???????????????╃????2020骞寸?6??
??????瑕?
????灏?纾??轰?涓轰?绉?骞查???娈靛??ㄤ??荤???ュ悍棰???锛?淇?绉扳??纾?????锛??ㄨ??荤??????骞翠汉绫诲???蹭腑?炬??杩?澶?娆$??浜?璁轰?璧蜂????变?缁???涓?涓????哄?朵?娓?绛?澶??归?㈠????锛???纾?????????浣?涓轰?涓??翠?杩????骞挎??ュ?????惰??锛?杩?骞存?ヤ?浠????╃?ㄨ???茬??虹??缁?棰?纾??烘?琚??瑰??搴??ㄤ?涓村?锛?骞朵???瓒??ヨ?澶???瀹?楠?璇????剧ず锛??轰?绋虫??纾??虹???ュ悍骞查?涔???????ソ??搴??ㄥ????????绔?涓昏??寸?绋虫??纾??哄?琛?娴???楠ㄩ????肩??涓??归?㈢??褰卞??锛??荤??剁??绌剁?扮?跺苟?????跺???涓??板?锛???寰?涓???瀛︾?????????绌惰???藉?娑?瓒虫?棰???锛?杩?琛??磋???????绯荤?????娣卞?ョ??绌讹??ㄦ??纭??舵?哄?剁??????涓?瀵圭??哄???拌?琛?浼???锛?浠?????互?╂?ョ?瀛﹀?般???????板?绋虫??纾??轰?涓轰?绉?骞查???杈??╂??娈靛??ㄤ??荤???ュ悍棰?????
?????抽??? 绋虫??纾??猴?纾???锛?琛?娴?锛?楠ㄩ?锛??肩??
????绋虫??纾??轰?绉伴??纾??烘??绋虫??纾??猴???????己搴﹀???瑰??涓????堕?磋????????纾??恒??灏界??充?纾??虹??寮哄害?????ㄤ?????瀛︾?棰???????涓???锛?涔?浼?????纾??ф??????瓒?瀵肩???????杩?涓?姝ュ??灞???????????锛?浣????????ㄧ???藉?ュ悍棰???锛?浜轰滑涓?????浣?浜?1 mT ??纾??虹О涓哄急纾??猴?1 mT??1 T 涓轰腑绛?纾??猴?1 T浠ヤ?涓哄己纾??猴?5 T????20 T浠ヤ?绉颁负瓒?寮虹??恒??渚?濡?锛?瀵逛?涓???父瑙??????规??兼?ョ??纾???锛??惰〃纾?寮哄害?藉?ㄤ腑绛?纾??鸿???村???????ㄥ?荤??棰???骞夸负搴??ㄧ??纾??辨??????(MRI)涓???涓讳??ㄥ??灏辨???涓?己绋虫??纾??猴?????澶у??板?婚?㈤?????ㄧ??MRI 涓?.5??3 T???变??哄己????楂??存?ユ???╀???楂???????杈ㄧ??锛?杩?骞存?? T ??MRI 宸叉?瑰??搴??ㄤ?涓村?锛?9.4 T??MRI涔?杩?琛?浜?涓?浜???????浜轰?涓村?璇?楠???
?????や??╃?ㄧ??鸿?琛?MRI妫?娴?浠ュ?锛?杩?骞存?ラ?????╃????宸ョ??????藉???诲???棰???????????灞?锛?浜轰滑寮?濮??╃?ㄥ??绉?涓???????????娈典?澶?涓??搴︽?ョ??绌剁??哄?浜????╀???浣????涓?浠?瀵圭??轰??ㄤ?浜轰?????搴???浜?涓?瀹???浜?瑙o?涔???姝ュ???浜?纾??哄?ㄤ?杩?浜虹被?ュ悍涓???搴??ㄣ??渚?濡?锛?缁?棰?纾??烘?(TMS)锛??冲?╃?ㄨ???茬??洪?跺???ф????浣??ㄤ?涓??㈢?缁?锛?宸茶?FDA?瑰???ㄤ?娌荤??澶?绉??剧??锛???????????????澶寸??????????楂???浼ゅ?璧风??涓??㈡?х?肩?????辩?瑰??绁?缁?????绾ょ淮???????㈢?缁??х?肩??绛?[1??3]???ㄦ???斤?2009 骞存?姹?渚???寰峰???哥??浜х??TMS璁惧??峰?浜?SFDA 娉ㄥ??璇???2012 骞达?涓??藉?诲?绉?瀛﹂?㈢???╁?诲?宸ョ???绌舵??娈锋??㈤???????跺?浜???纾??烘?璁惧????藉??昏???涓???????姝ゅ?锛?纾?澶?绉?锛??冲?纾??哄??ㄤ?澶?绉?澶?绉??????渚?濡??╃?ㄧ?浣??寸???稿???ヨ?琛?缁?缁??ゅ??锛?浠???????缂?绾匡??垮??浜?????瀛???搴???甯︽?ョ???诲???f?浠ュ???诲???f按?裤??????缂??㈢?涓?????搴????ㄨタ瀹?浜ら??澶у?绗????灞??婚?㈠??姣??㈤??涓轰唬琛ㄧ???荤??浠????卞??????涓?锛??ㄨ??绉绘???????淇??绛?澶?绉?????腑?剧ず?轰????剧??浼???4]??
?????告?涔?涓?锛??充?灏?绋虫??纾??轰?涓轰?绉?骞查???娈垫?ュ??ㄤ??荤???ュ悍棰???锛??虫??绉???涔?涓?????纾?????锛??界?舵??????涔??????诧?浣?涓??村??ㄧ??浜?璁????ㄨ??荤??????骞撮?翠???涓烘?颁?灏????稿?崇??绌?5锛?6]锛?浣??变?缁???涓?涓????哄?朵???绛?????锛?瀵艰?村?剁????杩?娌℃??琚?富娴??诲???骞挎?璁ゅ????涔????ㄦ????锛???浠??缁?浜?绋虫??纾??哄??跨?ゅ奖??????绌惰?灞?[7]???ㄦ????涓????????浜??扮????涓烘?绋虫??纾??哄?ㄧ???藉?ュ悍棰???瀹?楠?璇????稿?杈?澶???涓?涓??归?㈣?琛??荤???灞???锛??宠?娴???楠ㄩ????肩??锛?涔??????ュ?绋虫??纾??烘?ㄥ???荤???ュ悍棰???????娼?????涓?涓??归?€??
