stage, a pulse current including a pulse having a negative polarity (negative polarity) is applied to the cheek 30 on the right side of the living body on the first first B electrode portion 3C1-1B attached to the lower jaw portion 10 on the left side of the living body. A second first B electrode portion that oscillates a pulse current including a pulse having a positive polarity (plus polarity) on the second electrode 3C1-2 of the first channel that is pasted, and is pasted on the lower jaw 10 on the right side of the living body. A pulse current having a pulse having negative polarity (negative polarity) in 3C2-1B and a pulse having positive polarity (plus polarity) in the second electrode 3C2-2 of the second channel attached to the cheek 30 on the left side of the living body Oscillates the pulse current provided. Thereby, electrical stimulation can be given especially efficiently to the laryngeal elevation muscle group or the like.

  In the second stage, a pulse current including a pulse having a positive polarity (positive polarity) is applied to the cheek 30 on the right side of the living body on the first first B electrode portion 3C1-1B attached to the lower jaw portion 10 on the left side of the living body. A pulse current having a negative polarity (negative polarity) pulse is oscillated on the second electrode 3C1-2 of the first channel pasted, and the second first B electrode portion pasted on the lower jaw 10 on the right side of the living body A pulse current having a pulse with positive polarity (positive polarity) on 3C2-1B and a pulse with negative polarity (negative polarity) on the second electrode 3C2-2 of the second channel attached to the cheek 30 on the left side of the living body Oscillates the pulse current provided. Thereby, electrical stimulation can be given especially efficiently to tongue parts, such as a tongue muscle and a genioglossus muscle.

Next, in the third stage, a part of the third example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention is performed.
That is, in the third stage, a pulse current including a pulse having positive polarity (plus polarity) is applied to the first first A electrode portion 3C1-1A attached to the front neck 20 on the left side of the living body, and the cheek 30 on the right side of the living body. A pulse current comprising a pulse having a negative polarity (negative polarity) is oscillated on the second electrode 3C1-2 of the first channel attached to the first channel, and the second first A attached to the front neck 20 on the right side of the living body. The second electrode 3C2-2 of the second channel pasted on the cheek 30 on the left side of the living body has a negative polarity (negative polarity) with a pulse current including a pulse having a positive polarity (positive polarity) in the electrode portion 3C2-1A. A pulse current including a pulse is oscillated. As a result, electrical stimulation can be applied particularly efficiently to the nasopharyngeal constrictor muscle or the like.

Subsequently, in the fourth stage, a fourth example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention is performed.
That is, in the fourth stage, the first first A electrode portion 3C1-1A attached to the front neck 20 on the left side of the living body and the second electrode 3C1-2 of the first channel attached to the cheek 30 on the right side of the living body. And a second channel attached to the cheek 30 on the left side of the living body and the second first A electrode portion 3C2-1A attached to the front neck 20 on the right side of the living body. A bipolar pulse current is oscillated with the second electrode 3C2-2. Thereby, electrical stimulation can be applied particularly efficiently to the nasopharyngeal constrictor muscle, the oropharyngeal constrictor muscle, the hypopharyngeal constrictor muscle, and the like.

Furthermore, in the fifth stage, a part of the third example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention is performed.
That is, in the fifth stage, a pulse current including a pulse having a negative polarity (negative polarity) is applied to the first first A electrode portion 3C1-1A attached to the front neck 20 on the left side of the living body, and the cheek 30 on the right side of the living body. A pulse current comprising a pulse having a positive polarity (positive polarity) is oscillated in the second electrode 3C1-2 of the first channel attached to the first channel, and the second first A attached to the front neck 20 on the right side of the living body. The second electrode 3C2-2 of the second channel pasted on the cheek 30 on the left side of the living body has a positive polarity (plus polarity) including a pulse current having a negative polarity (minus polarity) pulse in the electrode portion 3C2-1A. A pulse current including a pulse is oscillated. As a result, electrical stimulation can be applied to the hypopharyngeal constrictor muscle or the like particularly efficiently.

  As described above, through the first stage to the fifth stage, the biological sites that give electrical stimulation particularly efficiently are the laryngeal elevation muscles, the tongue, the nasopharyngeal constrictor muscles, the upper, middle, and lower pharyngeal constrictor muscles. It changes in the order of hypopharyngeal constrictor muscles. This order follows the order of the living body part in the oral cavity / pharyngeal region 90 that functions during the swallowing operation. As described above, according to the fifth example of the oral cavity / pharyngeal laryngeal stimulation method according to the embodiment of the present invention, it becomes possible to remember the swallowing action in the body of the dysphagia patient and to obtain the rehabilitation effect of the dysphagia. be able to. Therefore, according to the fifth example, in particular, the therapeutic effect on dysphagia can be enhanced.

  The fifth example of the oral cavity / pharyngeal stimulation method according to the embodiment of the present invention includes all of the first to fifth stages, but the oral cavity / pharyngeal stimulation method of the present invention is limited to this. Without being performed, each stage of the first stage to the fifth stage can be appropriately combined depending on the purpose of treatment, and a method including this combination can be obtained.

-Electrical stimulator-
Details of the electrical stimulation device 1 (1a, 1b) shown in FIGS. 1 (a) and 1 (b) will be described below.
As described above, the electrical stimulation device 1 includes the operation unit 500. The operation unit 500 includes an input unit 500a, a display unit 500b, a power supply unit (not shown), a pulse generation unit (not shown) as an oscillator, a control unit (not shown), and an amplification unit (not shown). (Not shown).
The input unit 500a is provided with a switch for performing various operations and a switch for performing various settings including, for example, a switch for turning on / off a current for electrical stimulation. When the user of the electrical stimulation device 1 presses the switch of the input unit 500a, a signal corresponding to the switch is output from the input unit 500a, and each output signal is input to the control unit.
The control unit performs processing according to the signal output from the input unit 500a to control the operation of the pulse generation unit.
The pulse generator (oscillator) outputs a pulse current.
The display unit 500b displays various setting values input through the input unit 500a, for example, so that the user of the electrical stimulation device 1 can check the setting contents.
The power supply unit is made of, for example, a secondary battery and supplies power to the oscillation unit of the operation unit 500, the display unit 500b, and the like.
The amplifying unit is located between the pulse generating unit and the electrode 3 and amplifies the electrical stimulation current oscillated by the pulse generating unit. By amplification in the amplifying unit, a current having appropriate power can be given to the living body.

= Electrode =
Hereinafter, it describes about the detail of the electrode 3 with which an electric stimulator is provided.
The shape of the electrode of the electrical stimulation device 1 is not particularly limited, and can be appropriately adjusted to the shapes of the lower jaw 10, the front neck 20, and the cheek 30. For example, the electrode positioned on the lower jaw 10 has an arcuate shape that can be attached along the lower jaw line from the lower jaw angle (not shown) on the left side of the living body to the lower jaw angle (not shown) on the right side of the living body. It can be. Further, the electrode 3 positioned on the lower jaw 10 may be formed in a circular shape that can be attached to the center of the lower jaw bottom.

  In particular, when an electrical stimulation is performed on the oral cavity / pharyngeal region 90 using an electric current of an interference wave as an electrical stimulation current oscillated with respect to the living body, the electrode 3 positioned on the lower jaw 10 is applied to the living body surface. The contact area (hereinafter, also referred to as “energization area”) is preferably smaller than the conduction area of the electrode 3 positioned on the front neck 20 and / or the cheek 30. With the above-described configuration, the interference area of the interference wave current can be set to a region (such as the epiglottis or the hypopharyngeal constrictor muscle) in the oral cavity / pharyngeal region 90, particularly in the vicinity of the neck. Therefore, it is possible to effectively apply electrical stimulation to the oral cavity / pharyngeal region 90 of the patient to enhance the effect of treating the oral cavity / pharyngeal dysfunction.

  When electrical stimulation is applied using an interference wave as described above, as shown in FIG. 27 (a), a region Ai where current interferes (that is, a region where electrical stimulation is effectively applied) constitutes each channel. This is a region Ai where planes Pa and Pb formed by connecting the electrodes 3 to be connected with a straight line intersect. At this time, as shown to Fig.27 (a), it is desirable that area | region Ai where an electric current interferes contains the desired position (stimulation target site | part) Ad in the biological body. However, when the attachment position of the electrode 3 is changed for some reason, as shown in FIG. 27B, the region Ai may change and may not include the desired position Ad in the living body. Here, as shown in FIG. 27C, when the size of the electrode 3 is changed, the region Ai where the current interferes can be changed, and the region Ai includes a desired position in the living body. be able to.

