I. Early treatment of peripheral nerve injury 1. ultrashort wave therapy Ultrashort wave can dilate blood vessels, improve blood circulation and tissue nutrition of nerves and peripheral tissues, strengthen local tissue metabolism and nervous system function, and achieve the purpose of anti-inflammation and edema nI. Experimental studies have shown that after clamping the left sciatic nerve in rabbits, ultrashort wave therapy, electrode pairs placed at the wound, microcaloric, 7O-8omA, 12min/ times, 1 time / d, 2O times l treatment, total 2 treatment courses 6, 8, 10 weeks after surgery, the treatment group fibrillation potential, positive phase potential decreased, the appearance of motor unit potential, l2 weeks after surgery. The treatment group returned to normal. The nerve conduction velocity was also faster in the treatment group than in the control group. In addition, the results of the efficacy of ultrashort wave treatment at the site of the injured nerve showed that. No heat a microcaloric, lO-15min / time, 1 time / d, most in l-3 treatment, muscle strength and function back to normal or close to normal. 2. Microwave therapy Microwave action on peripheral nerves can increase neuromuscular excitability and bioelectrical activity, and at the same time can stimulate nerve regeneration. Small dose can improve blood circulation, dissipate edema, accelerate regeneration of nerve tissue and recovery of nerve conduction function. In the treatment of nerve injury, microcalories are generally used. In the early stage, no heat is mostly used. In the treatment of nerve injury, microcalories are generally used, and warm calories are used in the deep or recovery period. 3. Therefore, a certain amount of fractional wave radiation has antispasmodic, analgesic, promote the dissipation of inflammation and accelerate the process of tissue repair, which is conducive to the regeneration and repair of injured nerve tissue 4. Small power, after irradiation is conducive to nerve regeneration. A large number of studies have shown that the laser has a role in promoting the body’s immune function and tissue repair, and some literature suggests that it is helpful for the repair of nerve tissue. Laser acupuncture has a strong penetrating power and can produce not only mechanical stimulation similar to acupuncture, but also photochemical stimulation and thermal stimulation, so it has the dual effect of acupuncture and phototherapy, which has a number of biological effects such as improving the circulation, improving the respiratory chain, promoting nerve cell repair and increasing immune function. The He-Ne laser can directly stimulate peripheral nerves, enhance their excitability, and promote nerve cell repair. Laser irradiation promotes nerve fiber regeneration mainly because laser radiation changes the molecular conformation of collagen in the severed tissue, causing it to reconstitute new molecules and cross-link. The thermal and biological effects of the laser act on the neurons and promote the metabolism of the injured nerve. (2) Infrared therapy: Infrared radiation is mainly thermal effect. It can improve the local blood circulation of the damaged nerve, accelerate tissue metabolism. Promote the absorption of inflammatory edema and create conditions for the regeneration of nerve axons. Ma Jian et al. made a rabbit sciatic nerve injury model, infrared irradiation. 30 min / time, 1 time / d, resulting in an increase in local skin temperature of 2-3 ℃ after treatment on rabbit toe activity, running ability, the degree of muscle atrophy, changes in muscle morphology, muscle tissue enzymatic changes have certain effects. In contrast, infrared irradiation had a small effect on the electromyography of the injured nerve. The stimulation threshold of muscle contraction and motor nerve conduction velocity were better than those of the control group after irradiation, which had a certain effect on the enhancement of tissue repair and regenerative function. In addition, the efficacy of combining infrared irradiation with other physical therapies for the treatment of peripheral nerve injury was also satisfactory. In clinical use, infrared light can be used as an adjunct to exercise therapy, occupational therapy, or used in conjunction with other physical therapy. 5, hydrotherapy Hydrotherapy uses the buoyancy of water, which has the effect of relieving muscle tension and accelerating blood circulation and lymphatic reflux ~ the buoyancy of water helps the movement of paralyzed muscles when the limb is moved in water after peripheral nerve injury [61: II, the recovery period after peripheral nerve injury treatment 1, low-frequency current therapy Gao Bitao et al. selectively conducted a comparative analysis of 68 patients with peripheral nerve Seddon class injury. The results showed that the treatment group was significantly better than the control group, and low-frequency pulse current stimulation of the affected muscle could cause rhythmic muscle contraction. The results showed that low-frequency pulsed current stimulation of the affected muscle could cause rhythmic contraction, promote local blood circulation, thereby delaying the atrophy of the affected muscle and inhibiting muscle fibrosis. 2, electrical stimulation therapy electrical stimulation therapy is the most common and effective treatment method for peripheral nerve injury a general 2-3 weeks after the injury began to carry out a specific can be adjusted according to the degree of nerve damage and the waveform required for treatment pulse width, gap time and stimulation intensity of stimulation. The stimulation effect on the diseased nerve muscle is unique. Without causing excessive contraction of normal neuromuscular pain a mild nerve injury can be selected pulse width 5O- lOOms, gap 1500 – 2000ms; moderate nerve injury selected pulse width lO0-200ms, gap 3000-4000ms; severe nerve injury selected pulse width 200-300ms, gap 3000-6000ms: the electric flow to be able to cause nerve injury. 