????01??绋虫??纾??轰?琛?娴?
????琛?娑叉??ㄦ????版哀???ュ?荤?╄川??渚?搴?浠ュ???轰?浠h阿锛?涓?浜轰???澶?绉??????????舵??瀵????稿?炽??纾??轰?琛?娑叉??ㄧ???崇郴涔???汉浠?????虫敞???︾?广??浜?瀹?涓?锛?缁?杩??????ユ?撅???浠????颁??冲???39 绡??充?绋虫??纾??轰?琛?娴?????绌舵?ラ?????惰??锛?瀹?浠???缁???骞朵?涓??达????冲??ㄤ?浜???浼肩???剧??缁???锛?杩?涓?2007 骞寸??涓?绡?缁艰堪缁?璁虹被浼?8]??浣??????浠????颁?涓???瓒g???拌薄锛?灏辨???ㄨ?39 绡?绋虫??纾??轰?琛?娴??稿?虫????腑锛???15 绡?(38.5%)?ラ??浜?绋虫??纾??哄??互澧???琛?娴?(?朵腑澶ч?ㄥ???芥??夯??/?????ㄧ?╂ā??锛?????4 绡?涓洪??楹婚??/?????舵??)锛???7 绡?(17.9%)?ラ??浜?绋虫??纾??哄??互??浣?琛?娴?(1 绡???夯??/?????ㄧ?╂ā??锛?6 绡?涓洪??楹婚??/?????舵??锛???涓???浣???澶у????剧???舵??琛?娴?锛?渚?濡??跨?や腑??琛?娴?)锛?11 绡?(28.2%)?剧ず绋虫??纾??哄?琛?娴???褰卞??锛?杩???6绡?(15.4%)?剧ず绋虫??纾??哄?琛?娴???褰卞?????板?????с????瀵逛?姝e父(???剧?????????╄?瀵肩?舵??)??浜哄???ㄧ?╃??绌跺?辨??25 绡?锛??朵腑15 绡?(60%)??琛?娴?(?朵腑澶ч?ㄥ???芥??夯??/?????ㄧ?╂ā??锛?????4 绡?涓洪??楹婚??/?????舵??)锛?3 绡?(12%)??琛?娴?(1 绡???夯??/?????ㄧ?╂ā??锛? 2 绡?涓洪??楹婚??/?????舵??)锛?7 绡?(28%)??褰卞????瀵逛??剧???????╄?瀵兼???朵???姝e父?舵????浜哄???ㄧ?╃??绌跺?辨??14 绡?锛??朵腑6 绡?(42.9%)?剧ず????璋????э?4 绡?(28.6%)??琛?娴?(1 绡???夯??/?????ㄧ?╂ā??锛?2 绡?涓洪??楹婚??/?????舵??)锛?4 绡?(28.6%)??褰卞??????瀵逛?14 绡?楹婚??/?????舵??涓????ㄧ?╃??绌跺???帮?11 绡??芥?剧ず浜?澧?蹇??娴???????锛??朵?3 绡??????剧ず??浣?琛?娴???????璋?????????褰卞??(??)??
????澶?绡??????ラ???芥?剧ず绋虫??纾??哄??互璋????轰???琛?娑叉??ㄣ??渚?濡?锛?2001 骞?kano??Ohkubo??绌跺??ㄦ?藉??1 mT绋虫??纾???0 ????瀵规??????冲??涓?ぎ?ㄨ????琛?娴??ㄥ??瀛﹀奖??锛????扮??哄??-纭???L-绮炬皑?哥?查???瀵奸?琛?????琛?绠℃?剁缉???典????捐????寮辫?绠℃?剁缉(琛?娑叉??ㄥ???)骞舵???惰?????楂?锛??ㄥ凹?″?板钩璇卞???琛???????寮?琛?绠℃???典????捐????浣?琛?绠¤??寮?锛?澧?寮鸿?绠℃?剁缉(琛?娑叉??ㄥ??灏?)锛?????琛?????浣?锛?????????烘?撮?叉?????惧????[9]??绋虫??纾??哄???????缂轰????惧??搴????芥???变?姝e父?????舵?????????╂不????琛?绠″?浜?骞冲??寮???????澶??¤?绠$?????稿??搴??垫?浜?琛?娑叉??ㄧ??浠讳?????????Morris ??Skalak ?ㄥぇ榧?涓????峰????0 mT 绋虫??纾??哄??ㄦ?撮??5 ????瀵瑰ぇ榧?楠ㄩ???寰??绠″??????㈠?浣?????冲??濮??舵??涓鸿?绠℃?╁???杈?灏??村?琛?绠$?纾??哄?????琛?绠″????捐??澧???锛???濮??舵??涓鸿?绠℃?剁缉??杈?灏??村?琛?绠$??寮????捐????灏?[10]??姝ゅ?锛?Kim绛?浜哄????4 ???ュ悍??璇??????宠??棰?棰??跺?????剧疆浜?0.3 T姘镐???纾???锛????板?抽?椤跺?跺???冲??剁????琛?娴????惧???锛?宸︿晶棰??跺??宸︿晶椤跺?跺?哄????琛?娴????鹃??浣?[11]??