Hereinafter, an electrode 3 that can be changed in size (hereinafter also referred to as “size-variable electrode 300”), which is preferably used in the case of applying electrical stimulation by causing current to interfere, will be described.
A specific example of the variable size electrode 300 will be described with reference to FIGS. Note that the size variable electrode 300 can also be applied to a stimulation device other than the electrical stimulation device 1 described above.

Here, the electrode 300-1 of the first embodiment of the variable size electrode will be described with reference to FIG.
As shown in FIG. 28A, the electrode 300-1 of the first embodiment of the variable size electrode has a disk-shaped main body 301 and a wiring 302 extending from the approximate center. The main body 301 is formed of an attachment-side portion 303 including a portion that is attached to the surface of the living body and applies a current for electrical stimulation to the living body, and a case portion 304 that includes an energization range changing portion described later. Yes.
Further, the attachment surface (bottom surface) of the electrode 300-1 is shown in FIG. 28 (b), and a sectional view taken along line aa in FIG. 28 (b) is shown in FIG. 28 (c). Has a mounting surface P (the surface below FIG. 28A) attached to the living body and a non-mounting surface N located on the opposite side of the mounting surface P. The case portion 304 is fixed on the non-mounting surface N using a known means such as adhesion or welding.
In addition, although the main-body part 301 is a disk shape in illustration, it can be made into arbitrary shapes.

The attachment side portion 303 of the electrode 300-1 includes a plurality of conductive portions 312 and a plurality of insulating portions 313. At least one of the conductive portion 312 and the insulating portion 313 is an adhesive member, such as a conductive polymer gel, or an electrolyte or a conductive substance, so that the electrode 300-1 can be attached to the surface of the living body. It is formed with hydrogel or sol containing. Hydrogels and sols include, for example, poly (amidoamine), poly (dimethylsiloxane), poly (hydroxyethyl methacrylate), poly (N-isopropylacrylamide), poly (acrylamide), poly (acrylic acid), and poly (methacrylic). Acid), polyurethane, poly (ethylene glycol), poly (ethylene glycol monomethacrylate), poly (methacrylic acid) -co-poly (ethylene glycol), poly (vinyl alcohol), and poly (vinyl-pyrrolidone), poly (acrylamide) ), Poly (aminopropyl methacrylamide), and poly (N, N-dimethyl-2-aminoethyl methacrylate) or copolymers thereof, block copolymers, graft copolymers, and heteropolymers thereof, or these Comprising at least one polymer selected from the combination.
As shown in FIG. 28B, in the electrode 300-1, the conductive portions 312 and the insulating portions 313 are alternately arranged concentrically.
In this embodiment, three conductive portions 312 (a disk-shaped conductive portion 312a1, annular conductive portions 312a2 and 312a3 from the center side toward the outer peripheral edge side) and two annular insulating portions 313 are provided. Although alternately provided, in the variable size electrode 300, the number of the conductive portions 312 and the insulating portions 313 can be arbitrarily increased or decreased. In the variable size electrode 300, the conductive portion 312 and the insulating portion 313 may be arranged in a shape other than the concentric shape, and the conductive portion 312 and the insulating portion 313 are formed in a shape such as a rectangular parallelepiped shape or a cubic shape, for example. It is also possible to do. Further, in this embodiment, the conductive portion 312 and the insulating portion 313 are members having adhesiveness. However, in the size variable electrode 300, the conductive portion 312 and the insulating portion 313 are non-adhesive members and the attachment side portion 303 is used. You may provide an adhesive material in the outer peripheral side of this. In addition, the insulating portion 313 may be an air insulating member that uses a space formed by separating the conductive portions 312 and using an insulating member.

In the wiring 302 and the case portion 304 to which the wiring 302 is connected, as shown in FIG. 28C, the number of conducting wires 302a corresponding to the number of the conductive portions 312 (three in the illustrated example) passes. . Each of the conductive wires 302a has one end connected to one of the conductive portions 312 and the other end connectable to a current source for electrical stimulation (not shown) (for example, an oscillating unit or an amplifying unit of the electrical stimulation device). Is formed. Each of the conductive wires 302 a is covered with an insulating member so that the conductive wires 302 a do not come into contact with each other in the wiring 302 to be conductive.
Note that one end of the conducting wire 302a and the conductive portion 312 may be directly connected to one end of the conducting wire 302a to the conducting portion 312. Indirectly, that is, one end of the conducting wire 302a and the conducting portion 312 may be In the meantime, it is possible to connect via a conductive transmission member such as a conductive metal plate, a metal sheet, or a carbon sheet.
Further, in the electrode 300-1, three conductive wires 302a are accommodated in one wiring 302 and the wiring 302 is connected to the case portion 304. However, the variable size electrode 300 accommodates one conductive wire 302a. A plurality of wires 302 may be connected to the case portion 304.

  And according to the electrode 300-1 shown in FIG. 28, the several electrically conductive part 312 arrange | positioned mutually spaced apart, the insulating part 313 located between the electrically conductive parts 312 and each electrically conductive part 312 were connected individually. By making the conducting wire 302a function as an energization area changing mechanism, it is possible to change the area through which the electrical stimulation current is applied to the surface of the living body to which the electrode 3 is attached.

Specifically, in the electrode 300-1, for example, by using a control unit of an electrical stimulation device (not shown), by changing the number and position of the conducting wire 302a and the conductive unit 312 that conducts the electrical stimulation current, The area and position where the electrical stimulation current is applied can be changed. That is, in this electrode 300-1, the conducting wire 302a individually connected to each conductive portion 312 functions as an energization range changing portion that changes the number and range of the conductive portions 312 that energize the current for electrical stimulation.
As a result, the contact area (energization area) of the electrode 3 can be changed after the electrode is attached.

As described above, a plurality of conductive portions 312 that are spaced apart from each other, an insulating portion 313 positioned between the conductive portions 312, and a conductive wire 302 a individually connected to each conductive portion 312 are changed in energization area. In the electrode 300-1 for an electrical stimulation device that functions as a mechanism, since the conducting wire 302a is individually connected to each conductive portion 312, the energization area can be changed reliably and quickly. Moreover, since the conducting wire 302a is individually connected to each conductive portion 312, for example, the user or the like operates the electrical stimulator without worrying about a change in the energization area due to a physical impact on the electrode 3. The operation of changing the current-carrying area can be performed by operation or electrical control at the unit. When electrical control is performed, electrical stimulation can be applied to the living body with a control pattern such as changing the energization area or the stimulation position in the living body over time.
Moreover, since the conducting wire 302a is individually connected to each conductive portion 312, the degree of freedom in designing the arrangement positions of the conductive portion 312 and the insulating portion 313 is high.

Next, an electrode 300-1a according to a modification of the first embodiment of the variable size electrode will be described with reference to FIG.
FIG. 29 (a) shows a modified example of the electrode 300-1a, the attachment surface (bottom surface) of which is shown in FIG. 29 (b), and the sectional view taken along the line bb of FIG. As shown in (c), only one conductor 302a is disposed in the wiring 302, and the electrode 300 shown in FIG. -1 and the configuration are different. That is, the electrode 300-1a according to the modification includes a conductive portion 312a (312a1) with a conductive wire to which the conductive wire 302a is connected, and a conductive portion 312b (312b1, 312b2) without a conductive wire to which the conductive wire 302a is not connected. .

In addition, the electrical stimulation device electrode 300-1a according to the modified example includes a conductor without conductors in the case portion 304, as shown in FIG. 29D, which is a cross-sectional view taken along the line cc of FIG. The first conductive member 316-1 (316-1a, 316-1b) connected to the portions 312b1 and 312b2, and the conductive portion 312a1 with a conducting wire, and can contact / separate from the first conductive member 316-1. Also in the point provided with the formed second conductive member 316-2, the configuration is different from the electrode 300-1 shown in FIG.
Specifically, in the case portion 304, an inner first conductive material is disposed so as to cover a part of the upper side of the insulating part 313 located between the two conductive parts 312 a 1 and the conductive part 312 b 1 in a fan shape in plan view. A member 316-1a and an outer first conductive member 316-1b arranged so as to cover a part of the upper side of the three conductive portions 312a1, 312b1, 312b2, and the two insulating portions 313 are arranged in a fan shape in plan view. ing. Further, in the case portion 304, a second conductive member 316-2 having a fan shape in plan view is slidable on the conductive portion 312a1 above the conductive portion 312a1, and the first conductive member 316-1 (316). -1a, 316-1b) and can be contacted / separated.