6000ms: electric flow to cause muscle contraction, generally between 20-4OmA Each affected muscle stimulation 6rain / time, 1 time / d, 2O-3Od for a course of treatment, the interval between courses 7 a lOd, generally continuous treatment for several months. Electrical stimulation therapy can make the affected muscle get moderate stimulation, because too weak stimulation can only cause weak contraction of muscle fibers, not play a therapeutic role, while too strong stimulation can destroy the muscle fibers. Electrical stimulation causes passive rhythmic muscle contraction and diastole, which can improve the recovery of nerve excitation and conduction function and nerve regeneration; after the loss of innervation, the muscle has the tendency to fibrosis and sclerosis, electrical stimulation can prevent the thickening of muscle connective tissue, which can prevent muscle contracture and fibrosis To prevent tendon contracture and deformity, and loosen scar tissue, audio electrical therapy can also be used 3. It stimulates muscle fibers, produces muscle tension and contraction, reflexively accelerates blood and lymphatic circulation, and can improve neural tissue and aerobic metabolism. Yu Shufen et al.51 used modulated IF electrotherapy instrument for treatment, with bidirectional symmetric square wave, modulated wave frequency of 2-2.5 Hz, wave width of 0.1 ms, modulated wave frequency of 4 kHz, stimulation treatment intensity of l50-180 mA, 30 min/time, 1 time/d, the latency of action potential, conduction velocity, waveform, and Waveform and amplitude were restored to the pre-injury level, motor dysfunction was basically recovered, and serum creatine phosphokinase values and neurotrophic necrosis were significantly lower than those of the control group: suggesting that medium-frequency electrotherapy can promote the repair of diseased nerve tissue in the injury area and restore its bioelectric activity, thus promoting the recovery of nerve function. 4, DC iodine ion guide After the acute period of peripheral nerve injury, DC iodine ion guide therapy can be used, because iodine ion guide in the site of injury has the effect of strengthening nerve nutrition, improving nerve excitability and promoting nerve function recovery. The mechanism of action of electromagnetic field to promote peripheral nerve regeneration is not completely clear, and may be related to the following factors: accelerating the process of Wallerian degeneration in the distal nerve segment of the injury. The electromagnetic field accelerates the process of Wallerian degeneration, which may be related to the electromagnetic field stimulating the proliferation of Chevron cells and enhancing the phagocytosis of Chevron cells and macrophages. At the same time, the accelerated degeneration process provided a good regenerative microenvironment for proximal axon regeneration, allowing it to grow into the distal basement membrane canal and Bungne’s band as early as possible, which is the same situation as nerve injury accelerating regeneration after nerve re-injury Promoting axon regeneration. Promotes the proliferation of Schwann cells and myelin regeneration. Promotes recovery of target organ function. Magnetic therapy promotes peripheral nerve regeneration, mainly due to the obvious proliferation of Schwann cells after magnetic field stimulation and the mild inflammatory response, which facilitates the regeneration of unmyelinated axons, which in turn stimulates more Schwann cells to divide and proliferate, converging and guiding axons to grow distally. The electromagnetic field does have a promoting effect on peripheral nerve regeneration, and there is still a significant promoting effect when treating for a longer period of time (e.g. 8 weeks), so the course of physical therapy should be long enough. 6, ultrasound therapy ultrasound has a thermal and non-thermal effect: used in the treatment of peripheral nerve injury, the use of small doses of pulsed ultrasound, so the thermal effect is small. The rat peroneal nerve clamp injury, ultrasound treatment, frequency 1.5MHz, sound intensity 0.5W, cm, pulsed l: 10, 5min / time, 1 time, d, a total of 4 d. Ultrasound treatment is effective in restoring the function of nerves and muscles. Ultrasound promotes muscle nerve re-innervation, mainly because of the mechanical effect of ultrasound, which can promote and induce many chemical changes and play a role in strengthening metabolism and improving tissue nutrition. Third, the treatment of complications after peripheral nerve injury After peripheral nerve injury, a more delayed painful pathology called complex regional pain syndromes (CRPS), is a common complication after peripheral nerve injury: the essence of the pathological mechanism of CRPS is nerve injury and atrophy, which is manifested along the alignment of the damaged nerve and a wider range than this. The appearance of spontaneous pain, nociceptive hypersensitivity, nociceptive hypersensitivity ~ the main methods of physical therapy for CRPS are alternating warm and cold baths, electrical stimulation therapy, laser therapy, automatic movement therapy, passive movement therapy, daily movement training, etc.: After peripheral nerve injury, the choice of physical therapy methods should, in principle, be adjusted according to the requirements of the different stages of nerve recovery: the principles of early treatment are: elimination of the cause, early elimination of Inflammation, edema, reduce nerve damage, prevent limb contracture and deformation, promote nerve regeneration, prevent muscle atrophy, and enable nerve conduction function and muscle strength to be restored. The use of light and electricity is good for analgesia, anti-inflammation, enhancing local blood circulation and improving the nutritional status of nerves and muscles, and can be used: ① ultra-short wave therapy; ② decimeter wave, microwave therapy; ⑧ ultraviolet therapy; ④ laser therapy; ⑧ warm therapy and hydrotherapy, wax therapy, infrared irradiation, etc. The principles of treatment during the recovery period are: focus on preventing muscle atrophy, promoting nerve regeneration, improving local nutrition, and assisting in functional recovery, and can be used: ① warm heat therapy, including wax therapy, infrared, electro-optical bath, etc.; ② direct current iodine ion infusion, ultrasonic and audio electrotherapy, etc.; ⑧ electrical stimulation therapy; limb vortex bath, etc. The treatment after peripheral nerve injury focuses on promoting nerve regeneration and improving the quality of regenerated nerve fibers, reducing the degree of limb dysfunction, and improving limb function Nerve regeneration is a very complex pathophysiological process with many influencing factors. Physiotherapy is one of the important therapeutic measures after peripheral nerve injury Physical factors accelerate nerve regeneration and reduce fiber tissue proliferation, and their mechanism of action still needs further in-depth study.