本研究目的最主要為研發一個新型中醫脈診擷取系統,其中包含心電圖機(ECG),西醫腕式脈壓帶擷取脈波的設計,另外並整合接觸型壓力感測器單點施壓裝置。有別於以往的舊式脈診儀,其往往無法將脈波參數完整擷取與分析,在新型的脈診儀製作上,除了結合單點式、脈壓帶式等兩種不同脈診擷取系統外,並在施壓前端裝置新式接觸型的高靈敏度感壓元件(Kyowa PSM-1KAB),使得接觸式脈波可以高靈敏的擷取到血壓波的訊號。 而在分析波形的參數上,也創新的採用多參數分析,包含波形振幅的表現量方面,以S, A, P, E, B, T, C, D, F等波形轉折點之座標值量化加以表現,而特徵角度上並會自動運算出波形中的P角(∠APE),U角,以及波形總面積(sum)供作分析。本研究在新型脈診擷取系統研製完成後並進行醫院臨床的應用並對新型脈診儀進行波形與特徵參數的評估,並與傳統的脈診儀進行比較波形解析度與參數的討論,臨床實驗設計以TENS療法分別刺激正常人與高血壓病患耳背部降壓溝穴位,並比較前後脈象圖的差異性。 結果顯示Lab View擷取與分析系統可有效同時擷取與分析主要脈波、ECG等生理參數,並發現脈壓帶式的穩定度較高,單點接觸型的解析度較高等個別優點。另外在臨床研究結果可以發現,10分鐘電刺激耳穴降壓溝會對病患及正常人產生血壓下降的影響,參數分析亦可發現當血壓降低時,P波角度會減少,波形總面積(sum)減少,以及脈波波形各轉折點A, P, E, T, D, F等座標參數皆產生相對應上升量的改變。 而在比較高血壓病患與正常人的波形差異上,可得到數個特徵參數以區別高血壓病患與正常人的波形差異,其中包含高血壓病患具有較大的P角(∠APE)與U角(p<0.05),且波形總面積值亦比較大(p<0.05)等現象,另外討論中並加入以Gamma Density Function 來探討高血壓患者主要血壓波數學函數模型的建立,並與相對應各種波形函數以相關度進行比較,發現高血壓患者的血壓脈波較趨近於弦、大、滑、濡等四大脈象(R2>0.5)等結果。
This study was the development of a cardiovascular analytical system in Chinese and western medicine and its application in evaluation of Acupuncture-Like Transcutaneous Electrical Nerve Stimulation (AL-TENS) in the treatment of hypertension. The system was designed to measure the blood pressure pulse of three points on the wrist. In Chinese medicine, doctors usually use these blood pressure pulses of these three points to diagnose the disease of patients. After finishing the development of the device, we studied the effect of AL-TENS on the ear acupoints of patients with hypertension. The results showed that the device was easier and clearly to record and analyze the blood pressure pulse and the ear acupoint could lower the systolic pressure. In this new pulse signal measurement system, there were many parameters defined to compare the normal subjects with patients. The results showed that the angle P, angle U, and the summation of the curve area (sum) were statistically different between the normal subjects and patients with hypertension. In the other analysis results showed that the parameters (A, P, E, T, D, and F) of coordinates in pulse had changed (p<0.05) after AL-TENS on ear acupoint. These results showed that AL-TENS could be easier and more effective to lower the blood pressure. The new pulse signal measurement system could be more accurate at the research of the pulse signal in traditional Chinese Medicine.