?????????????ラ??缁???涓?涓??寸?????藉????????归?㈢????渚?濡?锛??ㄧ??绌剁ǔ??纾??烘?撮?插?寰?惊????寰??绠$郴缁???浣??ㄦ??搴??讹???浜??ㄧ?╁?楠????ㄩ夯???舵??涓?杩?琛?锛???楹婚?????╁??互褰卞??绁?缁?锛????冲???藉奖??琛?娑叉???12??13]???﹀?锛?涓?浜???绌舵???纾??哄????寸??琛?娴?锛?涓?浜???绌舵???纾??哄???????琛?娴?锛?杩???涓?浜?娴????ㄨ?涓や釜?舵????琛?娴?锛?浣?????哄??????村??澶?????瑙?瀵??扮??浣??ㄦ??搴????戒?????濡?Ichioka(1998 骞?绛?浜哄???伴夯??澶ч??撮?蹭?8 T 绋虫??纾??哄??1??5 ???????ゅ井琛?绠¤?娴????惧???[14]锛?涔???浠?浠??涓?姝ョ??绌跺???帮?8 T绋虫??纾??轰??ㄤ?楹婚??澶ч??ㄨ韩???寸???よ?娴?????浣?锛???浠?纾?浣?涓??ょ????㈠?姝e父锛?杩????芥???变?纾??烘?撮?叉???磋?娴?????灏???寮?璧风??琛ュ?挎?у??琛?[15]??姝ゅ?锛?杩???寰?澶???绱?涔?浼?浣挎???垫?村??澶?????锛?姣?濡?澶????堕?淬??浣??ㄥ?璞″??纾??烘?搴︾???????杩?浜??镐??茬?????瀹规?х????绌剁???寰?寰???寮变????扮??????????骞跺??寸?璁轰?纭??????姝わ???浠???瑕?浠?缁?璁捐?骞惰?褰?瀹?楠?缁???锛?浠????ㄧ??璁轰?澧?????绌剁?????????澶??у苟涓??村?ㄩ?㈠?颁?瑙h?涓???绌堕?????
??????绌惰??浠??瀵圭ǔ??纾??哄奖??琛?娑叉??ㄧ?????芥?哄?惰?琛?浜???杩板???ㄦ???渚?濡?锛?Tzirtzilakis ???轰?涓?涓????ㄤ???杩板???纾??轰??ㄤ???椤挎?浣?娴??ㄧ?????╃?娴?浣??ㄥ??瀛︽?板?妯″????璇ユā??????浜???娴?浣???瀛﹀??纾?娴?浣???瀛︾??????锛????惰????浜?琛?娑茬??纾???寮哄害???靛??????剁????剧ず纾??哄己搴﹀??姊?害?戒??跺奖??琛?娴???????????16]锛?杩???澶?椤圭??绌朵?纾?娴?浣???瀛︾??瑙?搴﹁?绠?浜?纾??哄?琛?娴??????藉奖??锛?渚?濡?锛?2017 骞达?Rashidi 浠?纾?娴?浣???瀛︾??瑙?搴︽?荤???????浜?纾??哄?琛?娴?浠ュ??琛???褰㈡??绛???褰卞???????芥?哄?跺???诲?搴???17]锛??惰??锛?浠????╁?诲???瑙?搴﹁??瑷?锛?浠?浠?娴?浣???瀛︾??归?㈠苟涓??藉?瀹??ㄨВ?????╀?浣?涓轰?涓???????翠??ㄧ??轰?????搴???渚?濡?锛???绌跺???扮ǔ??纾??哄???介??杩?璋???浜ゆ??绁?缁?娲诲?ㄦ?ユ???朵氦??婵??ㄥ??寮?璧风??琛?娴??ㄥ??瀛︾??????[18]??涔?????绌惰〃??纾??哄???藉奖??涓?姘у??姘?????????灏??????у??Ca2+淇″?风???寰?璇卞?浣??ㄦ??搴?[19锛?20]????姝わ?????纾??轰??ㄤ?浣???琛?娑叉??ㄥ?ㄥ???归?㈣?芥??浜?寰?澶???绌讹?浣??舵?哄?跺?涓?瀹??ㄧ‘瀹?锛???瑕?杩?涓?姝ユ繁?ョ??绌躲??
?????讳???瑷?锛?灏界??充?绋虫??纾??轰?琛?娑叉??ㄧ??瀹?楠??版??????璁鸿В??浠??舵病??纭???缁?璁猴?浣?澶?椤圭??绌惰〃??绋虫??纾??轰技涔???互缁存??寰???郴缁???骞宠 ????姝e父????琛?绠″???斤?杩???绀虹ǔ??纾??烘?????芥??涓轰?绉??????夸唬??琛ュ????娈典互搴??ㄤ?琛?娴?杩?澶???涓?瓒崇??稿?崇?剧???舵?????瑰????瀵规?锛?浜轰滑杩???瑕?杩?琛??村??存繁?ョ???㈢储??绌讹?涓烘???ヤ复搴?璇?楠???涓ユ?艰?琛?濂?瀹??虹?锛?渚?濡??哄??涓????ㄤ???涓???绫诲????琛?绠★?浠ュ??涓????剧???舵????璧峰??舵??涓???琛?娴????????舵?哄?剁???
????02??绋虫??纾??轰?楠ㄩ?
????杩?骞存?ュ凡??澶?绉??轰????茬?电??虹???荤??浠??ㄧ?ㄤ?楠ㄨ川???惧??楠ㄦ??绛???杈??╂不?????告?涔?涓?锛??界?剁????杩?娌℃??绋虫??纾??虹?稿?崇???荤??浠????浣?宸叉??澶ч?????稿?崇??绌舵?剧ず锛?绋虫??纾??哄?ㄩ?叉不楠ㄨ川???俱??淇?杩?楠ㄦ????????楠ㄧ己??淇????娌荤??楠ㄥ?宠????绛??归?㈡??????ソ????????搴??ㄥ??????瑗垮??宸ヤ?澶у?????婢?璇鹃?缁?澶?骞存?ュ?姝ゆ??绯荤??х??绌讹??舵??杩???琛ㄧ??涓?绡?缁艰堪涔?杩?琛?浜??ㄩ?㈠????[21]??浠??哄?朵?璁诧?纾??轰??ㄤ?楠ㄧ?缁?涓??跺?楠ㄧ?缁?缁???澧?娈?????????璋????稿?炽???ㄤ?澶?锛???纾??哄???杩?楠ㄩ??村??璐ㄥ共缁???????楠ㄧ????????????垮??锛??????堕?楂????哥??????撮?缁???????????楠ㄥ?告?舵椿??????纾??哄?楠ㄧ?缁?缁???璋??х?????芥?哄?舵????纾??哄奖??浜?缁??????垮??瀛???淇″?峰??瀛???缁???楠ㄦ?躲??缁???????缁???????绂诲?????浠h阿[21]??杩?浜??藉?浠?寰?澶х?搴︿?瑙i??纾??哄?楠ㄩ?绯荤???澶?绉?浣??ㄣ??