  The inner first conductive member 316-1a is made of a conductive member such as metal, and a part thereof is connected to the non-mounting surface N side of the conductive portion 312b1 without conducting wire as shown in FIG. . Of the inner first conductive member 316-1a, the contact portion 317 located above the conductive portion 312a1 with conductor and the insulating portion 313 is at least the conductive portion 312a1 with conductor (in the illustrated example, the conductive portion 312a1 and the insulating portion 313). It is formed so as not to come into contact with both of the non-mounting surfaces N (that is, to be located in a hollow portion in the case portion 304).

  The outer first conductive member 316-1b is made of a conductive member such as metal, and as shown in FIG. 29 (c), a part thereof includes a conductive portion without conducting wire 312b1, a conductive portion without conducting wire 312b2, and a conductive without conducting wire. The insulating portion 313 located between the portion 312b1 and the conductive portion 312b2 without conducting wire is connected to the non-mounting surface N side. Further, in the outer first conductive member 316-1b, the contact portion 317 located above the conductive portion 312a1 with the conductive wire and above the insulating portion 313 located between the conductive portion 312a1 with the conductive wire and the conductive portion 312b1 without the conductive wire. Is formed so as not to be in contact with at least the non-mounting surface N side of the conductive portion 312a1 with conductive wire (both the conductive portion 312a1 and the insulating portion 313 in the illustrated example) (that is, located in the hollow portion in the case portion 304). Has been.

Further, the second conductive member 316-2 can contact the conductive portion 312a1 and can slide on the conductive portion 312a1 on the non-mounting surface N of the conductive portion 312a1 with a conductive wire (in the illustrated example, the center of the conductive portion 312a1). Is arranged so as to be rotatable around a conducting wire 302a connected to the. Then, when the second conductive member 316-2 is rotated around the conducting wire 302a, the second conductive member 316-2 is in contact with a portion 317 (hereinafter referred to as “contact portion 317”) of the first conductive members 316-1a and 316-1b. It is configured. In addition, a handle portion 318 used when sliding the second conductive member 316-2 is fixed to the second conductive member 316-2, and a hole 324 from which the handle portion 318 protrudes is formed in the case portion 304. The second conductive member 316-2 is formed in an arc shape matching the range in which the second conductive member 316-2 is slid. The second conductive member 13b may directly contact and slide on the non-mounting surface N of the conductive portion 113c with a conductive wire, or indirectly, that is, a carbon film or a metal plate, a metal sheet, or the like. You may contact and slide through the conductive member.
Specifically, the second conductive member 316-2 has a dimension that is shorter than the radius of the conductive part 312a1 with a conducting wire having a circular shape in plan view and longer than the shortest distance between the conducting wire 302a and the contact portion 317. ing. The second conductive member 316-2 has a thickness equal to or greater than the distance D in the direction orthogonal to the non-mounting surface N between the conductive portion 312a1 with the conductive wire and the contact portion 317 (thickness equal to the distance D in the illustrated example). have. Therefore, in the electrode 300-1a, if the second conductive member 316-2 is positioned below the contact portion 317, the second conductive member 316-2 and the contact portion 317 are in contact (in the illustrated example, the second conductive member 316-2 The upper surface of the conductive member 316-2 contacts the lower surface of the contact portion 317).

In the electrode 300-1a, the thickness of the second conductive member 316-2 is equal to or greater than the distance D, and the side surface and the contact portion 317 of the second conductive member 316-2 are slid when the second conductive member 316-2 is slid. The side surface of the second conductive member 316-2 may be in contact with each other, or the thickness of the second conductive member 316-2 may be less than the distance D, and the handle portion 318 may be formed of a conductive member, so that the second conductive member 316-2 is formed. The handle portion 318 and the side surface of the contact portion 317 may come into contact with each other.
However, from the viewpoint of reliably bringing the second conductive member 316-2 and the contact portion 317 into contact with each other and maintaining the contact state with certainty, is the thickness of the second conductive member 316-2 equal to the distance D? Alternatively, the second conductive member 316-2 may be fitted in a state where the second conductive member 316-2 is sandwiched between the upper surface of the conductive portion 312a1 with the conductive wire and the lower surface of the contact portion 317, with a size slightly larger than the distance D. It is preferable. If the second conductive member 316-2 is fitted in a sandwiched state, the second conductive member 316-2 will move even if vibration or the like is given while applying electrical stimulation to the living body. This is because it can be prevented.
From the viewpoint of reliably bringing the second conductive member 316-2 and the contact portion 317 into contact with each other and maintaining the contact state with certainty, as shown in FIG. A wide portion having a relatively wide width, wherein at least one of the peripheral portion of the hole 324 from which the 318 protrudes or the handle portion 318 is made of a soft material, and the holes 324 are provided at both ends and the middle of the hole 324. 325 and a narrow portion 326 having a relatively narrow width located between the wide portions 325. Specifically, the narrow width portion 326 is formed with a width slightly smaller than the diameter of the handle portion 318, and the wide width portion 325 is larger than the width of the narrow width portion 326 and the handle portion 318 is weakly fitted. It is formed to match. By forming the hole 324 with the wide portion 325 and the narrow portion 326, a resistance force is generated when the handle portion 318 slides from the wide portion 325 to the narrow portion 326, so that the handle portion 318 is attached to the hole 324. If the second conductive member 316-2 is in contact with the contact portion 317, the handle portion 318 is fixed to the wide portion 325 in the middle of the hole 324. When positioned, the second conductive member 316-2 can be fixed to the contact portion 317 in a non-contact state. Therefore, if the handle portion 318 is positioned in the wide portion 325, the second conductive member 316-2 is prevented from moving even if vibration or the like is applied to the living body while applying electrical stimulation. be able to.

  In addition, according to the electrode 300-1a of the above-described modified example, the insulating portions located between the plurality of conductive portions 312 (the conductive portion with conductive wire 312a1 and the conductive portion without conductive wire 312b) that are spaced apart from each other and the conductive portion 312. By causing the part 313, the first conductive member 316-1, and the second conductive member 316-2 to function as an energization area changing mechanism, a current for electrical stimulation is applied to the surface of the living body to which the electrode 3 is attached. The area to be changed can be changed.

Specifically, in the electrode 300-1a, for example, the second conductive member 316-2 is placed in a state where a current for electrical stimulation is supplied from the electrical stimulation device 1 (not shown) to the conductive portion 312a1 with the conductive wire via the conductive wire 302a. By changing the position of the second conductive member 316-2 by sliding it, the number and range of the conductive portions 312 through which a current for electrical stimulation is applied can be changed. More specifically, if the second conductive member 316-2 is positioned in a position where it does not contact the contact portion 317 in a state where a current for electrical stimulation is applied to the conductive portion 312a1 with conductor, only the conductive portion 312a1 with conductor is provided. Can be energized. Further, when the second conductive member 316-2 is brought into contact with the contact portion 317 of the inner first conductive member 316-1a in a state where a current for electrical stimulation is applied to the conductive portion 312a1 with conductive wire, the conductive portion 312a1 with conductive wire is brought into contact. In addition, it is possible to energize the conductive portion 312b1 without a conducting wire. Further, when the second conductive member 316-2 is brought into contact with the contact portion 317 of the outer first conductive member 316-1b in a state where a current for electrical stimulation is applied to the conductive portion 312a1 with conductive wire, the conductive portion 312a1 with conductive wire is brought into contact. In addition, it is possible to energize the conductive portions 312b1 and 312b2 without conducting wires.
That is, in this electrode 300-1a, the conducting wire 302a connected to the conducting part with conducting wire 312a1, the first conducting member 316-1 connected to the one or more conducting parts without conducting wire 312b1, 312b2, and the conducting part with conducting wire The second conductive member 316-2 connected to the 312a1 and formed so as to be able to contact / separate the first conductive member 316-1 changes the number and range of the conductive portions 312 through which a current for electrical stimulation is passed. It functions as an energizing range changing unit.
As a result, the contact area (energization area) of the electrode can be changed after the electrode is attached by moving the second conductive member 316-2.

