CN104799814A - Qi deficiency, blood deficiency state quantitative measurement method and device - Google Patents
Qi deficiency, blood deficiency state quantitative measurement method and device Download PDFInfo
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Abstract
The invention discloses a qi deficiency, blood deficiency state quantitative measurement method and qi deficiency, blood deficiency state quantitative measurement device for syndrome of traditional Chinese medicine. The NIRS technology is adopted for acquiring PPG and SaO2 information, physiological information directly acquired by finger tip pressure pulse wave TPW, radial artery pressure pulse wave RPW and standard ECG-II is combined for acquiring dynamic value of multiple physiological parameters under different states of the body. Integrated analysis for synchronization information is used for acquiring secondary information. The acquired information is combined with the diseasing experience of traditional Chinese medical doctor and traditional Chinese medicine identification theory for realizing quantitative diagnosis for traditional Chinese medical doctor. Taking qi deficiency and blood deficiency as an example, the application space of the device in quantitative evaluation for syndrome of traditional Chinese medicine, such as virtual, actual, cold, hot diseases is expounded.
Description
Technical field
Patent of the present invention belongs to State medicine; Measures of quantization, TCM syndrome etc.Near infrared reflectance spectroscopy (NIRS) medical measurement field, TCM syndrome qualitative assessment field.
Background technology
The deficiency of vital energy, blood deficiency is the describing method of the macroscopic evaluation that the health status of traditional Chinese medical doctor to people is done.It describes the restriction often with subjectivity and personal experience's property, cannot accurately objectively describe the degree of deficiency of vital energy blood deficiency.Simultaneously due to multiformity and the diversity of individuality, be difficult to the state that whether accurate quantification evaluate patient has the deficiency of vital energy actually, blood deficiency is mingled with.Since ancient times, the disease relevant for the traditional Chinese medical science describes, and has no precedent a describing method that can quantize, and all realizes contrast by metaphor.If stringy pulse person is as pressed string; Tense pulse person should refer to effectively; Color white color like dried bone person is dead, if white cream fat person life etc.By using the environment object that can use to compare, realizing relatively known diagnosis and describing, but the experience accumulation that depends on for many years of this description needs and comprehensive analysis of the data gained by the four methods of diagnosis, and be difficult to realize quantitatively evaluating.Along with the development that traditional Chinese medical science four diagnostic methods information digitalization quantizes, the inevitable accuracy more and more depending on diagnosis of quantification of the side's of sending medication.
The research trend of current tcm diagnosis index is explored and essential analysis in mechanism, does not have to use to carry out quick diagnosis with clinical auxiliary traditional Chinese medical doctor.Near infrared light spectral analysis method NIRS can to blood oxygen saturation SaO
2carry out noinvasive, Quick Measurement, simultaneously, NIRS technology can also by calculating the light transmittance of the body area determined, and the amplitude change of NIRS ripple, real-time content of hemoglobin (Local hemoglobin quantity in reaction blood, LHQ), regional perfusion amount (local cardiac output, LCO) and dynamic oximetry value (SaO
2) etc. information, any information of the data centralization that accurate acquisition is so all has comparatively ripe technology, but not yet occur at present these information being carried out extract and the research integrated, do not occur these information and the traditional Chinese medical science being carried out associating and quantizing the trial of the diagnostic message of the traditional Chinese medical science yet. comprehensivelyTherefore, use NIRS technology, the deliverability of clear and definite acquisition body local blood and corresponding all kinds of parameter, the corresponding informance of the digitized diagnosis quantitatively evaluating deficiency of vital energy, blood deficiency is unprecedented innovation.
The theory of knowledge object of the determination for the treatment of based on pathogenesis obtained through differentiation of symptoms and signs theory that the traditional Chinese medical science is particular about and the harmony between man and nature is just: will recognize interindividual difference to the evaluation of individual state, but owing to lacking the expression quantized, succession experience becomes very difficult, needs the time of people's at substantial generation upon generation of to go to try to figure out and comprehend.Quantitative expression tcm diagnosis information, can provide Data support for the development of traditional medicine.
Summary of the invention
Invention is the deficiency of vital energy, blood deficiency state quantizes measuring method and device, can quantize TCM syndrome and describe and diagnostic message.Device name is deficiency of vital energy blood deficiency quantitative evaluation instrument.Below if no special instructions, described device refers in particular to deficiency of vital energy blood deficiency quantitative evaluation instrument.