????棣???锛?澶?椤瑰?楠?璇???〃??绋虫??纾??哄??互?瑰??楠ㄨ川???撅??????缁???绯?灏跨??寮?璧风??楠ㄨ川???撅?浠ュ??缂鸿??ч?璐ㄧ???剧?????杩?灞??ㄦ?????ㄨ韩绋虫??纾??哄???锛?瀹?楠??ㄧ?╃??楠ㄨ川???炬?????瑰????渚?濡?锛??ㄥ?诲?靛发澶ч????版??充晶妞??ヤ?涓????搴?寮哄害涓?80 mT??纾??ф????锛?6 ?ㄥ?????板?ㄩ??杩?纾??ф??????澶ч??版?楠ㄧ??楠ㄥ?搴︽?捐????楂?[22]??灏??诲?靛发澶ч??ㄨ韩?撮?蹭?30??200 mT????纾??轰腑12 ??????板?堕?瀵?搴﹀??楠ㄩ?㈢Н???捐??楂?浜?????纾?缁?[23]??灏????╄?瀵肩??I ??绯?灏跨??澶ч??撮?蹭?4 mT??纾??轰腑16 ??????伴??纾??哄??互???剁?灏跨??澶ч???灏?姊?楠ㄥ????川楠ㄧ??缁?????浼ゅ??楠ㄥ??瀛︽?ц?界????浣?[24]??
?????舵?锛?瀹?楠?璇???〃????纾??哄??互淇?杩?楠ㄦ????????楠ㄧ己??淇????渚?濡?锛?瀵规??浜ょ???琛?妗¢?涓????????涓ゅぉ???ㄦ?????ㄤ???瑁逛???0.1 T 纾???锛?8 ?ㄥ?????扮??烘?捐??淇?杩?浜?楠ㄦ??????[25]?????藉????╂??涔???澶?渚??╃?ㄧ?????绌堕??纾??哄?瀹跺??楠ㄦ????????褰卞??锛?缁?????琛ㄦ??涓?瀹?寮哄害????纾??哄???杩?楠ㄦ???ㄤ???娌?绉???缂╃??????????堕?淬????绌舵?剧ず??纾??烘?撮?茶?藉???????楂?楠ㄧ己??澶???楠ㄧ??????澧?寮烘??ョ?╀??ㄥ?撮?璐ㄧ??缁????ヤ?杩?楠ㄧ己????淇????
????姝ゅ?锛?涔???璇???〃??绋虫??纾??哄???戒?缂?瑙i??宠??????渚?濡?锛?浜轰滑瀵圭??杩?琛??充晶???宠????浜ゅ???у甫???????ら????楠ㄥ?宠????妯″??锛??╃?ㄦ??纾??у????纾??х???剁?风??瑕?????绐????版?匡??ㄧ?68 ?ㄦ??ュ???扮??虹?婊???????婊???绉?恫??杞??琛ㄩ?㈢???村????杞??婧??$????????姣???纾??哄???缁?瑕?灏?锛?琛ㄦ???撮?蹭?纾??虹??????宠????????灞????颁?????26]??Taniguchi 绛?浜轰负浜???绌剁ǔ??纾??哄?澶ч?浣????у?宠??????????浣????瀵?0 ??????D 澶ч?杩?琛?涓烘??12 ?ㄧ??瀹?楠?锛????扮ǔ??纾??哄???缁???浣????у?宠??????澶ч?灏鹃?ㄨ〃?㈡俯搴︺??杩??ㄦ椿?у???¢?楠ㄥ?搴﹀???捐??楂?浜???纾??哄???缁?锛??惰?娓???????蹇??╀????句?浜???纾??哄???缁?[27]??Morris 绛?浜哄?ㄧ??哄?璧峰ぇ榧????㈡按?垮??绔??崇?ㄧǔ??纾??烘??缁??烘?15 ??30 ????锛?????0 mT??70 mT??纾??哄??娇姘磋?垮舰????灏?20锛???50锛?[28]??浣????变??????充?绋虫??纾??轰?楠ㄥ?宠???????????涓?澶???瓒筹???姝よ???杩?琛??村?????绌躲??
????03??绋虫??纾??轰??肩??
?????肩??????????绫诲??澶?绉?澶??凤?涓?褰卞????浜虹兢??涓哄箍娉?锛???姝や????界?ㄥ??涓????规??ユ不??涓?????涓????姝ゅ?锛??跨??绫昏???╁凡琚??ㄤ?娌荤???????????????h???ㄥ????涓ラ???㈡?х?肩??锛?浣??充??跺????ㄧ???ュ???ョ??澧???????姝わ?瀵绘??村??ㄣ???存????????杞荤?肩?????规????荤????绉?瀛﹀????卞????????
