什麼是手汗症？
自主神經系統分成交感和副交感神經系統，而人的汗腺是由交感神經系統所支配。手掌多汗症（Palmar Hyperhidrosis ）乃因交感神經功能亢進引起，導致兩側手掌流汗量比正常人多且異常。
What
is the cause of Palmar Hyperhidrosis (excessive sweating of the hands)?
The autonomic
nervous system is divided into the sympathetic and parasympathetic nervous
system. The sweat glands are predominantly controlled by the sympathetic
nervous system. Excessive hand sweating is caused by hyperfunction of the
sympathetic nervous system.
手汗症帶來的困擾
因交感神經是自主神經的一種，當患者在緊張、興奮、壓力及天氣熱時，兩側手掌會不自主的流汗過多，變成濕漉漉的狀態，此時患者可能愈流愈緊張，愈緊張愈流，變成惡性循環。不流時雙手又變得太乾。天氣冷時，雙手血管收縮又變成冰冷的狀態，造成汗友在生活、工作以及心理上的困擾。
因交感神經是自主神經的一種，當患者在緊張、興奮、壓力及天氣熱時，兩側手掌會不自主的流汗過多，變成濕漉漉的狀態，此時患者可能愈流愈緊張，愈緊張愈流，變成惡性循環。不流時雙手又變得太乾。天氣冷時，雙手血管收縮又變成冰冷的狀態，造成汗友在生活、工作以及心理上的困擾。
What
are symptoms of excessive palmar sweating?
Excessive palmar
sweating is made worse by heat or emotional stimuli. Excessive palmar sweating
often leads to a fear of shaking hands and soiling of papers. Patients may have
difficulty with work or leisure activities that require a dry grip. Patients
report that excessive sweating often results in social problems on a both
personal and professional level. Palms are generally excessively dry when they
are not sweating profusely. During cold weather, vessels in the palm constrict
and hands become cold.
手汗症依嚴重程度分為三級
(一)輕度
手掌潮濕。
對生活沒有太大的困擾。
(二)中度
手掌出汗時濕透一隻手帕。
隨時留意手汗情況。
日常生活造成困擾。
(三)重度
手掌出汗時呈滴珠狀。
因工作經常轉換、生活不便、心理(避免社交或較無自信)，對人生造成極大的衝擊。
手掌潮濕。
對生活沒有太大的困擾。
(二)中度
手掌出汗時濕透一隻手帕。
隨時留意手汗情況。
日常生活造成困擾。
(三)重度
手掌出汗時呈滴珠狀。
因工作經常轉換、生活不便、心理(避免社交或較無自信)，對人生造成極大的衝擊。
Palmar
hyperhidrosis is characterized into three levels of severity
1.
Mild
a.
Palms are damp
b.
Minimal interference with daily living
c.
Patients are aware of their increase in sweating and sought
medical treatment but did not have to take any social precautions and had no
lifestyle impact
2.
Moderate
a.
Palmar sweat can soak through a handkerchief
b.
Moderate interference with daily living
c.
Patients who had to take social precautions, such as providing
an extra shirt in axillary hyperhidrosis or having to constantly hold a small
hand towel in palmar hyperhidrosis, but with no lifestyle impact
3.
Severe
a.
Sweat drips from palms
b.
Severe interference with personal and professional life.
c.
Patients who not only took social precautions but had a major
impact on lifestyle, such as avoiding social functions, change of job and
emotional strain
手汗症的發生率
根據台灣調查，手汗症發生率為0.5%(即200人當中有一位有手汗症)，家族遺傳者占72%(隱性遺傳)。在1000名手汗患者家族史之統計，直系血親家庭有2人以上發生手汗症54%，只有1位占46%，尤其當父母都有手汗症時，則所有下一代都會有手汗症，只是程度上的差異
根據台灣調查，手汗症發生率為0.5%(即200人當中有一位有手汗症)，家族遺傳者占72%(隱性遺傳)。在1000名手汗患者家族史之統計，直系血親家庭有2人以上發生手汗症54%，只有1位占46%，尤其當父母都有手汗症時，則所有下一代都會有手汗症，只是程度上的差異
How
common is palmar hyperhidrosis?
In
Taiwan, prevalence of palmar hyperhidrosis in the general population is 0.5% (1
in 200 people). Study suggests that palmar hyperhidrosis may have a genetic
component. Seventy-two percent of the patients diagnosed with palmar
hyperhidrosis have a family history of hyperhidrosis.
