1.

6 (Windows 8 / 7 / Vista / / 2000)

2014
2 " "

...................................................................................................................... 3

............................................................................................................................................. 4

1. ................................................................................................................................. 5

2. ..................................................................................................................... 5

3. ................................................................................................................................ 5

4. ........................................................................................................................................... 5

5. ................................................................................................................................. 5
5.1. ................................................... 5
5.2. ............................................................................. 5
5.3. ................................................................................................... 6
5.4. ............................................................................................................................... 6
........................................................................................................ 7
................................................................................. 8
....................................................................................................................................... 8
........................................................................................................... 9
6. ........................................................................................................................................... 10
6.1. (R-) ...................................................................................... 10
6.2. ........................................................................................................ 11
6.3. .......................................................................................................................................... 14
6.4. - ......................................................................................................................................... 19
6.5. ........................................................................................................... 20
6.6. ........................................................................................................................ 21
6.7. .......................................................................................................................................... 22
7. ........................................................................................ 23

8. ................................................................................................................................. 24

9. .................................................................................................................................... 25

10. .......................................................................................................................................... 27

11. ............................................................................................................... 27

12. ............................................................................... 27

. . ....................................................................... 28
....................................................................................................................................... 28
1. .................................... 31
2. .................................... 31
2.1. ............................................................................................ 31
2.2. ............................................................................................................... 32
2.3. ........................................................................................................ 32
3. .................................................................................... 32
3.1. .................................................. 32
3.2. ................................................................................................... 32
3.3. ......................................................................................................... 33
3.4. ............................................................................ 36
4. ................................ 36
4.1. , ................................... 39
4.2. ............................................................. 40
5. .................................................................................... 44
....................................................................................................................................... 45
 3

-
()
4 " "

Y. Nakatani -
.
50- .
- . ,
,
. "" -
. ,
,
.


, ""
.
. ,
, .

,
.
, ""
-
. 2002 . [2].

. , .

- , , , .

. ,
, ,
,
, , .

-

.

" " - :

.
.
, (3-5 ).
.
, -, .
.
().
.

.
.
.
 5

1.
. , "
()".

2.
. " . "

3.
. " . "

4.
. " . "

5.
5.1.

"", . 2.

, 3%
70% .

5.2.

(
)
+ (15),

(
) - (14).

. (
.)
,
( + ).
- ""

() "" ().
""

"" (+).

""
.
,
.
6 " "

5.3.
.
, ,
, (NaCl 0.9%).
1 .
, , .
.
,
.
.
.
, ,
. , .

5.4.

"" .
2 :
, - ,
.
.

( H
F ), ,
, (L-R S-D
).
.
 7

. , ,
.
" \ \ \ "
.

: .
, ,
, H1 H6 F1 F6 .

: H1 - H6 , H1 - H6 , F1 - F6 , F1 - F6
.
8 " "

( ) .

1. .
2. (, ,
, ).
3. .
4. .
5. / .

, .. ,
.
.
, .
,
.
.

, .

, .

.
,
.
3-
24 , . ,
.
.

Windows. "
" Windows. ""
" " ,
, Notify.

.
- ,
, .

! , 10
. ,
,
.

, ,
.

24 .
 9

( ) . INS
.
10 " "

6.

" .
: , 24
.
, ,
. ,
.

" ".

6.1. (R-)

Ryodoraku (R-),
.

,
. , R-
12 . ,
, R-.
.
(),
. - ,
.
1\2 ,
3 (),
.
(), , "+", ,
, "".
, ,
.
 11

, , " +"
"".
, , " "
"".
,
,
R-.

+3 ,
+2 ,
+1 ,

-1 ,
-2 ,
-3 ,

:
:
() 24 [-2] ,
, (24) 2-
( -2), - , .

,
, .

, (

).

.

1.6 .

6.2.
R- .
,
, ,
,
.
.
:
- () ;
- , ;
- .
.
, .
12 " "

24
" 24" 24 24
, 6 6 .
, 4 ,
. , .
, , : ,
, , . , ,
, .
-
, .
,
, , () .
 13

12+12
" 12+12" 12 .
,
. .
, .
.

12
" 12" " 12+12".
. ,
, - .
14 " "

6.3.
, .
"" "".
"" "" ,
:
1. - , .. , "".
2. - () () .
3. - () () .

.
, "" (, , ), ,
, "" (, , ) - .
100%.
().
. .
" " "" ( ).
"" ,
.

