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研究生: 鄭友為
Cheng, Yu-Wei
論文名稱: 中醫脈診之三部九候的浮中沉研究:雙感測脈診與超音波影像的相關性
The Fu-Zhong-Chen Study of Three-Positions-Nine-Indicators Pulse Diagnosis in Traditional Chinese Medicine:Correlation of Bi-Sensing Pulse Diagnosis with Ultrasonic Image
指導教授: 羅錦興
Luo, Jin-Sing
學位類別: 碩士
Master
系所名稱: 電機資訊學院 - 電機工程學系
Department of Electrical Engineering
論文出版年: 2013
畢業學年度: 101
語文別: 中文
論文頁數: 69
中文關鍵詞: 中醫脈診三部九候浮中沉標準雙感測脈診儀
外文關鍵詞: Traditional Chinese Medicine (TCM), Pulse diagnosis, Standards of Fu-Zhong-Chen, Bi-Sensing Pulse Diagnosis Instrument (BSPDI)
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  •   三部九候為脈診核心的方法,中醫師把脈時佈指於寸關尺,而施壓浮中沉,以此得不同部位不同深度之脈象。脈象在不同部位與不同深度代表著不同生理訊息。近年來脈診量化研究中多集中探討脈象分類的方法,卻鮮少研究取脈行程之浮中沉量化準則,因而造成眾多研究在重現度沒有一致性。因此,本研究試著提出脈診之浮中沉量化準則,期許建立脈診的標準取脈流程,使得脈診量化研究能建構在同一操作準則上,以提高脈診的臨床應用性。
      一般在確認脈管被按壓的變化必須借助超音波儀器成像,但此舉複雜化了脈診儀的研發。因此,本研究提出以團隊研發之雙感測脈診儀(Bi-Sensing Pulse Diagnosis Instrument, BSPDI)取得之脈波參數來取代超音波,以簡化取脈過程。實驗方法分別以BSPDI和超音波將脈管壓扁,記錄其按壓深度資料。並在超音波的部分紀錄撓動脈脈管按壓過程直徑的變化,擷取BSPDI完整脈波訊號與脈波參數,作為浮中沉脈位建立的依據。
      根據中醫師實際取脈之深度,定義浮中沉對應脈管的變化分別為撓動脈脈管按壓15%、45%、75%。實驗結果由超音波得到的脈管按壓百分比與雙感測脈診儀的按壓深度之間的關係,對應浮中沉深度的靜態壓力值,經過一調整機制後可將誤差範圍由29.1%降至16.9%,有效的提高判斷浮中沉各深度的靜壓力值。依據脈管按壓百分比和按壓深度與調整機制來定義浮中沉脈位的準則。
      本研究利用醫師實際取脈,脈管被按壓程度之等分法來定義浮中沉之脈位,並提出超音波之相關數據做為驗證,有別於多數研究採用壓力做為脈位定義的做法,提供一更加快速與符合生理學的定義方式。本研究最重要的貢獻在以雙感測脈診儀之操作基礎,提出一套定義浮中沉脈位的方法,作為脈診儀把脈的初始標準,以期日後和中醫師臨床經驗進行比對和修正。站在中醫脈診量化的角度,在提出三部九候的脈位深度定義之後,脈像辨識才能有系統與精準的定義,以建立有用的臨床資料庫,如此在中醫脈診量化的研究才能持續的進行,在中醫的傳承與臨床的應用發揮其價值。

     Three Positions Nine Indicators is the main method of pulse diagnosis, physicians do pulse-taking with their fingers on Cum Guan Chi, and press on Fu Zhong Chen, in this way to get pulse of each part and depth. Pulse of each part and depth means different physical signification. Recently, pulse-taking quantify researches are discuss about different type of pulse, but few to discuss about quantitative standards of pulse-taking depth on Fu-Zhong-Chen, that is the reason of there’s no consistency for the research. Therefore, this thesis trying to propose of quantitative standards of pulse-taking, hope we can establish the standard of pulse, to make pulse-taking quantify researches can based on the same principle, in this way to enhance clinical application of pulse-taking.
     Generally, we need ultrasound instrument to get the image of pressed radial artery, but this way complicating the develop of Pulse Diagnosis Instrument. Therefore, this thesis mention that we can use Bi-Sensing Pulse Diagnosis Instrument (BSPDI) instead of ultrasound instrument, to simplified the process of pulse-taking. The experiment is using BSPDI or ultrasound to press artery, and record the press depth data. Also record the diameter variety of radial artery in ultrasound, capture the full pulse signal in BSPDI and analysis pulse parameter for the base on pulse position of Fu-Zhong-Chen.
