利用新研發的微細能量放大系統分析局部疼痛部位的表面生理電訊號

Pain Detector Based on Local Dermal Subtle Energy Measurement

邱紹承(Shao-Cheng Chiu)

指導教授 ： 廖重賓

國立虎尾科技大學/電機資訊學院/光電與材料科技研究所/碩士(2011年)

摘要

目前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。一般都透過病患主述，或依照疼痛量表的專用格式與數字做為疼痛評估。然而，這樣的方式亦存在不少使用上的缺點或盲點，例如，偽裝、誇大、個別差異性、意識或生理上處於無法正確敘述情況等（如：手術、插管中、昏迷中），皆有必要在醫療上建立另一個客觀的疼痛參考標準。因此本研究之目的是開始發展準確、客觀且定量的疼痛評估方法與設備，並期提供後續疼痛傳導機制及臨床上診斷疼痛和評估治療成效之應用。
　　首先本研究先客觀根據門控理論假設一疼痛傳導機制的新觀念，並初步係針對三種不同刺激方式造成的疼痛，以及同種刺激但造成不同程度的疼痛，利用新研發的微細能量表面肌電圖儀（subtle energy surface electromyography）擷取體表疼痛部位周邊所產生的微細生電訊號，並利用均方根值（root mean square, RMS）、快速傅立葉轉換（fast Fourier transform, FFT）及希爾伯特頻譜（Hilbert spectrum）進行時域、頻域及時頻域之分析。其實驗結果也初步佐證了本研究所提出的疼痛理論假設之合理性。

關鍵字

疼痛 ； 表面肌電圖 ； 均方根值 ； 快速傅立葉 ； 希爾伯特頻譜

並列摘要

At present, the guiding principle for pain relief medication is largely based on the WHO suggested 3-step treatment, namely, the pain reliever doses are given in accordance with the subjective feelings of pain of the patient. Accordingly, the discrimination of pain degrees becomes the dominant factor in pain relief medication [1]. In general, such discrimination process heavily relies on the subjective statement of each patient, and is only made quantitative through checking proper level on a pain sheet or circling a proper digit by the patient himself (or herself). However, such a widely used approach is often plagued by drawbacks and oversights, such as: pretending, exaggeration, diversified individual, conditions [2], situations wherein a patient is either mentally or physically unable to provide correct descriptions, etc.
The current research aims to provide an objective approach instead to serve as another reference to the world’s medication practice. To this end, it first proposed a new scheme wherein dermal measurements are to be performed at wherever the pains a patient feels, regardless of how the nerves are physically deployed and signals transmitted beneath the human skin. Then, based on such hypothesis, dermal measurements were taken on 3 kinds of pain stimulations of varying magnitudes on the author’s body, using the self-developed subtle energy surface electromyography. It was evidenced that different kinds of pain could be differentiated through the pain signatures manifested in the temporal behavior (including latency), fast Fourier transform (FFT), and the Hilbert-Huang transformations (HHT) .

並列關鍵字

Pain, ； Subtle energy ； Dermal measurement, ； Fast Fourier transform ； Hilbert spectrum

參考文獻

[1] Maureen L.”Pain as the Fifth Vital Sign.” Journal of Intravenous Nursing, 24(2), 85-94. (2001)

[2] 呂美嬅，”放鬆反應於善癌症末期病患之疼痛程度、情緒狀態及生理反應之成效”，台北醫學大學護理學研究所碩士論文。(2002)

[4] Bonica JJ., “The need of a taxonomy”, The Journal of Pain, 6(3), 247-252. (1979)

[6] Susan S. Lang., Richard B. Patt., You Don’t Have to Suffer. (1995)

[8] Dimitrios kostopoulos, PT, PhD, DSc Arthur J. Nelson, Jr., PT, PhD Reuben S. Ingber, MD, Ralph W. Larkin, PhD,“ Reduction of Spontaneous Electrical Activity and Pain Perception of Trigger Points in the Upper Trapezius Muscle through Trigger Point Compression and Passive Stretching“ Journal of Musculoskeletal Pain. 16(4), 266-278. (2008)