  As described above, the conductive portion 312 having the conductive portion 312a1 with the conductive wire and the conductive portions 312b1 and 312b2 without the conductive wire, the insulating portion 313, the conductive wire 302a, the first conductive member 316-1, and the second conductive member 316-2 are energized. In the electrode 300-1a that functions as the area changing mechanism, the energization area can be changed without complicating the wiring of the conducting wire 302a. Moreover, it is not necessary to design the part other than the electrode 3 of the electrical stimulator 1, for example, an operation part, for changing an energization area. Furthermore, the degree of freedom in designing the arrangement positions of the conductive portion 312 and the insulating portion 313 is high.

Next, an electrode 300-1b according to another modification of the first embodiment of the variable size electrode will be described with reference to FIG.
FIG. 30 (a) shows another modification of the electrode 300-1b, the mounting surface (bottom surface) of which is shown in FIG. 30 (b), and a sectional view taken along the line dd of FIG. 30 (b). As shown in FIG. 30C, the conductive wire 302a does not have the wiring 302 disposed therein, and a hole through which the movable energizing member 319 is inserted is formed on the side surface of the case portion 304. The configuration is different from the electrode 300-1 shown in FIG.

  In addition, in the electrode 300-1b of another modification, the conductive wire 302a is not connected to the conductive portion 312 as shown in FIG. 30 (d), which is a cross-sectional view taken along line ee of FIG. 30 (c). Also in that the insulating member 320 that covers the half surface of the non-mounting surface N, the film-like or sheet-like conductive member 321, and the insulating part 313 includes the film-like or sheet-like auxiliary insulating member 322. 30 is different from the electrode 300-1 shown in FIG.

The movable energizing member 319 is connected to the conducting wire 302a and is made of a conductive member such as a metal bar. The movable energizing member 319 is inserted through a hole formed in the side surface of the case portion 304 and is movable in the case portion 304. The movable energization member 319 has a dimension longer than the shortest distance from the center of the non-mounting surface N to the outermost conductive portion 312b3.
The movable energizing member 319 is moved by moving a lead wire 302a attached to the movable energizing member 319 and extending from the side of the case portion 304 through the through hole to the case portion 304, in the illustrated case. This can be done by sliding the portion 304 in the radial direction. At this time, by providing the rigid member 323 around the conducting wire 302a, the movable energizing member 319 can be moved together with the conducting wire 302a by sliding the rigid member 323. Here, from the viewpoint of moving the movable energizing member 319 with high directivity, wall-shaped guide portions may be provided on both sides of the region where the movable energizing member 319 is to be moved. The movable energizing member 319 may be moved using a mechanism such as a ball screw.

  As shown in FIG. 30 (d), the insulating member 320 is arranged so as to cover the half surface of the non-mounting surface N on the side where the hole through which the movable energizing member 319 is inserted is formed. Therefore, in the electrode 300-1b of another modified example, the movable energizing member 319 inserted from the hole does not make electrical contact (energization) with the conductive portion 312, and the inside of the case portion 304 is formed on the non-attachment surface N. It can move to the center.

  The conductive member 321 is disposed on a portion of the upper surface of the conductive portion 312 where the insulating member 320 is not disposed. That is, in the electrode 300-1b shown in FIG. 30, one semicircular conductive member 321 and two annular conductive members 321 having different dimensions are provided on the upper surfaces of the conductive portions 312b1, 312b2, and 312b3, respectively. Has been placed.

  The auxiliary insulating member 322 is disposed on a portion of the upper surface of the insulating portion 313 where the insulating member 320 is not disposed. That is, in the electrode 300-1 b shown in FIG. 30, two annular auxiliary insulating members 322 having different dimensions are arranged on the upper surface of each insulating portion 313.

  And according to the electrode 300-1b shown in FIG. 30, the movable electricity supply member to which the some electrically conductive part 312 arrange | positioned mutually spaced apart, the insulation part 313 located between the electrically conductive parts 312 and the conducting wire 302a were connected. By causing 319 to function as an energization area changing mechanism, the area where the electrical stimulation current is applied to the surface of the living body to which the electrode 3 is attached can be changed.

Specifically, in the electrode 300-1b for the electrical stimulation device, for example, in the state in which the electrical current for electrical stimulation is applied to the movable energization member 319 from the electrical stimulation device 1 (not shown) via the lead wire 302a, By sliding the movable energizing member 319 inserted through the hole, the number and range of the conductive portions 312 that energize the current for electrical stimulation can be changed. More specifically, when the electric current for electrical stimulation is applied to the mobile energization member 319, the mobile energization member 319 is positioned above the semicircular conductive member 321 (first energization position). The movable energizing member 319 and the conductive portion 312b1 can be electrically contacted via the conductive member 321, and only the conductive portion 312b1 can be energized. In addition, in a state where the electric current for electrical stimulation is applied to the movable energizing member 319, the movable energizing member 319 is placed on the upper surface of the insulating portion 313 positioned between the semicircular conductive member 321 and the conductive portions 312b1 and 312b2. If the annular auxiliary conductive member 322 and the annular conductive member 321 located on the upper surface of the conductive portion 312b2 are positioned above the second conductive position, the movable conductive member 319 and the conductive portion 312b1 are disposed. , 312b2 can be brought into electrical contact with each other through the conductive member 321, and the conductive portions 312b1 and 312b2 can be energized. Furthermore, in the state where the electric current for electrical stimulation is applied to the movable energizing member 319, the movable energizing member 319 is arranged in a semicircular conductive member 321 and an annular auxiliary insulating member positioned on the upper surface of the insulating portion 313. 322 and the conductive portions 312b2, 312b3, the movable conductive member 319 and the conductive portions 312b1, 312b2, 312b3 are electrically conductive by being positioned above the annular conductive member 321 (third energization position) positioned on the upper surface of the conductive portions 312b2, 312b3. The conductive portions 312b1, 312b2, and 312b3 can be energized by being brought into electrical contact with each other through the conductive member 321.
That is, in this electrical stimulation device electrode 300-1b, the movable energization member 319 to which the conducting wire 302a is connected functions as an energization range changing unit that changes the number and range of the conductive units 312 that energize the electrical stimulation current. To do.
As a result, the contact area (energization area) of the electrode can be changed after the electrode is attached by moving the movable energization member 319 to which the conducting wire 302a is connected.

  Here, in the electrode 300-1b that causes the conductive portion 312, the insulating portion 313, and the movable energization member 319 to function as an energization area changing mechanism as described above, the energization area can be increased without complicating the wiring of the conducting wire 302a. It can be changed. Moreover, it is not necessary to design the part other than the electrode 3 of the electrical stimulator 1, for example, an operation part, for changing an energization area. Furthermore, the degree of freedom in designing the arrangement positions of the conductive portion 312 and the insulating portion 313 is high.

  In the electrode 300-1b, the conductive wire 302a or the rigid member 323 in the vicinity of the hole of the case portion 304 is provided with a scale or small unevenness, so that the position of the movable energization member 319 in the case portion 304 or the conductive portion. The energization range 312 may be recognizable. Alternatively, in the electrode 300-1 b, small irregularities and nails are provided on the auxiliary insulating member 322 so that the operator can feel resistance when getting over the irregularities and nails when moving the movable energizing member 319. Thus, the position of the movable energization member 319 in the case portion 304 or the energization range of the conductive portion 312 may be made recognizable.

Here, in the electrode 300-1b described above, by using the insulating member 320, the conductive member 321 and the auxiliary insulating member 322, the movable energizing member 319 moves in contact with at least one conductive portion 312b1. The number of conductive portions 312 that contact the conductive portion 312b1 and the conductive wire 302a with which the conductive member 319 is in contact with the first conductive position and the first conductive position are larger than the first conductive position, and the movable conductive member 319 is in contact The number of conductive parts 312 that contact the conductive parts 312b1 and 312b2 and the conducting wire 302a is greater than the second conductive position and the first conductive position and the second conductive position. It was made possible to move between the conductive parts 312b1, 312b2, 312b3 and the third energization position where the conducting wire 302a is energized.
However, the size variable electrode 300 is not limited to the configuration shown in FIG. Specifically, in the electrode 300-1 b shown in FIG. 30, the movable energizing member 319 and the conductive portions 312 b 2 and 312 b 3 are arranged on the hole side of the case portion 304 by disposing the semicircular insulating member 320. Although the electrical contact (energization) is avoided, the insulating member 320 is configured such that the movable energization member 319 and the conductive portions 312b2 and 312b3 are in electrical contact (energization) on the hole side of the case portion 304. If it is possible to avoid this, it is possible to have an arbitrary shape (for example, a shape covering only the upper surfaces of the conductive portions 312b2 and 312b3). Further, without providing the insulating member 320, for example, by covering a part of the movable energizing member 319 (side connected to the conducting wire 302a) with an insulating member, the movable energizing member 319 and the conductive portion 312b2 are covered. 312b3 may be prevented from being electrically contacted (energized) on the hole side of the case portion 304.