     According to the practical pulse depth taking from Traditional Chinese doctors, we define the changes of artery corresponding to Fu-Zhong-Chen are 15%, 45% and 75%. We can get experience results by the relationship corresponding to the static pressure value of Fu-Zhong-Chen between pressure percentage of artery and the pressure depth of BSPDI. We can reduce inaccuracy from 29.1% to 16.9% through a monitoring system and effectively rise the accuracy of the static pressure value of each depth of Fu-Zhong-Chen. We can define the position of Fu-Zhong-Chen according to the pressure percentage of artery, the pressure depth, and monitoring system.
     In this research, we equally divide the pulse position depth when pressing on, and defining the pulse position depth into three part, which called Fu-Zhong-Chen. Also, we provide ultrasound experiment data to verify the result which we defined. This research differs from other researches which utilize pressure to be the parameter of definition, the definition in this research is faster and suitable in physiological aspect. The most important contribution of this research is that we establish a standard which defining pulse parameter of Fu-Zhong-Chen based on BSPDI. To quantify the traditional chinese medicine (TCM) pulse diagnosis in the future, we make pulse detection more accuracy after we establish the depth definition of TPNI. By this way, we can establish a practical clinical database and continue the research of quantification of TCM pulse diagnosis and have a great revolution in TCM.

    摘要 i Abstract iii 誌謝 v 目錄 vi 圖目錄 ix 表目錄 xi 第一章 緒論 1 1.1 傳統中醫的介紹 1 1.2 研究動機與目的 2 1.3 論文架構 4 第二章 研究背景與文獻探討 5 2.1 文獻回顧 5 2.1.1 古籍文獻回顧 5 2.1.1.1 診脈手法與部位 6 2.1.1.2 診脈深度 7 2.1.2 近代文獻回顧 11 2.1.2.1 現代脈象分析文獻回顧 11 2.1.2.2 脈診儀研究與發展回顧 12 2.1.2.3 診脈深度相關研究回顧 15 2.2 血管醫學理論 16 2.2.1 撓動脈血管結構 16 2.2.2 脈波圖結構分析 17 第三章 研究架構與實驗設計 20 3.1 雙感測脈診儀 20 3.1.1 機械手指 21 3.1.2 電容式陣列壓力感測器 22 3.1.3 深度檢測系統 24 3.1.4 腕部固定器 24 3.1.5 操作介面 26 3.2 超音波探測儀 27 3.2.1 超音波原理介紹 27 3.2.2 超音波探測儀操作 28 3.3 實驗設計 29 3.3.1 受試者樣本 30 3.3.2 診脈方法 30 3.3.3 浮中沉之定義實驗方法 32 3.3.4 實驗取脈流程 33 3.3.4.1 超音波 34 3.3.4.2 脈診儀 35 3.3.5 脈波參數 37 3.3.6 統計方法 40 第四章 實驗結果 41 4.1 受試者基本資料 41 4.2 超音波脈管資料 42 4.2.1 受試者超音波深度資料 42 4.3 脈診儀脈波參數 44 4.3.1 深度描述性統計資料 44 4.3.2 動態壓力描述性統計資料 45 4.3.3 靜態壓力描述性統計資料 46 4.3.4 彈性係數K值統計資料 47 4.4 脈波參數與脈管按壓之關係 48 4.4.1 撓動脈變化量與彈性係數K值 48 4.4.2 撓動脈變化量與動態壓力 51 4.4.3 撓動脈變化量與按壓深度 54 4.5 浮中沉之深度定義 55 4.5.1 醫師之診脈準則 55 4.5.2 浮中沉深度定義 56 4.5.3 取脈流程 60 4.6 討論 61 4.6.1 深度定義於不同樣本的穩定性 62 4.6.2 脈診儀與輔助儀器 63 第五章 結論及未來展望 64 5.1 結論 64 5.2 未來展望 65 參考文獻 66 附錄 69

    [1] 南京中醫學院(1994),黃帝內經素問譯釋
    [2] 丁錦(1738),古本難經闡註 (p.18)
    [3] 丁錦(1738),古本難經闡註 (p.18)
    [4] 丁錦(1738),古本難經闡註 (pp.18-19)
    [5] 丁錦(1738),古本難經闡註 (p.20)
    [6] http://tw.myblog.yahoo.com/1900-1900/article?mid=2370&prev=2371&next=2367&l=f&fid=28
    [7] http://tw.myblog.yahoo.com/1900-1900/article?mid=157&prev=158&next=156&l=f&fid=28
    [8] http://tw.myblog.yahoo.com/1900-1900/article?mid=156&prev=157&next=147&l=f&fid=28
    [9] J.C. Meng and Z.Y. Zhou(2001), Introduction to Chinese Medicine, Jyin Publishing Company, Taipei
    [10] 李廷是(1664),脈訣匯辨
    [11] L. Y. Wei and T. Winchester, "Electronic Diagnoser of Arterial Pulse," Journal of Medical Engineering & Technology, vol. 9, pp. 183-186, 1985.
