以不同的分析方法探討正常人與脂肪肝患者手部反應點電位之差異性

Evaluation of the palm electrical potential in normal subjects and patients with fatty liver

林淑月(Shu-Yueh Lin)

指導教授 ： 翁清松

中原大學/工學院/醫學工程研究所/碩士(2006年)

https://doi.org/10.6840/cycu200600710

摘要

目前罹患脂肪肝的人數已佔全國人數的1/4，此比率相當之高。在現今醫院最常使用超音波作為診斷之儀器，不過此診斷較為昂貴也較為費時。在中醫方面，使用良導絡、ARDK以及手部穴位檢測儀用來檢測各種疾病已經許多年了。但由於良導絡與ARDK需要有專業的知識以及操作較複雜，反觀手部穴位檢測儀則不需要專業的知識且操作簡便。
本研究的目的在使用手部穴位檢測儀，以不同的分析方法探討正常人與脂肪肝患者手部反應點電位之差異性。實驗開始前先對儀器本身之再現性以及穩定性作探討。再針對50位一般未罹患任何肝病的大學部學生進行手部病徵反應點之電位量測，所得之數據將其作為正常人之資料庫，再將50位患有脂肪肝病患之數值帶入資料庫內。運用不同之統計方法加以整理、分析，試圖找出最佳之運算法則以提高其量測準確率。最後再探討其接納度、敏感度及特異度。
研究結果顯示，儀器本身有相當高之再現性以及穩定性，當由不同人之量測及不同的握姿均對所量測之數值無明顯之差異性。但是若將給予不同壓力、手心濕度改變及不同時刻量測均會對數值有明顯之差異性，重壓與手掌心潮溼均會造成所量得之電壓值降低，但均可由參考點校正後減少其誤差值，在不同時刻量測其變化無整體的規律性，但可以得知時辰會影響其量測值。因此在量測的同時必須避免掉這些會影響之因素，這樣所得之數值才會更加的準確。在準確率方面準確率，本實驗利用了回歸分析、誤差百分比、回歸分析結合誤差百分比，以及運用了常態分布和信賴區間所得之準確率各不盡相同，最低為49%，最高為67%，對於各種不同的特徵反應點也有不同的準確率，因此不同的特徵反應點在判斷疾病時應採用不同的判斷準則。在針對影響因子(BMI，脂肪肝程度...等)作評估中發現到，BMI越高則其量測數值越低，相同的情形也發生在脂肪肝程度此影響因子上，脂肪肝指數越高其量測數值也越低。經由重複量測結果發現，利用各自之最佳判斷法則其準確率相當之高，約有70~80%以上。在四周內總共量測了ㄧ般大眾2129人其接納度高達87%，其敏感度為72%和特異性為96%。由此量測系統之九成接納度觀之，該量測系統可被廣泛應用於居家保健，進而提供保健新資訊，開創預防醫學新紀元。

關鍵字

統計學 ； 良導絡 ； 手部電位 ； 脂肪肝

並列摘要

In Taiwan, there are one fourth of the people suffering from the fatty liver. Hospital usually uses ultrasonic device to do the diagnosis, but it costs more money and more time for patients. In Chinese medicine, using the Ryodoraku、ARDK and the Hand-Acupoint Device to diagnose the various kinds of diseases last for a long time. However it needs professional knowledge to use Ryodoraku and ARDK, and it is more complex to operate. The Hand-Acupoint Device doesn’t need professional knowledge and it is easy to operate.
The purpose of this study is to use the Hand-Acupoint Device for the evaluation of the palm electrical potential in normal subjects and patients with fatty liver. First step in the study, we investigated the reproducibility and the stability of the instrument. And then the fifty healthy participants without any liver disease were measured on their hand acupoints by the Hand-Acupoint Device to study the relationship between liver condition and hand acupoints. These data were collected and processed to become the “Healthy Database”. Patients with fatty liver from the Tao Yuan General Hospital followed the same procedure to become the “Fatty Liver Patient Database”.
The results of experiment revealed that the instrument has quite high reproducibility and stability. The measured voltages of different subjects or the same subject with different Hand-Acupoint Device holding gestures were not obviously different. However the different Hand-Acupoint Device holding pressure, hand humidity and measuring time caused the results change. The measurement was reduced when holding the Hand-Acupoint Device heavy or the palm of the hand are humid, but the voltage difference could be adjusted by the voltage value of the reference point. The changes of the measurement results were irregular during different timeframe, but we found the measuring time influence the measurement result. Therefore, in order to increase the accuracy, we must be careful to avoid the influence factors.
At the accuracy study, methods of regression analysis, error percentage, combination of regression analysis and error percentage, and distribution analysis were used. The lowest accuracy was 49 percent and the highest was 67 percent. For different acu-points, the different analysis methods should be used to get better accuracy. According to evaluation of influence factors (BMI, Fatty liver index …etc), the higher the BMI was the lower the measurement result was. The fatty liver index had the similar result, the higher the fatty liver index was the lower the measurement result was. According to the repetitive measurement, the
accuracy was quite high and to be about 70~80 percent.The study totally accumulated 2129 measurements for investigation within four weeks. Acceptability of the Hand-Acupoint Device was as high as 87 percent, the sensitivity was 72 percent and the specificity was 96 percent. Therefore this bioinstrumentation (Hand-Acupoint Device) could be utilized in Home-care to provide new healthy information and create new prevention medical applications.

並列關鍵字

Satatistics ； Fatty Liver ； Ryodoraku ； Palm Electrical Potential

參考文獻

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