"" , ""
"". .

"" , ""
"". .

,
,
.
 15

, , (), ,
, (.. 100%) ().
"" ,
().

"" , "". 12
. "l" "r" .

, . ""
, .

("" ), " ",
.. " > ".

("" ), " ", ..
" < ".
16 " "

.
- - (Vr > Rr) 1 -
- (MCr > TRr).

1 ( > ) = 1 ( > )
=

, .

.

"" ""
.
("", "" "")
, .
, , " " ( "
"). , , " ".

"", "", "".
,
:

("", "
" > " " "") ,
""
" " "".

,
(" > ").

" < " ,
(" < ")
" "

" " ,
, .
.

.
 17

-
"l" "r" .
12 .

( ).
()

(MCr > MCl), .. " < ".

0 ( > ) <1 ( > )

<
""

"" ,
()
, 3

"" ,
()
, 3

""
2

18 " "

()
, . "l"
"r" . 12 .

(.. ) (.. ).
- -
(Fl > MCl, Rl > Cl, Vr > IGr)
- (MCr > Fr).

1 ( > ) < 3 ( > )

<

"-"

"" ("") :

" "
3 ( )

" " 3
,
, ,

.

,
"-" " "
 19

6.4. -
-
.

.
, . -
, -. ,
- -.

,
. ,
.
. ,
( ).
.
" ".
20 " "

6.5.
" " .

,
- .
,
.
,
.
,
. ,
, .
, , ,
,
(). ,
.
, ( - ).
- ,
.
 21

6.6.
"" ,
.. .
,
,
, , ,
, , ,
, ,
,



1-2 3 4-5, 6-7 6-7, 4-5 8

,


,
, ,
, ,


-
, ( ,
- ,
), ,
, ,
( , ,
-
),
( )
(-
, )
L2, L3, S3, S4, S5, C5, C6, C7, D3, C7, D1, D5, D6,
D9, D10 D11, D12, L1
D4, L4, L5 S1, S2

,
.
.
22 " "

6.7.
" ,
.
 23

7.

" ".

.
, .
.
,

.
.
, .

, , ,
" ", ,
.
24 " "

8.

"".
, .
. ,
"", , .

:
1.
2.
3. -
4.
1.6 .
"" .
.
" " ,
, ,
: , ,
. .
"" ""
.
.
 25

9.

" \ ".

,
-.

" "
,
.

, , "
", "",
,
,
.

1.6
.

"" , ,
.

"" ,

.

,
.

" " .
,
.
, . (.
. . .. .
2002/34. -.: , 2003).
, .
26 " "

,
,
, .. ..
.
. :
:
H6 GI5 GI4
:
H4 IG4 IG5
F4 V64 V65
( )
.

" "
. "" 10
(, , ..).
.
 27

10.

"" ,
" \ ".

,

" ".

( )



"".

, , "",
" \ ".
" \ " ,
, , .

. ,
Windows
(, ).
, .

11.
. " . "

12.
. " . "
28 " "

. .

1956 .
.
,
.
,
, , .
, .
"" ( : ryo , do ()
, raku ).
, ,
Ryodraku (, , , 67 -
), ,
. , ,
, ,
(Ryodraku). ,
, , -
(, ).

.
.
.,
. ,
,
. , ,
,
.
. ,

. ,
, ,
- . . , "" -
, ,
.
( ..,1963; .., 1980; . ., .
., 1981) ,
(). , (.
.., 1980)
. ,

,
, .
, -
,
. , ()
(),
(), - (),
(), () , , ().
- (),

.
()
, , ,
,

.
.
 29

, .
, - ,
- , -
- - ,
" " .

( ) (. 1).
, .

1.

.

H1 9I - 5-7 -7 -4(1)2-
5(6-9)

2 7IX - 5-8 -7 -5-8.1-

(4-6)

7V - 8; 1 - 2 5-7 -5,8;1-
(4-6)

4 4VI - 7-8 -7 6-12, LI

5 3 4 - 5-1 -7 4-7

6 5II - 5-8, 2 -7 6-12, S2-S4

30 " "

F1 - 3IV - S2-S4 8-L2 6-10

F2 II - S2-S4 8-L2 7-10, L1-L2

F3 3VIII - 8-L2 11 (10-12)

F4 65VII - S4-L5, 1-2 8-L2 11-L1, L2

F5 40XI - S2-S4 8-L2 (7) 8, S1-S2

F6 42III - S2-S4 8-L2 (6) 7-8

"" . "" "F" ( . Hand -

Foot - ): H1 - ; 2 - ; 3 - ; 4 - ; H5 -
; 6 - ; F1 - ; F2 - ; F3 - ; F4 -
; F5 - ; F6 - .
.
, ( 200
, 12 , 3- ).