    [12] L. Y. Wei and P. Chow, "Frequency-distribution of human pulse spectra," IEEE Transactions on Biomedical Engineering, vol. 32, pp. 245-246, 1985
    [13] Y. Y. L. Wang, T. L. Hsu, M. Y. Jan, and W. K. Wang, "Theory and Applications of the Harmonic Analysis of Arterial Pressure Pulse Waves," Journal of Medical and Biological Engineering, vol. 30, pp. 125-131, 2010.
    [14] 黃進明(2001),中醫脈診圖譜診斷,知音出版社
    [15] C. S. Hu, Y. F. Chung, C. C. Yeh, and C. H. Luo, "Temporal and spatial properties of arterial pulsation measurement using pressure sensor array," Evid Based Complement Alternat Med, vol. 2012, 2012.
    [16] C. H. Luo, Y. F. Chung, C. S. Hu, C. C. Yeh, X. C. Si, D. H. Feng, Y. C. Lee, S. I. Huang, S. M. Yeh, and C. H. Liang, "Possibility of Quantifying TCM Finger-Reading Sensations: I. Bi-Sensing Pulse Diagnosis Instrument," European Journal of Integrative Medicine, vol. 4, pp. e255-e262, 2012.
    [17] Y. F. Chung, C. S. Hu, C. H. Luo, C. C. Yeh, X. C. Si, D. H. Feng, S. M. Yeh, and C. H. Liang, "Possibility of Quantifying TCM Finger-Reading Sensations: II. An Example of Health Standardization," European Journal of Integrative Medicine, vol. 4, pp. e263-e270, 2012.
    [18] 蔡運寧(2006),碩士論文「寸口脈診操作之預壓與位移研究」,中國醫藥大學中國醫學研究所碩士論文
    [19] 汪叔游,「脈波圖及其各同步曲線在時域上與傳統脈學之相互印證」Journal of Chinese Medicine
    [20] 黎恩彰、傅式恩(1989),「脈診機械手指暨脈波分析系統之設計」,中原大學醫學工程研究所碩士論文
    [21] 蔡運寧(2006),碩士論文「寸口脈診操作之預壓與位移研究」,中國醫藥大學中國醫學研究所碩士論文
    [22] H.Marieb and R.Mallatt,Human Anatomy,Benjamin,New York, pp.480-485,1997
    [23] G.Vander, Human Physiology, McGRAW-HILL, United States os America, pp 430-431,1994
    [24] 黃世林、孫明異(1995),中醫脈象研究pp.45-46 ,知音出版社(人民衛生出版社授權)
    [25] 費兆馥(2003),現代中醫脈診學 pp.130-154, pp.162-163, pp.163-166, pp.58-63, pp.196.,北京:人民衛生出版社
    [26] C.S. Hu, Y.F. Chung, C.C. Yeh, and C.H. Luo, “Temporal and spatial properties of arterial pulsation measurement using pressure sensor array,” Evidence-Based Complementary and Alternative Medicine, DOI:10.1155/2012/745127
    [27] 吳裕弘(2008),「應用熱壓嵌入技術製作電容式壓力感測器」,大同大學機械工程研究所碩士論文
    [28] http://tw.myblog.yahoo.com/skindr-wang/article?mid=3135
    [29] 陳世宜、王碩盟、吳明修 “彩色與強力都卜勒超音波:一般原理及在腎臟學的臨床應用” 腎臟與透析2004年 16卷3期
    [30] Yu-Feng Chung, “How to standardize the pulse taking method of traditional Chinese medicine pulse diagnosis”, Computers in Biology and Medicine
    [31] http://tw.myblog.yahoo.com/jw%21dXOO11mWAh1XgGQWUxjvrw--/article?mid=159&prev=160&next=158
    [32] 鍾裕峰(2012),「以雙感測脈診儀為基礎的脈診健康準則和弦脈之研究」,成功大學電機工程所博士論文
    [33] 湯昌煜 “寸、關、尺脈與撓動脈下段的解剖關係”貴陽中學院學報1994年01期16卷,pp.62-63
    [34] Yu-Feng Chung, Chung-Shing Hu, Ching-Hsing Luo, “Possibility of quantifying TCM finger-reading sensations: II. An example of health standardization” European Journal of Integrative Medicine 4 (2012)
    [35] 費兆馥(2003),現代中醫脈診學,北京:人民衛生出版社
    [36] 蔡運寧(1989),「寸口脈的操作與位移研究」,中國醫藥大學中國醫學研究所碩士論文

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