Next, the electrode 300-2 of the second embodiment of the variable size electrode will be described with reference to FIG.
As shown in FIG. 31A, the electrode 300-2 of the second embodiment of the variable size electrode includes a substantially disc-shaped cover portion 332, a wiring 338 extending from the substantially center thereof, and a conductive fluid (not shown). ) And an injection pipe 336 for injecting a conductive fluid.
In addition, although the cover part 332 is a disk shape in illustration, it can be made into arbitrary shapes.

  As shown in FIG. 31 (b), the cover portion 332 is a disk having a mounting surface (bottom surface) of the electrode 300-2 as shown in FIG. 31 (b) and a cross-sectional view taken along line ff in FIG. And an annular mounting portion 334 fixed to the peripheral portion of the mounting side surface of the substrate 333 facing the surface of the living body by a known method. And the annular attachment part 334 is comprised by the adhesive member, and the surface on the opposite side to the board | substrate 333 side of the annular attachment part 334 is the annular attachment surface P attached to a biological body. Become. Therefore, in the cover portion 332, a concave portion 331 is formed on the inner peripheral side of the annular mounting surface P. And the recessed part 331 defines closed space with the inner surface of the recessed part 331, and the surface of a biological body, when the cover part 332 is attached to the surface of a biological body.

  As shown in FIGS. 31B and 31C, the recess 331 of the cover 332 is made of an insulating material, and a partition plate 337 that partitions the recess 331 into a plurality of spaces, for example, an energizing member as shown in the figure. It is partitioned by a concentric partition plate 337 centering on 335. Here, the partition plate 337 is fixed to the substrate 333, and a fluid passage hole 337a is formed in a part thereof. The fluid passage hole 337a is formed so as to be positioned closer to the substrate 333 toward the partition plate 337 positioned outside the concentric circle. 31 (b) and 31 (c), the innermost partition plate 337b is defined as the innermost partition plate 337 in the radial direction, and the outer partition plate 337c is disposed adjacent to the inner partition plate 337b. And

One wire 338a is accommodated in the wiring 338 connected to the cover portion 332. The conducting wire 338a is connected to a current-carrying member 335 disposed in the recess 331 of the cover portion 332.
The energizing member 335 can be a conductive member having an arbitrary shape. The energizing member 335 is disposed so as to be separated from the surface of the living body with the electrode 300-2 attached to the surface of the living body. The energization member 335 is fixed in the recess of the cover portion 332 by, for example, attaching a fixing member that fits and fixes the board-side portion of the energization member 335 to the attachment side of the board 333 by a known method. It can be carried out.

The container 339 contains a conductive fluid, and one end of an injection pipe 336 is connected to the container 339. And the container 339 is arrange | positioned on the outer surface of the board | substrate 333 of the cover part 332, for example, consists of a resin-made deformable container.
Here, the conductive fluid (not shown) can be any fluid as long as it is a fluid having conductivity and fluidity. For example, a sol having conductivity is preferable.

The injection tube 336 extends from the container 339 containing the conductive fluid to the vicinity of the energization member 335 in the recess 331 of the cover portion 332. Therefore, in this electrode 300-2, the container 339 is compressed and deformed to push out the conductive fluid in the container 339, so that the conductive fluid can be injected into the recess 331 of the cover portion 332 via the injection pipe 336. it can.
Note that the electrode 300-2 may be a syringe-like container instead of the container 339. When a syringe-like container is used, the amount of conductive fluid injected can be confirmed. In addition, by using a transparent material for the substrate 333 of the cover portion 332, it is possible to design the injection amount visually.

  And according to the electrode 300-2 shown in FIG. 31, the cover part 332 which has the recessed part 331, the electricity supply member 335 arrange | positioned in the recessed part 331 of the cover part 332, and connected to the conducting wire 338a, and a recessed part are made into a conductive fluid. By causing the injection tube 336 to be injected into the 331 to function as an energization area changing mechanism, the area for supplying the electrical stimulation current to the surface of the living body to which the electrode 3 is attached can be changed.

Specifically, in the electrode 300-2, for example, in a state where a current for electrical stimulation is applied to the energizing member 335 via a lead wire 338a from an electrical stimulation device (not shown), the inner surface of the recess 331 and the surface of the living body are defined. By injecting the conductive fluid into the formed closed space via the injection pipe 336, the range in which the current for electrical stimulation is applied can be changed. More specifically, the conductive fluid is injected only into the space defined by the inner partition plate 337b positioned radially inward in the closed space, and the conductive fluid and the current-carrying member 335 can be brought into contact with each other. For example, it is possible to energize only the region where the conductive fluid is injected. Further, the conductive fluid is caused to flow outward in the radial direction through the fluid passage hole 337a of the inner partition plate 337b, and between the inner partition plate 337b and the outer partition plate 337c disposed adjacent to the inner partition plate 337b. If the conductive fluid is also injected into the space and the conductive fluid is brought into contact with the energization member 335, the two regions into which the conductive fluid has been injected can be energized.
As a result, the contact area (energization area) of the electrode 3 can be changed after the electrode is attached by changing the injection amount and injection region of the conductive fluid.
In the electrode 300-2, the fluid passage hole 337a is formed on the substrate 333 side toward the partition plate 337 located on the outer side of the concentric circle. Therefore, the second partition plate (outer side) from the center is formed. Before the conductive fluid overflows outward from the partition plate 337c), the two regions (the region surrounded by the inner partition plate 337b, and the region surrounded by the inner partition plate 337b and the outer partition plate 337c). ) Can be energized.
In addition, an end surface of the partition plate 337 opposite to the substrate 333 (biological side) can be formed as an adhesive surface. According to this, it is possible to effectively prevent the conductive fluid from leaking from the inside to the outside of the partition plate 337 between the end face of the partition plate 337 and the surface of the living body. Further, the substrate 333 may be provided with at least one vent hole (not shown) that allows air to enter and exit from the inside and outside of the cover portion 332. According to this, even if a conductive fluid is injected, it is possible to prevent the pressure in the cover portion 332 from increasing. Since the pressure in the cover part 332 does not increase, it is easy to inject the conductive fluid, or the deformation of the surface of the living body due to the pressure is suppressed, so that the conductive fluid can be introduced from the inside of the partition plate 337. It is possible to effectively prevent leakage to the outside.

  Then, as described above, the cover portion 332 having the concave portion 331, the energizing member 335 disposed in the concave portion 331 of the cover portion 332 and connected to the conducting wire 338a, and the injection tube for injecting the conductive fluid into the concave portion 331 In the electrode 300-2 that causes 336 to function as an energization area changing mechanism, the energization area can be changed while reducing the number of components to be used. In addition, it is possible to prevent the electrode from being unusable due to the occurrence of a component failure or the like. Further, without using a relatively expensive conductive gel, the electrode can be used repeatedly by washing and removing a relatively inexpensive conductive fluid.

  Here, in the electrode 300-2 shown in FIG. 31, the partition plate 337 is used as a restriction mechanism for restricting the space where the conductive fluid is located in the concave portion 331. For example, a high-viscosity fluid of about 5 to 15 Pa · s is used, and the conductive member 335 is brought close to the opening side (surface side of the living body) of the concave portion 331 to thereby inject the conductive fluid into the concave portion 331 of the cover portion 332. May be prevented from spreading unnecessarily widely in the recess 331. Further, in the electrode 300-2 shown in FIG. 31, the fluid passage hole 337a is provided in the partition plate 337. However, in the size variable electrode 300, each space defined by the partition plate 337 is provided without providing the fluid passage hole 337a. An injection tube 336 and a container for injecting a conductive fluid may be provided.

Next, the electrode 300-3 for an electrical stimulation device according to the third embodiment of the size variable electrode will be described with reference to FIG.
As shown to Fig.32 (a), the electrode 300-3 for electrical stimulation apparatuses of 3rd embodiment is provided with the substantially disc-shaped cover part 348, the press member 349 located in the approximate center, and the press member 349. And a connected wiring 340.
In addition, although the cover part 348 is a disk shape in illustration, it can be made into arbitrary shapes.