????纾?????互寰?瀹规???板??ㄥ??绉婚?わ?灏??肩???ㄤ?灞??ㄦ?撮?蹭?纾??鸿??涓?褰卞???朵??ㄤ?锛???姝よ?璁稿?浜虹?ㄦ?ュ??杞荤?肩?????惰??锛?瀹?浠????︽????涓??撮?芥??浜?璁???涓轰?杩?涓?姝ユ??纭?ǔ??纾??哄??肩????褰卞??锛???浠??琛?浜?绯荤????????锛?瀵规????扮????涓烘???璁炬????褰???????纾?瀵圭?х????稿?虫?????ラ??杩?琛?浜?缁煎??????????浠??辨?堕????9 绡??????????5%??浜轰???绌?23 绡?)??100%??灏?榧???绌?6 绡?)?芥?剧ず浜?绋虫??纾??虹??缂?瑙g?肩??浣??ㄣ??棣???锛??ㄦ?堕???扮??23 绡?绋虫??纾??哄??肩??褰卞????浜轰???绌朵腑锛???15 椤规?剧ず浜?绋虫??纾??虹‘瀹?瀵逛汉浣??????剧??????浣??ㄣ??渚?濡?锛?1997 骞达?Vallbona 绛?浜鸿?琛?浜?涓?椤瑰???茶??圭??绌讹?浠ユ?????楂??拌川??缁煎?????h???????????宠?????肩???h??瀵圭ǔ??纾??虹???肩????搴???浠?浠????帮?76%???h???ㄧ??.03??0.05 T??绋虫??纾??烘不??45???????肩??寰??版?瑰??[29]??2011 骞达?Kovacs-Balint 绛?浜哄???帮???澶т负330 mT????????绋虫??纾??哄???捐????楂?????????30]??2012 骞达?Laszlo 绛?浜哄??????192 mT纾??ц?澶?5????灏卞??互?????板?棰?涓?棰??宠??绱?涔辩??缁??h?????h???肩??璇???浠?2.0 ??浣???.5锛?浣??烘场?????g?????????炬????[31]??杩?浜??芥?剧ず浜?绋虫??纾??哄??肩????缂?瑙d??ㄣ???惰??锛???浠????颁???涓?浜??ラ??娌℃??瑙?瀵??拌?绉?浣??ㄣ??渚?濡?锛?1997 骞达?Caselli 绛?浜轰负瓒宠??肩???h????渚?浜?10 楂?????????娌荤??4 ?ㄥ??锛?浠?浠????版不??缁???瀵圭?х????肩???芥?????瑰??( ????负58% ??60%)锛? 浣?涓よ??涔??存病???捐??宸??[32]??2000 骞达?Collacott 绛?浜轰娇??00 楂????澶?娌荤???㈡?ц?扮???h??涓????娌荤??缁???瀵圭?х????肩??璇?????涓???(0.49 vs. 0.44)锛?涓ょ?涔??存???捐???у樊寮?[33]??2002 骞达?30???h???ュ??浜?娌荤??锛?浣跨??.1 T璁惧?娌荤?????宠???肩???h??绾?5 ?????讹?娌荤??缁?涓?瀵圭?х?涔??存病???捐??宸??[34]??2007骞达?Kuipers绛?浜哄???帮??撮??.06 T纾???灏??朵?浼??瑰??????搴?婵?寮?璧风???肩????瑙?[35]??
????浣????????????????界?跺?ㄦ????腑????灏??板?充?绋虫??纾??哄??肩??褰卞?????ㄧ?╃??绌讹?浣????????ラ???芥?剧ず浜?姝i????ㄣ??渚?濡?锛?2007骞达?Laszlo绛?浜鸿〃??锛?绋虫??纾??鸿?藉??????扮?瑙?.6%???告敞灏?寮?璧风??灏?榧??????肩??锛?涓??锋??娌荤???堕?村??纾??哄己搴︿?璧???36]??2008 骞达?Gyires 绛?浜哄???帮?1.6 mT??0.16 T/m ????????绋虫??纾??烘?撮??0 ???????捐????浣?灏?榧??????肩??姘村钩[37]??Kiss 绛?浜鸿????帮?30 ????????????绋虫??纾??烘不????骇??姣?????绋虫??纾??烘?村己????????????杩?浜???绌堕?借〃??娌荤???堕?村??纾??哄己搴︿互??绋虫??纾??哄?????ч?芥??奖??绋虫??纾??洪???????????抽????绱?[38]??姝ゅ?锛?涔????朵?灏?榧????肩??妯″???剧ず浜?绉???????????????渚?濡?2009 骞达?Antal绛?浜哄???帮???澶у己搴︿负476 mT??姊?害绋虫??纾??哄??互???舵?烘??烘?寮?璧风??灏?榧?绁?缁????????у???[39]??2017骞达?Zhu绛?浜哄???帮??ㄥ?榧???榻跨Щ?ㄦā??涓??20??204 mT绋虫??纾??烘不??14 澶╁??互?捐????浣??肩??绋?搴?40]??
????绋虫??纾??哄??肩??缂?瑙g??褰卞??涓?绋虫??纾??哄己搴︺??娌荤???堕?村???肩??绫诲???芥???炽????涓?浜???绌舵?杈?浜?涓?????绋虫??纾??哄己搴︼?琛ㄦ??楂?寮哄害??绋虫??纾??烘???村ソ??姝㈢??????(琛?)????姝わ????藉???寮???浜?1.5 T ??2.9 T ??瓒?瀵肩ǔ??寮虹??鸿?澶?锛?????姝e?ㄥ?姝よ?琛???绌???)??姝ゅ?锛??肩??绫诲?????冲?绋虫??纾??烘???﹀?锋??????浣??ㄧ??涓?涓??抽????绱???渚?濡?锛????㈡???颁?绋虫??纾??鸿?芥?捐????浣?棰?涓?棰??宠??绱?涔辩???h??????瑙?锛?浣?瀵硅?烘场?????g??病???捐??褰卞????
????????锛??充?绋虫??纾??洪????浣??ㄧ???哄?剁??绌堕??甯告????锛?瀵瑰?堕????浣??ㄦ?哄?剁????绌跺?涓???纭???ㄧ???????瀛?姘村钩涓?涔?娌℃???存?ョ??璇????浣???姝ョ??瀹?楠?璇????剧ず锛?杈f?绱???浣?VR1/TRPV1???跨????浣???P2X3 ??浣?绛?????浣????藉??涓??朵腑[37锛?40锛?45锛?46]??杩?浜???绌朵负浜轰滑??渚?浜?涓?浜?娼??ㄧ????绌舵?瑰????姝ゅ?锛?姝e?涓?浜???绌惰?????ㄦ????f?凤?绋虫??纾??虹???????哄?跺???借?涓?缁???????韩??绂诲?????浠ュ??淇???/淇?浼ゅ??х?缁??芥???筹?涔??????藉??涓?杩扮??琛?娴??存?ョ?稿?筹?杩?浜??芥??寰?杩?涓?姝ョ??绌躲??
?????昏??瑷?涔?锛???杩?瀵瑰?楠?缁?????????锛???浠????扮ǔ??纾??虹?瑙g?肩????浣??ㄥ??澶?涓???绱???褰卞??锛?????ǔ??纾??哄己搴︺??娌荤???堕?村???肩??绫诲??绛?????浠??涓猴?濡???浣跨?ㄩ??褰???绋虫??纾??哄???帮?绋虫??纾??哄???涓?瀵圭?????浜??瑰?绫诲?????肩???锋???稿?澶х??甯?????缁煎??璇?浠风ǔ??纾??虹?????板???跺?涓????肩??绫诲????????浣????浠ュ???舵??ㄧ????瀛??哄?讹?灏????╀?杩?涓?姝ラ?璇??跺?ㄦ???ョ?肩??娌荤??涓???娼?????