From
a survey of 1000 patients with palmar hyperhidrosis:
·
When one first-degree relative has palmar hyperhidrosis, a
person has 46% chance of having the condition
·
When two first-degree relatives have palmar hyperhidrosis, a
person has 54% chance of having the condition
·
When both parents have palmar hyperhidrosis, a person has close
to 100% chance of having the condition
手汗治療方法
What treatments are available for palmar hyperhidrosis?
1. 局部擦劑(antiperspirants)：利用鋁鹽阻塞汗腺出口，如Drysol, Xerac或aluminium chlorhydrate)只對極輕微手汗能夠達到止汗目的。
Topical
Antiperspirants such as aluminum chloride (Drysol, Xerac). Treatment may be
effective for mild sweating.
2. 口服藥：如Valium(減少緊張和壓力)或Colnidine(減少交感神經緊張度，有口乾的副作用)只對輕微手汗有效。
Oral
medications such as Diazepam (Valium) to reduce stress and anxiety, or
Clonidine to reduce sympathetic nervous system outflow. Treatment may be effective for
mild sweating.
3.電泳法(Iontophoresis)或汗力克作用為暫時性阻塞汗腺，針對指尖或手掌表面效果不佳，當手掌部位有傷口時不建議使用。因效果短暫，長期使用相當耗時。
Iontophoresis
temporarily block sweat glands. Treatment is generally 20 to 30 minutes per
day, 3 times per week. Benefit is noted within 2 to 4 weeks after treatment.
Reduction in sweating is maintained by ongoing treatment. Potential side
effects include dry, cracked hands, skin redness and discomfort.
4. 肉毒桿菌皮下注射：兩側手掌注射約100針(明顯疼痛感)，維持約6個月，平均一年需打二次，長期費用累積可觀。
Botulinum
toxin injection under the skin spaced 1 to 1.5 cm apart. TBenefit is noted
within 7 to 10 days after the treatment and can persists for 6 months.
Reduction in sweating is maintained by repeated injection. he pain during injection
into palms and soles can be significant. Temporary muscle weakness is a common
complication. Treatment can be costly because 50 to 100 units of
onabotulinumtoxinA are required per hand per treatment.
5. 內視鏡交感神經切除術(ETS)，需年滿20歲，並承擔全身麻醉的風險及約28.7%患者術後產生嚴重代償性出汗，在身體其他部位如前胸、後背、腹部、大腿或小腿等其他身體部位，因醫療風險大，目前國內較少患者願意嘗試，醫師也不建議實施。
Endoscopic
thoracic sympathectomy (ETS) involves surgical interruption of the thoracic
sympathetic nerve chain. Surgery is performed under general anesthesia. A
concerning adverse effect of ETS is development of compensatory sweating in
28.7% of the patient. Compensatory sweating is when excessive sweating occurs
in other parts of the body such as chest, abdomen, back, thigh, and calf. Other potential complication of ETS include
Horner's syndrome, paresthesia (abnormal sensation such as tinkling or
burning), pneumothorax (air in chest cavity leading to lung collapse),
hemothorax (blood or fluid in chest cavity), hyperthermia, and bradycardia
(slow heartbeat).
6.無創微波: 美國Miradry原廠僅授權於腋下除汗使用，曾有患者術後起嚴重水泡及影響手部感知功能，恢復期長達數月。
MiraDry destroys axillary
apocrine glands. This procedure is not appropriate to treat excessive palmar
sweating.
上述療法皆有患者曾經嘗試過後，因無效或效果短暫，而至本診所接受治療。
75% patients
have tried several treatments before coming to see Dr. Chuang.
立體定位燒灼法：
Percutaneous
Stereotaxic Thermocoagulation (PST) for Palmar Hyperhidrosis (excessive sweating of the hands)
不會有嚴重代償性出汗之副作用
針對胸交感神經位置燒灼T3或T4，降低代償性出汗，與過去切除T2可能造成嚴重代償性出汗不同，根據診所統計數字，患者在完成療程後，沒有產生嚴重代償性流汗問題。代償性出汗分級:包括不顯著、輕度、中等及嚴重 。
No risk of developing severe type of compensatory sweating
Compared
to endoscopic thoracic sympathectomy (ETS), Percutaneous Stereotaxic
Thermocoagulation has much lower rate of developing compensatory sweating.