. , p
p ,
(, ).
, ( )
,
. ,
.
,
:

1) , ,
.

2)
.
 31

3)
,
.

4)

.

5)
.

6) ,
, .

.
-
3 , , .
R-,

(24 , 12 )
" ". ., ,
,
" ", ,

, " ". ,

,
R-.

1.
:
, ;
;
;
.
.
;
, .
.

2.
2.1.

. , -
, .
, .
70-80% 20-22 .

1,5 , 0,5 .

( 50 ).
, , ,
,
.
. ,
.
32 " "

2.2.
, ,
. ,
, .
( ,
).
.
/
2.3.
, (, ),
, ,
. , , ,
, .
1,5-2 ,
, . ,
,
( , , -
..). ,
, .

.
, .
1015 .

3.
3.1.
:
;
();
;
.

3.2.
()
, .
, , .
200 12
.
 33

3.3.
.
.

(. . 1).

. 1. () ,
.

,

..

H1 (LU9*, P9, -)
.
:
, , 1 (m. abductor policis
longus) (m. flexor carpi radialis)
; , .
.

H2 (PC7*, MC7, -)
.
: ,
(m. palmaris longus)
(m.flexor carpi radialis), ;
, ,
- .
.

3 (HT7*, C7, -)
.
: ,
(m. flexor carpi ulnaris),
, ,
.
.

H4 (SI4*, IG4, -)
.
: () ,
V ;
(m. extensor carpi ulnaris) , V (m.abductor digiti
minimi); - ,
, . .
34 " "

H5 (TE4*, TR4, -)
.
: ,
, (m.extensor
digitorum) V (m. extensor digiti minimi);
, ,
.
.

H6 (LI5*, GI5, -)
.
: ,
, I ;
, .
, ,
, I .

F1 (SP3*, RP3, -)
-
.
: , I
; , I ;
, ,
, ,
.

F2 (LR3*, F3, -)
.
: , I II
( I );
I ; ,
.

F3 (KI3*, R3, -)
.
: ,
, ; ,
, .

F4 (BL64*, V64, -)
.
: , ,
V ; , V (
);
, , ,
( ).

F5 (GB40*, VB40, -)
.
: ,
; ,
;
, ,
-
.

F6 (ST42*, E42, -)
.
: , IIIII
IIIII ; , ,
( ).
( 2),
.
: H1-H6 , H1-H6 , F1-F6 , F1-F6
. ()
 35

(
, ).
, .
.
.
3-
24 , .
R-.

2.
.

H1 LU9* P9

H2 PC7* MC7

H3 HT7* C7
H4 SI4* IG4
H5 TE4* TR4
H6 LI5* GI5

F1 SP3* RP3 -
F2 LR3* F3
F3 KI3* R3
F4 BL64* V64
F5 GB40* VB40
F6 ST42* E42

* -

,
,
: 3- , , .
, .
( ) ()
, ,
.
,
.

""
,

, .
,
"" ,
.
.
.
,
""
. ,
.
36 " "

3.4.
R-
(
), .
24 ,
R-, () .
,
7 2 . ,
,
. ,
(14 ) , R- 105 .
. R-
. .
R- ,
- .
R- , .. (1998).
:
Rj=0.866*Hmax*Ln(1+Ij/bj),
Rj - , R- j;
Hmax - R- ();
Ij j ();
bj j ;
j 1 12.
bj 3.

3.
R-
H2PC

F5GB
H3HT
H1LU

H5TE

F1SP

F2LR

F6ST
F4BL
H4SI

H6LI

F3KI

bj 81 69 81 94 94 76 60 76 70 60 67 89

,
, b = 76
:
R=0.133* Hmax
, R- . R=14 Hmax = 105 .