????04???扮?跺????涓?灞???
?????告??朵?绫诲????纾??猴?绋虫??纾??烘??????搴????垫??搴?锛?骞朵??轰?姘哥???????纾?浜у??浣跨?ㄦ?逛究????绌挎?存??妞??ャ??浠锋?煎????绛?锛???姝ゅ?ㄨ??╂不??涓??锋?????涓?瀹规??瀹??扮?浼??裤????????澶ч??瀹?楠??版????剧ず绋虫??纾??哄?ㄨ???琛?娴????瑰??楠ㄨ川??缂?瑙g?肩??绛??归?㈠?锋??娼??ㄤ复搴?搴??ㄥ??????浜?瀹?涓?锛??や???????娑?????杩?涓??归???杩?骞存?ョǔ??纾??哄?ㄤ唬璋€?????????????????卞??浼ゅ?f????绛??归????剧ず?轰???姝ヨ??ソ??搴??ㄥ???????惰??锛???纾??哄?ㄥ?诲?娌荤??棰?????搴??ㄤ????浜轰滑??骞挎??ュ??锛??冲?杩????涓绘??诲???璁ゅ???瀛??ㄧ??澶??归?㈢??????锛?
????(1) 缁???涓?缁?涓???灏界?澶у??板?楠???绌舵?ラ??浜???纾??哄?琛?娑茶?????楠ㄩ?绯荤?浠ュ??缂?瑙g?肩???锋??姝f??搴?锛?浣????朵???????搴?锛????虫??涓????ラ??????搴?[47]??瀵艰?寸???涓?缁?涓???????姣?杈?澶???锛???????哄???颁???(寮哄害??姊?害????甯?锛????崇??烘?瑰??绛?)????绌跺?璞′???(姝e父??涓??????剧???舵????涓???缁?缁???绫诲????缁???绛?)锛?纾??哄????瑰?涓???(澶????堕?村??棰???绛?)锛?浠ュ????浣跨?ㄦ?娴??规??垫??搴﹀????杈ㄧ??绛???宸??锛???姝や汉浠????瑕??村???瀹?楠?瀵逛骇????浣虫??????纾??哄己搴︺??纾??轰??ㄦ?瑰?浠ュ???剧???舵??绛?杩?琛?澶??归?㈢??绌躲??
????(2) ??绌朵?瑙???锛?缂轰?????????纾?????搴??ㄤ???浜????╋???涓哄?ㄤ???????绌朵腑锛????╁??互浠ョ?稿????????纭??拌??ヤ汉浣???缁???锛?浣?????虹?稿?冲?楠???瑕?????澶?涓????锛??????浣?琛ㄩ???缁?缁???璺?绂汇??纾?浣?琛ㄩ?㈢??哄己搴︺??纾?浣?????缁?????纾?浣????х?绛???浜轰滑浠ュ?绉?涓??????瑰?杩?琛???绌讹?杩????界?存?ュ奖??瀹?楠?缁??????ㄥ?澶???绌朵腑锛?纾??虹?????伴?芥病???蜂???杩帮????宠???浜???绌舵病??杩?琛????烘????纾??烘???锛???姝わ?涓???瀹?楠?寰??轰???缁???涔?灏变?瓒充负濂?????浠??ㄨ??瀵圭??鸿?琛?涓?缁寸┖?存????锛?浠????藉???纭??板??????璇?瀵硅薄??澶???纾??虹?????
????(3) ?哄?朵?娓?妤???渚?濡?锛??界?舵??涓?浜??充?绋虫??纾??洪????浣??ㄦ?哄?剁????绌讹?浣?澶у??轰???璁撅???姝ょ己涔??存?ョ????瀛?姘村钩??璇??????や?纾??哄?琛?娴???褰卞????澶ч?????板????╃???归?㈢????绌朵?澶?锛?????澶у??板?充?纾??虹???╁???搴?浣??ㄦ?虹??????绌跺???涓??ㄧ???╁??归??????????芥按骞崇????楂?涓???浣???缁???褰㈡????澧?娈???姝讳骸绛??烘??????绛?锛??惰??杩?浜????╁?姘村钩?????????介?戒????规??????锛??????璧风??涓??存??搴???Muehsam 绛?浜洪??杩?浣?澶?瀹?楠????扮ǔ??纾??哄??互?存?ユ??楂?浜鸿?绾㈣???界???辨哀??锛???绀轰?绋虫??纾??哄???戒?杩????╀?????姘у?╃?ㄧ??锛?杩????芥????哄??寸??澶?绉?浣??????╁???搴?????瑕??哄?朵?涓?[48]???惰??锛??跺?蜂?杩?绋?骞朵?娓?妤???浠?浠??板????╃???哄?朵?????锛?渚?濡?纾??哄?琛?娴???褰卞??锛?寰?寰????舵??娉????????╀?绯荤??澶????э?浠???涓??借В???ㄦ椿浣??ㄧ?╁??浜轰?涓???瑙?娴??扮???拌薄????姝わ?浜轰滑??瑕?杩?涓?姝ョ郴缁??у?颁??╃??????瀛︺?????┿???诲?澶?涓?????渚?濡?纾??哄?浣????垫??????卞?恒??姘у??杩????????╂?峰??绮剧‘纾??ф?????椤虹?????纾??х?╄川????搴??哄???????╀?绁?缁?璋??х?澶??归?㈣?琛?娣卞?ユ?㈢┒??
????(4) 浜轰?涓村?瀹?楠?涓?瓒筹?涓??版????灏??颁复搴?璇?楠?????涓????炽??????????绌跺?灞???浜?绂讳?缁??????ㄧ?╂ā??涓?锛?骞朵??ㄧ?╃??绌朵???甯告??????渚?濡?锛??界?跺?扮????涓烘????????ㄧ???ㄧ?╃??绌堕?芥?剧ず浜?绋虫??纾??虹??绉???????浣????浣?瀹?浠?????绌舵?伴??蹇?椤昏?涓?姝ユ?╁ぇ锛??????村????肩??绫诲????瀵逛?浜轰?瀹?楠???????涓????筹???浠??涓鸿????芥???变?纾??哄???颁?姝g‘??娌荤???堕?翠?瓒筹?浠ュ??娌℃???哄???蜂????剧??绫诲??锛?渚?濡??肩??绫诲??绛???浜轰滑杩?搴?杩?琛?澶ч??????绌讹?浠ヤ???绋虫??纾??虹?????板??涓??????肩??绫诲??锛?浠???寰??虹ǔ??纾??哄?浜轰?????浣??ㄧ??缁?璁恒??