ETS is at
T2 and T3 ganglia levels, which has higher rates of developing compensatory
sweating due to T2 interruption. Percutaneous
Stereotaxic Thermocoagulation involves T3 or T4 ganglion level, which
has low rates of developing compensatory sweating.
永久性、安全性、高成功率 -三大特色PST 根治手汗
Long term effectiveness, Safety, and High
cure rate -
Three benefits of Percutaneous
Stereotaxic Thermocoagulation:
不留疤痕
根治手汗而不留下任何疤痕，療程僅背後兩個小針點兩周後即消失，患者無須再擔心傷口不美觀。
根治手汗而不留下任何疤痕，療程僅背後兩個小針點兩周後即消失，患者無須再擔心傷口不美觀。
No residual scar
Just two needle puncture points on
upper back after treatment there is no residual scar after two weeks.
療程快速&恢復期短
目前最新引進的立體定位燒灼法療程快速，治療過程約１小時。患者術後稍事休息即可回家，不必回診，術後不影響日常生活與工作，不必忍耐漫長的恢復期。
Short procedure time and speedy recovery
The
entire procedure takes approximately 1 hour. Patients return home on the same
day with minimal restrictions on daily activity.
費用划算
以往對於手汗症，非侵入性的治療並無法根治手汗症。部分患者採用肉毒治療，然而因為針劑注射的效期只有半年，每半年需補打一次，除了需要再次忍痛，長期下來，費用會比其他非侵入式治療節省。
Cost effective and
time efficient treatment
This is a one-time procedure that
does not require maintenance treatment or additional treatment cost.
治療效果好
根據過去100位患者(平均追蹤5.8個月)經過立體定位燒灼法治療T3後，88％患者保持乾爽效果，10％與一般人手部的濕潤程度相同，減少術前汗量約70%), 2%減少術前汗量約50%。
根據過去100位患者(平均追蹤5.8個月)經過立體定位燒灼法治療T3後，88％患者保持乾爽效果，10％與一般人手部的濕潤程度相同，減少術前汗量約70%), 2%減少術前汗量約50%。
High cure rate
One hundred patients were
followed up for an average of 6 months: 88% of the patient reported dry palms,
10% of the patient reported normal palm sweat equal to a normal person and show
the hand sweating to decrease 70%, and 2% patients show the hand sweating to
decrease 50%.
可能治療合併多汗部位
67％患者因治療手汗也順利治好腳汗，91％患者因治療手汗腋汗也減少，81％患者因治療手汗臉汗也改善，不需要額外花錢治療，一次花費兩種享受。
67％患者因治療手汗也順利治好腳汗，91％患者因治療手汗腋汗也減少，81％患者因治療手汗臉汗也改善，不需要額外花錢治療，一次花費兩種享受。
The procedure has the potential to
treat excessive sweating in other body parts
After the procedure, 67% of the
patient had improvement in excessive sole sweating, 91% of the patient had
improvement in axillary sweating, and 81% of the patient had improvement in
facial sweating.
經驗豐富
莊醫師為神經外科專科醫師，在多汗症治療經驗已經有三十年，以專業神經外科方式進行治療手汗才能夠根治多汗症狀，也一定要選擇經驗豐富的醫師，使治療效果與風險降低，莊醫師的立體定位療法至今已進行過2000多位案例，成功率達99％，提醒大家在接受手汗症治療前多多了解與比較，選擇專業的醫師，才能讓您不會再為多汗所苦喔！
Extensive clinical expertise and experience
Dr. Chuang is a neurosurgeon who has been treating excessive palmar
sweating for over 30 years. He has treated over 2000 patients with a success
rate of 99%.
兩大永久保證－保證有效才收費&復發免費再治療
Patients pay after they have a
successful treatment. In the event of recurrence, Dr. Chuang will repeat the
procedure free of charge.
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Appointment
hours:
Wednesdays to Saturday at 9:00 am,
please make an appointment by app or by e-mail.
Toll Free call (Taiwan):
0800-866-833
Whatapp: +886 978 092 078
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Line: @erv5218e
Email: tfstereo@gmail.com
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Time Zone
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Address: No.
385-2, Jiuru 1st Rd, Sanmin District Kaohsiung City, Taiwan