As shown in FIG. 32B, the cover portion 348 is a cross-sectional view of the electrode 300-3 taken along the line gg of FIG. 32A. And an annular mounting portion 342 fixed to the peripheral portion of the mounting side surface facing the surface by a known method. And the annular attachment part 342 is comprised by the adhesive member, and the surface on the opposite side to the board | substrate 343 side of the annular attachment part 342 is the annular attachment surface P attached to a biological body. Become. Therefore, in the cover portion 348, the concave portion 350 is formed on the inner peripheral side of the annular mounting surface P. The recess 350 defines a closed space between the inner surface of the recess 350 and the surface of the living body when the cover 348 is attached to the surface of the living body.
A through-hole 343a through which a part of a pressing member 349 described later passes is formed in the center of the substrate 343 of the cover portion 348. And the board | substrate 343 has the rigidity of the grade which does not deform | transform large when operating the press member mentioned later.
In addition, the annular attachment portion 342 can be formed of a non-adhesive member.

  As shown in FIG. 32 (b), the elastic energizing member 341 and a part of the pressing member 349 that presses the elastic energizing member 341 toward the opening side of the recessed portion 350 are disposed in the recessed portion 350 of the cover portion 348. A current-carrying member 344 is arranged.

The elastic energization member 341 can be made of any material as long as it has conductivity and elasticity, and for example, conductive gel or conductive rubber can be used. Further, as shown in FIG. 32 (b), the elastic energizing member 341 has a peripheral portion attached to the inner peripheral surface of an annular attachment portion 342. In addition, the elastic energization member 341 is bent flat or on the other end side (attachment side) in a cross section orthogonal to the attachment surface P of the electrode 300-3 in a state before the electrode 300-3 is attached to the living body surface. In addition, it is disposed so as not to protrude from the opening position of the recess 350 (that is, to be located on the bottom side of the recess 350 from the opening position of the recess 350).
The elastic energization member 341 may be attached to the energization member 344 instead of the inner peripheral surface of the annular attachment portion 342.

  A single wire 340 a is accommodated in the wiring 340 connected to the cover portion 348. The conducting wire 340 a is electrically connected to the energizing member 344 disposed in the recess 350 of the cover portion 348. Specifically, the conducting wire 340 a extends through a pressing member 346 and an engaging member 345 described later, and is electrically connected to the energizing member 344.

  The pressing member 349 can be pushed toward the energizing member 344 disposed between the substrate 343 and the elastic energizing member 341 and toward the opening side of the recess 350 (the lower side in FIG. 32B). An engaging member 345 that engages with the hole 343a and a plate-like pushing member 346 that pushes the engaging member 345 into the opening side of the recess 350 using the lever principle are provided.

The energizing member 344 is a cross section orthogonal to the mounting surface P of the electrode 300-3, has a width smaller than the width of the elastic energizing member 341, and has a bowl-like shape that protrudes toward the opening side of the recess 350. . The energization member 344 has a lower surface in contact with the elastic energization member 341 in a state where the engagement member 345 is not pushed toward the opening side of the recess 350 (the state shown in FIG. 32B), and the upper surface is It is in contact with the engaging member 345.
The energization member 344 can have any shape as long as the elastic energization member 341 can be pressed toward the opening side of the recess 350.

  The engaging member 345 has a shape that restricts displacement of the engaging member 345 relative to the substrate 343 and is engaged with the substrate 343. Specifically, the shape of the engaging member 345 is, for example, a shape in which one or more (three in the illustrated example) barbs 345a are provided in the longitudinal direction of the engaging member 345 as illustrated. The return 345a can restrict the movement of the engaging member 345 toward the non-mounting surface N. The barb 345a has a tapered surface whose maximum radius is slightly larger than that of the through hole 343a and whose diameter is reduced toward the opening side of the recess 350. The engaging member 345 having such a barb 345a can be press-fitted into the concave part 350 by applying a force with such a magnitude that the barb 345a is deformed toward the opening side of the concave part 350. The barb 345a press-fitted into the recess 350 is engaged with the base plate 343 until a force large enough to deform the barb 345a toward the opposite side of the opening of the recess 350 is applied. 345 position is held.

  One end of the pushing member 346 is attached to the substrate 343 so that the pushing member 346 can swing with respect to the substrate 343, and the center portion is in contact with the engaging member 345. According to the pushing member 346, the engaging member 345 can be more easily press-fitted into the recess 350 by utilizing the lever principle by pushing the other end side toward the substrate 343 side.

And in the electrode 300-3 shown in FIG. 32, as shown in FIG.32 (c), by pressing the elastic electricity supply member 341 toward the opening side of the recessed part 350 via the press member 349, the said elastic electricity supply member is concerned. 341 can be moved between an insulation position that does not contact the surface of the living body (position shown in FIG. 32B) and an energization position where at least a part of the elastic energization member 341 reaches the opening of the recess 350. . Further, the elastic energizing member 341 can be kept pressed by the return 345a of the engaging member 345 of the pressing member 349.
Specifically, in the electrode 300-3 shown in FIG. 32, in a state where the electrode 3 is attached to the surface of the living body, the engaging member 345 is press-fitted through the pushing member 346, the energizing member 344 is pushed down, and the elastic energizing member. By deforming 341 and causing the elastic energization member 341 to reach the opening position of the recess 350, the elastic energization member 341 and the surface of the living body can be brought into contact with each other. Then, with the return 345a of the engaging member 345 of the pressing member 349, a current for electrical stimulation is supplied to the elastic energizing member 341 via the conducting wire 340a and the energizing member 344 while maintaining the state where the elastic energizing member 341 is pressed. be able to. In addition, by changing the length of press-fitting the engaging member 345, the area where the elastic energization member 341 contacts the surface of the living body is changed, and a current for electrical stimulation applied to the surface of the living body is energized. The area to be changed can be changed.

  That is, according to the electrode 300-3 shown in FIG. 32, the electrode 3 is formed by causing the cover portion 348 having the recess 350, the elastic energization member 341, the conducting wire 340a, and the pressing member 349 to function as an energization area changing mechanism. It is possible to change the area where a current for electrical stimulation is applied to the surface of the living body to which is attached.

  And in the electrode 300-3 for electrical stimulation apparatuses which makes the cover part 348 which has the recessed part 350 mentioned above, the elastic electricity supply member 341, the conducting wire 340a, and a press member function as an electricity supply area change mechanism, it is finer. The area can be adjusted.

-Modification of electrical stimulation device-
FIG. 33A shows a modification of the example 1a of the electrical stimulation apparatus shown in FIG.
The electrode 3 includes a first electrode 3C1-1 and a second electrode 3C1-2 of one channel (first channel 3C1). The first electrode 3C1-1 includes a first A electrode portion 3C1-1A and a first B electrode portion 3C1-1B, and the second electrode 3C1-2 includes a second A electrode portion 3C1-2A and a second B electrode portion. It consists of 3C1-2B.

  Here, the first A electrode portion 3C1-1A and the second A electrode portion 3C1-2A are carried on one sheet-like member 3s to form the first conductor 3i1, and the first B electrode portion 3C1-1B and the first The second B electrode portion 3C1-2B is also carried by one sheet-like member 3s to form the second conductor 3i2. Examples of the sheet-like member 3s include an adhesive cloth, a non-woven fabric, and a polymer sheet (foamed and non-foamed), and a polymer sheet is particularly preferable from the viewpoints of economy and storage stability. With the above configuration, two electrodes 3 can be attached at the same time by attaching one conductor 3i, so that the usability of the electrical stimulation device can be improved, and oral and pharyngeal stimulation The positioning accuracy of the electrode 3 in the positioning step of the method can be increased.

  The first conductor 3i1 and the second conductor 3i2 are connected to each other by an extendable / contractible member 3ec. Examples of the elastic member 3ec include elastic cloth, non-woven fabric, and polymer sheet (network structure, bellows structure). Particularly, a polymer sheet is preferable from the viewpoint of economy and storage stability. If it is set as the said structure, since it becomes possible to affix the 1st conductor 3i1 and the 2nd conductor 3i2 while making them a desired distance, the usability of an electric stimulator can be improved.

  The sheet-like member 3s and the elastic member 3ec can be used in appropriate combination with the electrode 3.

