背景與目的：熱敷包的熱傳導效果受到熱敷箱溫度設定與毛巾包裹層數的影響。然而，目前臨床對這兩種治療參數的設定尚無定論。本研究目的在探討熱敷箱溫度設定與毛巾包裹層數對於熱敷包在體表升溫表現上的影響。方法：20位健康年輕人（男性5位、女性15位，平均年齡24.1±2.8歲）參與本研究。所有受試者的右手臂伸腕肌群肌腹處，皆須接受四種不同的熱敷試驗，熱敷包在66℃或72℃的熱敷箱中隔夜加熱，使用前包裹4或8層乾毛巾（72℃／8層毛巾、72℃／4層毛巾、66℃／4毛巾層與66℃／8層毛巾）。以藍芽無線生理回饋儀記錄熱敷前3分鐘、熱敷20分鐘與熱敷後30分鐘的體表溫度變化。每次實驗至少間隔24小時。結果：所有的熱敷設定皆可使得體表溫度達到的40℃至45℃的治療範圍。相較於72℃／8層毛巾，66℃／4層毛巾產生的體表最高溫度顯著增加0.8℃（95％信賴區間為0.4℃至1.2℃，p＝0.001），體表達最高溫度所需時間顯著減少2.7分鐘（95％信賴鹿間為-4.2分鐘至-1.2分鐘，p＝0.001），以及治療溫度持續時間顯著增加1.9分鐘（95％信賴直間為1.4分鐘至2.4分鐘，p<0.001)。不管熱敷的設定，熱敷後第5分鐘與第30分鐘的體表殘餘溫度皆顯著高於熱敷前的體表溫度（平均差為0.7℃至1.4℃，p<0.001)）。結論：66℃／4層毛巾的設定對於體表升溫表現上的效益明顯大於72℃／8層毛巾的設定。

Background and Purpose: Thermal conductivity of hot pack can be affected by temperature settings of hot water tanks and wrapped layers of towel. In c1inic, however, these parameters have not well been established. In this study, the effect of temperature setting and wrapped layers of towel on the performance of skin temperature rise was investigated. Methods: Twenty healthy young adults (5 men and 15 women, mean age 24.1±2.8 years) participated in this study .Each subject performed four heating trials, i.e., 72℃/8 layers, 72℃/4 layers, 66℃/8 layers and 66℃/4 layers, which were composed of heating hot packs to 66℃or 72℃ by storing in hot water tanks for overnight and then wrapping those by 4 or 8 layers of dry towel before use. Hot pack was applied randomly to the skin surface overlying the right wrist extensor muscle bellies. Bluetooth wireless physiological biofeedback was used to record the changes of skin temperature during three-minute preheating, 20-minute heating, and 30-minute post-heating. At least one rest day between trials was required. Results: All the heating trials can raise the skin temperatures to the therapeutic range of 40-45℃. Compared with 72℃/8 layers, application of 66℃/4 layers can significantly increase the maximum skin temperature by 0.8℃(95% CI,0.4℃to 1.2℃, p=0.001) , reduce the time to reach maximum skin temperature by 2.7 minutes (95% CI, -4.2 minutes to -1.2 minutes, p=0.001), and increase the duration of skin temperature within the therapeutic range by 1.9 minutes (95% CI , 1.4 minutes to 2.4 minutes, p<0.001)。 Regardless of the heating trials , the skin temperature were significantly higher at 5- and 30-minute post-heating than at preheating stage (mean difference: 0.7-1.4℃, p<0.001). Conclusion: Application of 66℃/4 layers can produce a more significant effect on the performance of skin temperature rise, as compared with that of 72℃/8 layers.