可攜式脈波量測及分析系統

Portable arterial pulse measurement and analysis system

陳秉淮(Ping-Huai Chen)

指導教授 ： 林康平 ； 鍾炳濤

中原大學/工學院/電機工程研究所/碩士(2008年)

https://doi.org/10.6840/cycu200900405

摘要

中醫的脈診是累積數千年的臨床經驗，醫者經由手指施予不同程度的壓力，並由自身的觸覺來感受血管的反應，依據脈象的變化，來判斷病理上的狀況，所形成之中醫學獨特的診斷方法之一。
因此，本研究已完成自製壓脈袋(Cuff)、感測器固定支架及脈波量測系統之設計，利用小型壓脈帶結構的便利性及以不同施壓模式下擷取連續的脈搏訊號，進而收集施壓後血管（橈骨動脈）反應。藉此比擬中醫師在把脈時所使用浮舉、中尋及沉取之抽象壓力，並配合不同固定機構的設計可應用於各種部位上的壓力量測。
在實測方面，量測系統經脈搏模擬器試驗的結果發現在收縮壓誤差約在4.57mmHg±1.24，而舒張壓誤差約在4.16mmHg±1.69，之後以水銀式血壓計為標準，分別對系統及市售電子血壓計進行人體試驗，發現系統收縮壓及舒張壓平均誤差約4.85±3.98mmHg，與市售電子血壓計的誤差相比都來的小，因此，量測系統的血壓量測誤差及穩定度的方面，是符合一般電子血壓計的標準。
在脈波分析部分，本研究提出共振波輪廓及脈波特徵點之分析方法，並在臨床的試驗上，針對中醫師把脈後與系統量測之結果，對於常見之滑、澀、弦、弱等脈象進行初步驗證與對照，具備定量分析脈診之研究目的，以提供中醫脈診輔助診斷工具及心血管生理監測之應用。
最後將本研究設計之成果，用來量化中醫師於臨床診脈時之指下資訊並根據分析脈波訊號之技巧，未來可作為中醫科學化之輔助工具。

關鍵字

中醫 ； 脈波 ； 共振法 ； 量測系統

並列摘要

Pulse Diagnosis in the Chinese medicine has been developed and applied clinically for thousands of years. Doctors apply varying pressures with their fingers and sense responses of blood vessels through their touches. They give pathological diagnoses by the pulse signals. Pulse-taking is thus one of the unique diagnostic methods exclusive to the Chinese medicine.
Accordingly, this research project has developed the system design of a custom inflatable cuff, the supporting fixtures of sensors and the pulse measurement system.
This system acquires continuous pulse signals under different pressures with the help of small and portable inflatable cuffs and further collects responses of the blood vessel (the radial artery) under pressure. By this design, the system can emulate the pressures involved in techniques of light touching(浮舉), moderate feeling(中尋) and heavy pressing(沉取) that a Chinese medical doctor uses upon taking pulses. Moreover, combined with various designs of supporting fixtures, this system can measure pressures on a variety of positions.
Experimentally, this measurement system can achieve error margins of 4.57mmHg ±1.24 for systolic pressures and 4.16mmHg ±1.69 for diastolic pressures in tests on a pulse simulator. In subsequent tests on human bodies, the system gives average error margins of approximately 4.85 ±3.98mmHg for both systolic and diastolic pressures, which are smaller than what commercial electronic sphygmomanometers give.
Accordingly, the measurement errors and reliability of this measurement system are comparable to those of common electronic sphygmomanometers. In this research, the techniques of oscillation contour analysis and eigen-point analysis of pulse waves are proposed for pulse wave analysis. In clinical tests, the results produced by the measurement system are audited and compared with doctors diagnoses. In this way, the common pulse signals, such as “Hua (滑)”, “Se(澀)”,“Xian(弦)”, and “Ruo(弱)”, can be examined and diagnosis of pulse taking can be analyzed quantitatively. This system can be used for applications of diagnostic aids to pulse taking of the Chinese medicine and monitoring the cardiovascular physiological signals.
Finally, the system developed in this research can quantify the information a Chinese medical doctor uses upon clinical pulse taking and can serve, with the help of innovative techniques of pulse signal analysis, as an aid to scientific study of the Chinese medicine.

並列關鍵字

Chinese medicine ； Pulse ； oscillation ； measurement system

參考文獻

[9] 許智傑、翁清松,”新型中醫脈診系統之研發與應用”,中原大學醫學工程博士論文,2006

[11] 張峰碩,”建構非侵入式連續血壓量測系統以評估血管系統之數學模型”,中原大學醫學工程研究所碩士論文,2005.

[24] 范振臺,”可攜式低壓腕部脈搏訊號之量測”,中原大學電機工程研究所碩士論文,2001.

[25] 郭建志,”以恆壓低壓量測連續脈壓訊號＂,中原大學電機工程研究所碩士論文,2002.

[26] 林汶正,＂以可程式微控制系統晶片為基礎之生理訊號監測系統＂中原大學電機工程研究所碩士論文,2003.