FIG. 33 (b) shows a modification of another example 1b of the electrical stimulation device shown in FIG. 1 (b).
The electrode 3 is composed of two channels (first channel 3C1 and second channel 3C2), the first channel 3C1 is composed of the first electrode 3C1-1 and the second electrode 3C1-2, and the second channel 3C2 is composed of The first electrode 3C2-1 and the second electrode 3C2-2.

This modification includes a sheath-like member 3ca having a hook shape suitable for being hooked on an ear. The conducting wire 4 can be passed through the sheath-like member 3ca. The arrangement of the conducting wire 4 can be maintained by the sheath member 3ca. Therefore, it is possible to reduce the possibility that the position of the electrode 3 is shifted or the electrode 3 is peeled off due to the lead wire 4 existing near the surface of the living body being caught by a part or object of the living body. The positioning accuracy of the electrode 3 in the positioning step of the oral cavity / pharyngeal laryngeal stimulation method can be increased.
Moreover, this modification is provided with the earplug member 3ea fixed to the said sheath-like member 3ca. With the earplug member 3ea, the sheath-like member 3ca can be securely fixed to the ear, and the positioning accuracy of the electrode 3 in the positioning step of the oral cavity / pharyngeal stimulation method can be increased.

  EXAMPLES Hereinafter, although an Example demonstrates this invention further in detail, this invention is not limited to the following Example at all.

(Test Example 1)
Using an example 1a of the electrical stimulation apparatus shown in FIG. 1A, a test for applying electrical stimulation to the oral cavity / pharyngeal region 90 of one subject was performed. Specifically, the first electrode 3C1-1 and the second electrode 3C1-2 (size of each electrode: 50 mm × 50 mm) of the first channel are arranged in X1 to X8 and Y1 to Y8 shown in FIG. The pulse current (frequency: 2500 Hz, straight) was oscillated with respect to the subject. Then, using a pair of silver electrodes, positions in the oral cavity A to I (A: upper lip, B: soft palate, C: pharyngeal wall, D: tongue center, E: lower lip, F shown in FIG. 34 (b) : Left cheek, G: palatine, H: right cheek, I: palatine) and the potential (mV) was measured. Details of the conditions and results of Test Example 1 are shown in Table 1.

  From the results shown in Table 1, when strong electrical stimulation can be given to the pharyngeal wall (C) and the palatine canal (G, I), which are areas related to the oral cavity and pharynx of the patient, It is shown that the first electrode 3C1-1 is positioned at X4 and the second electrode 3C1-2 of the first channel is positioned at Y4. In addition, since the palate isthmus (G, I) are located close to the laryngeal region, it is presumed that the electrical stimulation is also given to the laryngeal region in the peripheral region by the electrical stimulation to the palatine.

(Test Example 2)
Using another example 1b of the electrical stimulation apparatus shown in FIG. 1B, a test for applying electrical stimulation to the oral cavity / pharyngeal region 90 of three subjects was performed. Specifically, the first electrode 3C1-1 and the second electrode 3C1-2 of the first channel, and the first electrode 3C2-1 and the second electrode 3C2-2 of the second channel (size of each electrode: 50 mm × 50 mm ) Is positioned at a position selected from X1 to X8 and Y1 to Y8 shown in FIG. 34 (a), and a pulse current (carrier frequency of the first channel 3C1: 2500 Hz, second channel 3C2 Carrier wave frequency: 2700 Hz, cross interference wave). Then, in the same manner as in (Test Example 1), the potential (mV) in the pharyngeal wall (C) and palatine isthmus (G, I) was measured, and after adding these potentials (mV), the added value was 3 Added the name. Table 2 shows details of the conditions and results of Test Example 2.

＊１：上位３番目以内の電位となった患者が３名中１名であった電極の位置決め
＊２：上位３番目以内の電位となった患者が３名中２名であった電極の位置決め
＊３：上位３番目以内の電位となった患者が３名中３名であった電極の位置決め

* 1: Positioning of electrodes where 1 out of 3 patients had the highest potential within the top 3 * 2: Positioning of electrodes where 2 out of 3 patients were within the top 3 potential * 3: Positioning of electrodes where 3 out of 3 patients had the top third potential.

  From the results shown in Table 2, when strong electrical stimulation can be given to the pharyngeal wall (C) and the palatine canal (G, I), which are regions related to the oral cavity / pharyngeal function of the patient, One channel 3C1; position of first electrode 3C1-1: Y6, position of second electrode 3C1-2: X4, second channel 3C2; position of first electrode 3C2-1: X6, position of second electrode 3C2-2 : Y4), and (first channel 3C1; position of first electrode 3C1-1: Y7, position of second electrode 3C1-2: X4, second channel 3C2; position of first electrode 3C2-1: X7) It was shown that the position of the second electrode 3C2-2 is Y4).

(Test Example 3)
Using another example 1b of the electrical stimulation apparatus shown in FIG. 1B, a test for applying electrical stimulation to the oral cavity / pharyngeal region 90 of three subjects was performed. Specifically, the first electrode 3C1-1 and the second electrode 3C1-2 of the first channel, and the first electrode 3C2-1 and the second electrode 3C2-2 of the second channel (size of each electrode: 50 mm × 50 mm ) Is positioned at a position selected from X1 to X8 and Y1 to Y8 shown in FIG. 34 (a), and a pulse current (carrier frequency of the first channel 3C1: 2500 Hz, second channel 3C2 Carrier wave frequency: 2700 Hz, cross interference wave). Then, as in (Test Example 1), the potential (mV) at the center of the tongue (D) was measured, and these potentials (mV) were added for three persons. The conditions of Test Example 3 and the details of the results are shown in Table 3.

＊１：上位３番目以内の電位となった患者が３名中１名であった電極の位置決め
＊２：上位３番目以内の電位となった患者が３名中２名であった電極の位置決め
＊３：上位３番目以内の電位となった患者が３名中３名であった電極の位置決め

* 1: Positioning of electrodes where 1 out of 3 patients had the highest potential within the top 3 * 2: Positioning of electrodes where 2 out of 3 patients were within the top 3 potential * 3: Positioning of electrodes where 3 out of 3 patients had the top third potential.

  From the results shown in Table 3, when strong electrical stimulation can be applied to the center of the tongue (D), which is a region related to the oral cavity / pharyngeal larynx function of the patient, in particular, (first channel 3C1; first electrode 3C1 -1 position: Y6, second electrode 3C1-2 position: X4, second channel 3C2; first electrode 3C2-1 position: X6, second electrode 3C2-2 position: Y4) It has been shown. When relatively strong electrical stimulation can be applied to the center of the tongue (D), in particular, (first channel 3C1; position of first electrode 3C1-1: Y7, position of second electrode 3C1-2: X4, second channel 3C2, position of first electrode 3C2-1: X7, position of second electrode 3C2-2: Y4).

(Test Example 4)
Using another example 1b of the electrical stimulation apparatus shown in FIG. 1B, a test for applying electrical stimulation to the oral cavity / pharyngeal region 90 of three subjects was performed.
Specifically, the first electrode 3C1-1 and the second electrode 3C1-2 of the first channel, and the first electrode 3C2-1 and the second electrode 3C2-2 of the second channel (size of each electrode: 50 mm × 50 mm ) Were positioned at the following positions: (first channel 3C1; position of first electrode 3C1-1: Y7, position of second electrode 3C1-2: X4, second channel 3C2; first electrode 3C2-1) Position: X7, position of the second electrode 3C2-2: Y4).
The pulse current shown in Table 4 was oscillated for the test subject. In Test Examples 4A to 4C, the synthesized wave formed from each pulse current consists of one synthesized pulse having a pulse duration of 250 μsec. In Test Example 4D, the pulse current is composed of one pulse having a pulse duration of 250 μsec, and there is no phase difference between the pulse currents. Therefore, even if the pulse currents are overlapped, the pulse duration does not increase. .
Then, as in (Test Example 1), the electric potential (mV) at the pharyngeal wall (C) was measured, and the electric intensity of the electrical stimulation applied to the oral cavity / pharyngeal region was estimated. Each pulse current is applied to the subject three times, and the subject begins to feel electrical stimulation at any location in the body, (ii) when he begins to feel muscle contraction, and (iii) ) Each electric intensity (potential difference) at the throat wall (C) when pain started to be measured was measured. The result of averaging the numerical values of the respective electric strengths is shown in FIG. Note that (i), (ii), and (iii) mean that each nerve fired exceeding the sensory threshold, the motor threshold, and the pain threshold, respectively. The larger each measurement value, the stronger current can be applied to the pharyngeal wall (C), that is, the oral cavity / pharyngeal region, before the nerves in the body ignite.