4.
Y.Nakatani . ,
,
, .
.
,
, "
", ,
,
" ".
., , ,
,
(. 4).
.
 37

4.
( Hyodo, 1975)

,
,
,
H1 , , ,
,
,
,
, ,
H2


, ,
,
, ,

, ,

, ,

,
4 , , , ,
() ,
,
, ,

5 " , ,
,
" , ,

,
6 , , , ,

,
,

,
F1 - ,
, , ,
, ,
, ,
()

, ,
, , ,
,
F2 , ,
,


,
F3 , ,

, ,
,
F4 , , , , ,

,

,
F5 ,
,
() (),

, , , ,
,
F6 , ,


38 " "

, , ,
, ,
H1 ,

, ,

,
,
H2 ,

,
, ,
,
,

,

4 , , , ,
() ,

5 " , ,
" , , ,

, ,
,
6 , , , ,

, ,


,
F1 - ,
, ,
, , ,
,
()

,
, ,
,
F2 , ,
,
,
,

,
, ,
F3 ,
,

,
F4 , , , , , ,
,

,
F5 , , ,
,


,
, ,
,
F6 , , ,
,
, , ,

 39

, ,
.
,
( ) Ryodoraku, ,
.

4.1. ,

" ". (-
) , .
,
.
1.
.
:
;

;

(,
);
(:


).
:

;

(,
);
(,
).
2. .
, ,
- .
3.

. , -
.
4.
. ,
.
5. . ,
, ,
.
40 " "

4.
,

.




P , , ,
,

GI ,

(
E
)

( ,
RP -
)



, ,
() ,


IG
()

,
R

, ,

MC
() ,


TR ,
()

( ,
VB
)

(
F
)

,
, ,
. ,

.

4.2.
:
(, anamnesis morbi, anamnesis vitae);
;
;
.

:
- ( R-)
, 4-
" ";
 41

- , 40
80 ; 40; 80 ;
-
, .

,
.
.
, . ,
.
.
1. , ,
, 5,
.
2.
, . 5.
,
.
, .
3.
.
4. ,
, ,
6.
5. , . 1-4
.


.
, .

* *
I. -

PC-, HT-*
1.
LR+
ST+


PC-, HT-

2.
ST+
ST+,TE+
PC-, HT-
3.
KI-

PC-, HT-
4.
KI+

5. PC-, HT-

 42 " "

LR+,GB+,TE-, LI-
PC+, HT+
PC+, HT+, SP+
6.
LR+, KI+
/
II.

SP-, BL-

1.
LR+
LU+, LI+
SP-, BL-
,
2. LU+, LI+ LU-,

LI-

III. -
, BL-

1. ,
TE+, LI+, SI+
/

, BL-

,
2. TE+, LI+, SI+
/

PC+, HT+
-/
,
BL-


3.

/,
TE-, LI-, SI-
/

, BL-
KI+
4.

GB+, ST+

, BL-
*
BL+*
5.

BL+*

-/
,
BL-


6.

/,
GB-, ST-
/

IV.

1. LU+ LI-
LU- LI+


2.
LU+ LI-
LU- LI+
 43

V.
1. PC-, HT- LU-
2. TE-, LI- SI-
3. SP+, KI-
4. SP-, BL- GB+
VI.
1. KI+, BL-

2. BL+, SP+
BL-,SP-,KI+

3. BL+, SP+
BL-, SP-
4. BL-, SP- LR-, KI-
5. SP-,KI-,LR- BL-, GB-, ST-
VII.
, ST- SP-, BL-

1.


VIII. -

ST+ SP-
1.
ST- SP+

2. ST+, SP- TE-, LI-
3. 12 . ST+, SP- TE-, LI-, SI+
SP+, LR+
GB+, ST+
4.

GB-, ST-

5. LR+, GB-
LR+, GB+
LR+, GB+
6.



7.
LI+ SP-
LI+ SP+
XI.

1. SP-, BL-

LU+, LI+
LR+, GB+
2. SP-, BL-
LU-, LI-
LR+, GB+

:
1.
, ,
" ".
2. "-" - "" .
3. "M+" - "" .
44 " "

1. LU-
PC- / HT-
2.
3. TE+
4. TE-,LI-
SP+
5.
6. LR+
7. LR-
8. , KI-
9. GB-
10. ST+
11. ST-

5.

.
1. ;
2. ;
3. ;
4. .
,
, .
,
.
,
.
 45

1. .. " ". - , 1996. - 192 .

2. .. . . .
2002/34. -.: , 2003. 28 .
3. . . .:
, 1990. 576 .
4. .. . : , 1988. 352 .
5. .. . . : ',
1994. 240 .
6. .. . - .: , 1980. - 560 .