????(5) 瀹??板????搴???瀹??板????搴??ㄧ?肩??娌荤??涓???甯稿父瑙????? 椤圭??烘????涓衡???存?р??????绌朵腑锛??朵腑6 椤圭??绌舵?剧ず????纾?缁???纾??哄???缁?涓????娌荤????瀵圭?х??告??肩???????瑰??锛?浣?????纾?缁???纾??哄???缁?涔??存病???捐??宸????杩?琛ㄦ??瀹??板????搴?璧风????瑕?浣??ㄣ??浜?瀹?涓?锛??ㄧ???涓烘???搴???澶?涓???绌朵腑锛?瀹??板????搴?涔???甯告???俱??渚?濡?锛?Vallbona 绛?浜虹????绌朵腑??????纾?缁?涔???涓?浜?瀹??板????搴?锛?杩?浣垮??h???肩??姘村钩浠?9.5 ????浣???.4 ??锛???????哄???缁????????翠负???俱??姝ゅ?锛?76%??纾??哄???缁??h???ュ???肩?????惧??杞伙???瀹??板??缁?????19%???h???ュ???肩??绋?搴﹀??杞汇????姝わ?瀹??板????搴??ㄧ??哄??肩????褰卞??涓????拷瑙???浣??充娇濡?姝わ?杩?????瓒?杩?涓???????绌舵?剧ず浜?纾??哄???缁?姣?璧峰??板??缁??ヨ??????村ソ??缂?瑙g?肩??????锛?骞朵??锋??缁?璁″???涔?(??)??姝ゅ?锛?浠や汉???磋叮????璁剁??????扮????涓烘?锛???浠????芥?惧?扮??100%宸叉?ラ????灏?榧???绌舵?剧ず浜?绋虫??纾??哄?锋??绉?????????浣??ㄣ??灏界?????????绌舵?伴?????肩??绫诲????纾??哄???板???介?介??浣?浜?浜虹被??绌朵腑?虫?х??????惧??姣?锛?浣?????浠??涓猴?浜虹被??灏?榧???????浣??ㄧ??绌剁??涓昏??哄???涓????芥????板????搴???浜?瀹?涓?锛??ㄥ?榧???绌朵腑缂轰?瀹??板????搴????堕?虫?х????ㄤ?瀹?绋?搴︿?璇???浜?绋虫??纾??哄?ㄧ?肩??缂?瑙f?归?㈢???????э??冲??ㄥ凡缁??ラ????杩?浜???绌朵腑??娑?????纾??哄???板???肩??绫诲???归?㈡???姝ゃ??瀵逛??肩??绛??剧???舵???ヨ?锛?瀹??板????浣??ㄥ???芥??己澶х??锛?瀹?瀵逛汉浣???宸ㄥぇ褰卞??寰?寰?浼??╃????浜?纾??虹??娉???韩??褰卞??锛??瑰?????ㄧ????澶у?纾??哄???拌?娌℃??浼???锛???姝ゆ????骞朵?????浣崇?????典?????姝わ???瑕??胯?瀹??板????搴???瀛?????胯?瀹?瀵圭??烘不?????翠???搴???璐$?????涓???????板?诲?﹁?瀹???
?? ??瀹??板????搴????ㄧ??哄?浜轰????肩????绌朵腑纭??瀛????浣?澶??扮??绌惰〃??绋虫??纾??烘??韩?告?浜???瀹??板????瀵圭?х?(??ham control锛?????纾?缁?)?ヨ??????村己
????05??缁?璁?br />
?????界?垛??纾???????绉?瀛︽?у???????т??撮?藉??ㄧ??浜?璁??涔??????浣?涓轰?涓???澶?骞翠?缁????╁?诲????茬??绉???宸ヤ????剧??绘?????跨??璇?棰???浣?????瀵圭??虹???╁???搴??哄?剁???㈢储??杩?骞存?ョ????绌剁Н绱??绗???璁や负??纾?????浜?瀹?涓??ㄥ?澶х?搴︿?涓?涓??诲??涓?????复????甯哥被浼肩???板?锛??崇簿??涓?绯?绮?骞跺????讳???瑷?锛?瀹?浠????哄?跺???骞朵?????杈?涓烘俯??锛???娉?涓?瑗垮?荤??绔?绔胯?褰辩?告?杈?锛?浣??????讹?瀹?浠????????娌荤?剧??锛?涔?涓???吉绉?瀛︺??涓??归????变??轰?姘哥?????涓?浜?纾???浜у????互灞??ㄥ??ㄤ?浜轰??瑰??ㄤ?锛??锋??杈?楂???绌块???????堕?存?у?惰?藉??锛?骞朵???甯告???????瀹??ㄦ?ц??ソ锛???姝ゅ?ㄤ??????介?芥??涓?瀹???浜虹兢?ㄤ娇?ㄥ?轰?姘哥?????纾???浜у??锛??ㄦ?ユ?瑰??涓?浜?杞诲井???剧??????浜??ュ悍?舵????杩?骞存?ユ??绉?瀛﹀?楠?璇???〃??绋虫??纾??哄?ㄨ???琛?娴????瑰??楠ㄩ?绯荤?浠ュ??缂?瑙g?肩????褰卞??浠h阿????杞荤????浠ュ??淇?杩?浼ゅ?f????绛?????涓?瀹?????????浣????︿??归???纾??哄?浜虹被???蜂?褰卞??骞朵?瀹??ㄦ??纭???杩?涓?浠????变?浠?浜????????绌剁??瀛﹁??杈?灏?锛?骞朵?瀵圭??烘??韩?????????╁?诲?浣?绯讳?缂轰?瓒冲???浜?瑙o?瀵艰?村?澶???绌朵?澶?瑙?????锛?寰??扮??缁???娌℃??寰?濂界??????澶??э?浠??哄?朵?涔?缂轰?娣卞?ョ???㈢储锛?????涓?浠?涓???????瀹惰????涓?榻???澶稿ぇ瀹d?绛?璐??㈠奖??锛??藉??翠?????????复???板???浣?骞歌??????????杩???骞磋??ヨ?澶???涓?涓?浜哄?????ユ?????锛???互???╁?瀛︾????颁唬妫?娴???娈点????杩???蹇典互???村ソ??纾??烘?′欢锛?瀵圭??轰??ㄤ?浜轰?????搴????哄?惰?琛?绯荤?娣卞?ョ????绌讹?骞堕??瀵逛?涓??????剁??纾??烘?′欢杩?琛?浼?????渚?濡?宸茬????帮?杈?楂??哄己??杈??挎?堕?寸??纾??哄?缂?瑙g?肩???????存???剧??浣????骞朵?绗???璇鹃?缁?杩???涔????帮?涓???纾??烘?′欢瀵逛???????????瀹??ㄤ?????????????浠??镐俊????瓒??ヨ?澶???瀛﹁?????ユ?????锛?杩?琛?瓒??ヨ?瑙???????娣卞?ョ???哄?舵?㈢储??绯荤???绌讹?纾??虹??娉?涓?瀹?浼??ㄦ???ヨ?绉?瀛﹀?板??ㄤ??诲?棰???锛??ㄧ?瑙g?肩?????瑰??楠ㄩ???琛?娴?绛?澶??归?㈠???ョ???圭??浣??ㄣ??