From the results shown in Table 4, in Test Example 4D, there is no phase difference between each pulse current, so when the electrical intensity of the pulse current was increased, the subject felt an electrical stimulus at a position directly below the electrode. In the electrical stimulation devices of Test Examples 4A to 4C, the pulse duration of the synthesized pulse by the pulse current output from each pulse generation unit becomes long. Therefore, when the electrical strength of the pulse current is increased, the subject's position immediately below the electrode is increased. I felt electrical stimulation in the deep part of the body (i.e., the nerves in the deep part of the body could be ignited (beyond each threshold)). Moreover, in Test Example 4D, the pulse current could not be increased because the nerves including the nerve that felt pain ignited at a position immediately below the electrode, but in Test Examples 4A to 4C, it was not at the position immediately below the electrode of the subject. Therefore, it was possible to ignite the nerves in the deep part of the body and to give an interference wave having a strong electric intensity to the pharyngeal wall (C).
In Test Examples 4A to 4C, the current reaches the deeper portion as the pulse duration of the pulse current is shorter. Therefore, in Test Example 4A, the stronger current is present in the pharyngeal wall (C), that is, in the vicinity of the oral cavity / pharynx. Could be given.

  According to the oral cavity / pharyngeal laryngeal stimulation method of the present invention, electrical stimulation is effectively applied to the oral cavity / pharyngeal region of the patient (particularly the tongue, pharyngeal wall, palatine) to treat oral / pharyngeal dysfunction. The effect can be enhanced. Furthermore, the rehabilitation from oral / pharyngeal dysfunction can be made more efficient.

DESCRIPTION OF SYMBOLS 1 Electrical stimulation apparatus 1a Example of electrical stimulation apparatus 1b Another example of electrical stimulation apparatus 3 Electrode 3C1 First channel 3C1-1 First channel first electrode 3C1-1A First channel first A electrode part (first first One A electrode part)
3C1-1B first B electrode part of the first channel (first first B electrode part)
3C1-2 1st channel 2nd electrode 3C1-2A 1st channel 2nd A electrode part (1st 2nd A electrode part)
3C1-2B first channel second B electrode part (first second A electrode part)
3C2 Second channel 3C2-1 Second channel first electrode 3C2-1A Second channel first A electrode portion (second first A electrode portion)
3C2-1B First B electrode part of second channel (second first B electrode part)
3C2-2 Second channel second electrode 3i Conductor 3i1 First conductor 3i2 Second conductor 3s Sheet-like member 3ec Expandable member 3ca Sheath-like member 3ea Ear plug member 4 Conductor 10 Lower jaw 11 Digastric muscle (frontal abdomen) )
12 Mandibular hyoid muscle 13 Hyoid hyoid muscle 14 Stemoid hyoid muscle 15 Gastrocnemius muscle (rear abdomen)
16 wide neck muscle 20 front neck 21 thyroid hyoid muscle 22 scapulohyoid muscle 23 sternohyoid muscle 24 cricoid thyroid muscle 25 sternum thyroid muscle 26 sternocleidomastoid muscle 30 cheek 31 zygomatic bone 32 maxilla 33 mandible 34 zygomatic arch Upper edge 35 Orbital lower edge 36 Mandible 37 Lower nasal bone 38 Gentoid nodule 39 Cervical vertebra 41 Wing projecting mandibular raphe 42 Mandibular incision 43 Orbital foramen 44 Masseter 45 Cheek muscle 46 Upper lip muscle 47 Large zygomatic muscle 48 Small zygomatic muscle 49 Lower corner of mouth Control muscle 50 Lower lip control muscle 51 Broad jaw muscle 52 Gentoid muscle 53 Gentoid muscle 54 Outer pterygoid muscle 55 Inner pterygomuscle 56 Nasopharyngeal constrictor 60 Head 70 Thorax 90 Oral / pharyngeal region 300 Size variable electrode 300-1 Electrode 300-1a of first embodiment of variable size electrode Electrode 300-1b of modified example of first embodiment of variable size electrode Electrode 301 of another variation of first embodiment of variable size electrode Main body 302 Wiring 302a Conducting wire 303 Mounting side portion 304 Case portion 312 Conductive portion 312a Conductive portion 312a1 with conducting wire Conductive portion 312a2 Conducting portion with conducting wire 312a3 Conducting portion with conducting wire 312b Conducting portion without conducting wire 312b1 Conducting portion without conducting wire 312b2 Conducting portion without conducting wire 312b3 Conductive portion 313 without conductive wire Insulating portion 316 Conductive member 316-1 First conductive member 316-1a Inner first conductive member 316-1b Outer first conductive member 316-2 Second conductive member 317 Contact portion 318 Handle portion 319 Mobile energization Member 320 Insulating member 321 Conductive member 322 Auxiliary insulating member 323 Rigid member 324 Hole 325 Wide part 326 Narrow part 300-2 Electrode 331 of second embodiment of variable size electrode Recess 332 Cover part 333 Substrate 334 Toroidal Mounting part 335 energization Member 336 Injection pipe 337 Partition plate 337a Fluid passage hole 337b Inner partition plate 337c Outer partition plate 338 Wiring 338a Conductor 339 Container 300-3 Electrode 340a Wire 340a Conducting wire 341 Elastic conducting member 342 Mounting portion 343 Substrate 343a Through hole 344 Energizing member 345 Engaging member 345a Returning member 346 Pushing member 347 Substrate 348 Cover portion 349 Pressing member 350 Recessed portion Ai Crossing region Ad Desired position P Mounting surface Cp Peak current value D Phase difference N Non-attachment Plane Pa plane Pb plane P1 first pulse wave part P2 second pulse wave part P3 third pulse wave part P4 fourth pulse wave part Sn non-application period Tp pulse duration Tn non-application time Tw weak pulse duration

Claims (4)

An electrical stimulation device for applying electrical stimulation to a living body,
An oscillator that oscillates an electrical stimulation current, and a plurality of electrodes that transmit the electrical stimulation current oscillated by the oscillator to the oral cavity / pharynx of the living body,
The plurality of electrodes includes a first electrode and a second electrode of a first channel, and a first electrode and a second electrode of a second channel,
Here, the plurality of electrodes are arranged at crossed positions, and a current for electrical stimulation is applied to the surface of the living body,
The electrical stimulation current is a pulse current having a waveform including a plurality of pulses,
When the pulse current waveform is superimposed, a composite wave having a composite pulse having a pulse duration longer than the pulse duration of the pulse of the pulse current is formed,
The pulse current has a pulse wave portion having one or more pulses having the same polarity, and has a weak pulse between each of a plurality of consecutive pulse wave portions,
Each weak pulse has the same polarity and an amplitude smaller than the amplitude of the pulse of the pulse wave section,
The electrical stimulation apparatus according to claim 1, wherein the composite wave has a composite weak pulse applied from the end point of the composite pulse to the start point of the next composite pulse during the composite pulse. An electrical stimulation device for applying electrical stimulation to a living body,
An oscillator that oscillates an electrical stimulation current, and a plurality of electrodes that transmit the electrical stimulation current oscillated by the oscillator to the oral cavity / pharynx of the living body,
The plurality of electrodes includes a first electrode and a second electrode of a first channel, and a first electrode and a second electrode of a second channel,
Here, the plurality of electrodes are arranged at crossed positions, and a current for electrical stimulation is applied to the surface of the living body,
The electrical stimulation current is a pulse current having a waveform including a plurality of pulses,
When the pulse current waveform is superimposed, a composite wave having a composite pulse having a pulse duration longer than the pulse duration of the pulse of the pulse current is formed,
The electrical stimulation apparatus according to claim 1, wherein the amplitude of the synthesized pulse is maximized at a central portion in the width direction.   Of the first electrode and the second electrode, the electrode disposed on the foot side of the living body has a negative polarity, and among the first electrode and the second electrode, the electrode disposed on the head side of the living body is plus. The electrical stimulation device according to claim 1 or 2, which is polar. The pulse current has a pulse duration of 25 to 10000 μsec,
The synthetic pulse of the synthetic wave has a pulse duration of more than 25 and not more than 15000 μsec.
The electrical stimulation apparatus as described in any one of Claims 1-3 .

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