應用於疼痛評估與量測之自律神經分析系統研發

Development of Autonomic Nervous System Analyzer for Pain Assessment and Measurement

鄭英輝(Ying-Hui Zheng)

指導教授 ： 鍾文耀

中原大學/工學院/電子工程研究所/碩士(2005年)

https://doi.org/10.6840/cycu200500661

摘要

癌症末期的病患中，大約有高達百分之八十的人飽受疼痛之煎熬。而疼痛緩解的用藥原則是參照世界衛生組織（WHO）所建議的疼痛緩解三階梯式治療法,即依照不同疼痛程度給予不同劑量與強度的止痛藥劑。因此，疼痛等級的判定即成為用藥的關鍵依據。臨床上，一般都透過病患主述，或依疼痛量表的專用格式與數字作為疼痛評估。本研究嘗試找出客觀的疼痛生理訊號作為疼痛強度的指標，藉以有效輔助現行疼痛評估方法。
本研究以壓痛計給予疼痛刺激，再擷取刺激過程中的心電訊號，並以自行設計的HRV(heart rate variability)分析程式來分析疼痛所造成的心率變異。由實驗結果可以發現，當疼痛刺激時，HRV參數將會產生變化，而且疼痛程度改變時，HRV參數亦會隨之改變。因此，以心率變異度作為疼痛程度指標是有其可行性。此外，以適當規劃之基礎實驗來說明疼痛生理訊號的存在。之後，再進一步以自行設計的系統從事臨床實驗，藉以驗證本系統作為疼痛強度評估之可行性。
除了自主神經分析系統部份，本研究將提出一種新的低電流低電壓OTA(operational trans-conductance amplifier)架構，且利用此架構設計出兩種不同功能之OTA應用於儀表放大器以及低通濾波器上，再將設計完成的兩個電路結合成一個心電訊號擷取系統，且此系統的偏壓為0.9V，整體消耗功率為106uW，使用之製程為TSMC 0.35um CMOS技術，其操作頻寬為0.05Hz~45Hz。

關鍵字

心率變異度 ； 心電圖機 ； 自主神經 ； 低功率 ； 疼痛

並列摘要

There are high to 80％ patients suffer from pain in the late cancer experienced. The rule of drug in pain relief refers to the three-stage therapy suggested by WHO is to give the analgesic in different dose and strength according to different level of pain. Therefore, the determination of pain grade becomes the key of medication. Clinically, pain assessment is generally got through the narration of patients or exclusive tables and numbers in pain inventory.
The algometer is utilized to give pain stimulations in this study, and captured the ECG signals during the stimulus process. Furthermore, the heart rate variability caused by pain was analyzed by HRV designed ourselves. Experiment results show HRV parameters could change when pain stimulation and HRV parameters change when algometer′s force varies. Therefore, it is feasible to take heart rate variability as the pain index.
Besides autonomic nerve analysis system presents in this paper is a new low-circuit low-voltage operational trans-conductance amplifier (OTA). Two different intellectual properties (IPs) were designed utilizing by OTA for instrumentation amplifier and low pass filter application. In addition, an ECG measurement system has been built based on the proposed circuitry which bias voltage is 0.9V, and power consumption is only 106uW. The system is fabricated in a 0.35um 2P4M CMOS technology, and the signal processing bandwidth is 0.05Hz~45Hz.

並列關鍵字

ECG readout circuit ； Heart rate variability ； Autonomic nerve ； Low power ； Pain

參考文獻

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