????????br /> [1] Schuster N M锛?Rapoport A M. Nat. Rev. Neurol.锛?2016锛?12锛?635
[2] Klein M M et al. Pain锛?2015锛?156锛?1601
[3] Lefaucheur J P et al. Clin. Neurophysiol.锛?2020锛?131锛?474
[4] 纾?澶?绉?瀛︽?洪????????(纾?澶?绉?涓?杈?)??绉?瀛﹂???ワ?2020锛?65 (13)锛?1163
[5] 寮?娆o?Yarema K锛?璁稿?. 绋虫??纾??虹?????╁???搴?. 绉?瀛﹀?虹??绀撅?2018.56-57
[6] Basford J R. Arch. Phys. Med. Rehabil.锛?2001锛?82锛?1261
[7] 寮?娆? ?╃??锛?2017锛?46(7)锛?409
[8] McKay J C et al. Bioelectromagnetics锛?2007锛?28锛?81
[9] Okano H锛?Ohkubo C. Bioelectromagnetics锛?2001锛?22锛?408
[10] Morris C锛?Skalak T. Bioelectromagnetics锛?2005锛?26锛?1
[11] Kim S et al. Brain Research锛?2010锛?131锛?211
[12] Alkire M T et al. Science锛?2008锛?322锛?876
[13] Adolphs J et al. Intensive Care Medicine锛?2004锛?30锛?2094-2101.
[14] Ichioka S et al. Medical & Biological Engineering & Computing锛?1998锛?36锛?91
[15] Ichioka S et al. Bioelectromagnetics锛?2000锛?21锛?183
[16] Tzirtzilakis E E. Physics of Fluids锛?2005锛?17锛?077103
[17] Rashidi S et al. Journal of Magnetism and Magnetic Materials锛?2017锛?439锛?358
[18] Okano H锛?Ohkubo C. Bioelectromagnetics锛?2007锛?28:369
[19] Okano H锛?Ohkubo C. Bioelectromagnetics锛?2003锛?24:139
[20] Okano H锛?Ohkubo C. Bioelectromagnetics锛?2005锛?26:469
[21] ?ㄥ缓??绛?. 绉?瀛﹂???ワ?2020锛?65 (13)锛?1238
[22] Xu S et al. Evid.-Based Complement. Altern. Med.锛?2011锛?2011锛?620984
[23] Taniguchi N锛?Kanai S. Evid.-Based Complement. Altern. Med.锛?2007锛?4锛?99
[24] Zhang H et al. Bone锛?2018锛?107锛?36
[25] Saifzadeh S et al. Iran. J. Vet. Res.锛?2007锛?8锛?8
[26] Rogachefsky R A et al. Bioelectromagnetics锛?2004锛?25锛?260
[27] Taniguchi N et al. Evid.-Based Complement. Altern. Med.锛?2004锛?1锛?187
[28] Morris C E锛?Skalak T C. Am. J. Physiol. Heart Circ. Physiol.锛?2008锛?294锛?50
[29] Vallbona C et al. Arch. Phys. Med. Rehabil.锛?1997锛?78锛?1200
[30] Kov谩cs-B谩lint Z et al. Bioelectromagnetics锛?2011锛?32锛?131
[31] L谩szl贸 J F et al. Int. J. Radiat. Biol.锛?2012锛?88锛?430
[32] Caselli MA et al. J. Am. Podiatr. Med. Assoc.锛?1997锛?87锛?11
[33] Collacott E A et al. JAMA-J. Am. Med. Assoc.锛?2000锛?283锛?1322
[34] Carter R et al. J. Fam. Pract.锛?2002锛?51锛?38
[35] Kuipers N T et al. J. Appl. Physiol.锛?2007锛?102锛?1410
[36] Laszlo J et al. Bioelectromagnetics锛?2007锛?28锛?615
[37] Gyires K et al. Bioelectromagnetics锛?2008锛?29锛?456
[38] Kiss B et al. Bioelectromagnetics锛?2013锛?34锛?385
[39] Antal M et al. Bioelectromagnetics锛?2009锛?30锛?438
[40] Zhu Y et al. Bioelectromagnetics锛?2017锛?38锛?22
[41] Khoromi S et al. J. Pain Symptom Manage.锛?2007锛?34锛?434
[42] Segal N A et al. Arch. Phys. Med. Rehabil.锛?2001锛?82锛?1453
[43] Eccles N K. J. Altern. Complement. Med.锛?2005锛?11锛?681
[44] Taylor A et al. J. Altern. Complement. Med.锛?2001锛?7锛?53
[45] Okano H et al. Bioelectromagnetics锛?2012锛?33锛?518
[46] Sandor K et al. Life Sci.锛?2007锛?81锛?97
[47] Harun R et al. Int. J. Environ. Res. Public Health锛?2015锛?12锛?8919
[48] Muehsam D et al. PLoS One锛?2013锛?8(4)锛?e61752