1. can quantize the technical foundation of tcm diagnosis information
Our medical science patent proposes a kind of deficiency of vital energy blood deficiency state measurement strategy of innovation, by NIRS technical limit spacing PPG, and SaO
2etc. information, in conjunction with finger tip pressure pulse wave TPW and radial artery pressure pulse wave RPW, the secondary information that the physiologic information directly obtained with standard ecg-II etc. and information integerated obtain, each void of quantitative evaluation, reality, the TCM syndrome such as cold, hot.Namely method and the relevant apparatus of the degree of the information evaluation deficiency of vital energy blood deficiency by applying NIRS technology and the acquisition of information such as pulse pressure, electrocardio is realized.
According to dynamic PPG ripple, SaO
2value, finger tip pressure pulse wave (Tip Pulse Wave, TPW) and radial artery pressure pulse wave (Radial artery PulseWave, RPW), the Wave datas such as standard ecg-II, can derive:
Pulse wave conduction speed (Pulse Wave Velocity, PWV);
Blood oxygen saturation (O
2saturation in Artery, SaO
2);
Regional vascular resistance (Local Circulation Resistance, LCR);
Local hemoglobin content (Local Hemoglobin Quantity, LHQ);
Regional perfusion amount (Local Cardiac Output, LCO);
Regional flow's kinetic energy loss (Local Kinetic Energy Lose, LKEL);
Blood flow of the tip speed (Local Blood Volume, LBV);
User carries out standard and holds one's breath after tolerance test and can obtain following information delta:
Mean blood flow velocity (Average Blood Velocity, ABV);
Per minute blood zmount of oxygen consumption (Consuming Intensity of O
2, CIO
2);
Breath hold (Breath Holding Time, TBH);
Blood oxygen saturation minimum (the minimum value of O
2saturation in Artery, SaO
2min);
Can be obtained as erythropoietin (Erythropoietin, EPO) etc. by additional metrical information, realize extendible acquisition of information analytical data analysis framework.Hereafter with the deficiency of vital energy, blood deficiency be measured as example, be described.
2. quantize target and the method for the deficiency of vital energy
The expression of content of the present invention to Traditional Chinese medical theory provides quantization scheme, by the feature of traditional medicine by being expressed clearly in conjunction with modern technologies, as
following table 1shown in: device described in patent and method can carry out preliminary quantification to the subjective feeling such as uncomfortable in chest, and what realize the science, method, prescription, drugs of differentiation of tcm is accurately auxiliary.
table 1. patent is to the improvement of Traditional Chinese medical theory and application
By the quantification to pattern of syndrome, source is Therapeutic Method, and the quantifications such as prescriptions, precision provide data foundation.
Use the methods such as the detection of non-invasive measurement, microscopic information and real-time monitoring, extract measured's health status information, aided quantification tcm diagnosis, be applicable to each pattern of syndrome of the traditional Chinese medical science, disease describes.In order to discuss conveniently, choose the deficiency of vital energy, blood deficiency is described.The wherein quantificational description method of the deficiency of vital energy
as table 2shown in:
table 2. for the deficiency of vital energy, the method for quantitative expression tcm diagnosis information is described
Carrying out in the process of quantitatively evaluating to syndrome of deficiency of QI, the thought angle of apparatus and method simulation traditional Chinese medical doctor described in patent and scope, cover various possible variable condition comprehensively.For example ordinary people is compared with professional athlete, in living environment, mode, stress level and metabolism rate etc., have larger difference, and between measurement numerical value, also can form larger difference, unified standard can cause
mistakejudge, need to be got involved by subjective information to realize correct identification.Usually under kinestate, body indices is higher than average level, and the energy of consumption is more, is usually in tired edge.By the preliminary surveying to sample, draw the scope of data corresponding to the index of gas can be reflected under different deficiency and excess state.
The data pattern of table 3. deficiency of vital energy-health-QI excess compares
in upper tablenumerical range is measure for part sample the estimated value calculated, during specific implementation, only for reference.
In said method, the acquisition of arbitrary measured value all needs to consider and gets rid of relevant influence factor.With SaO
2for example, affect SaO
2because have ambient oxygen partial pressure, blood pressure, skin color, sex, tested position blood perfusion amount, age and current metabolism rate etc.Get rid of the impact of pathologic factor, wherein need the most important non-pathology effects factor considered to be then ambient oxygen partial pressure and age.While measurement deficiency of vital energy degree, need to obtain age, blood pressure, body temperature and the information such as height, body weight, first estimate its influence factor, will SaO be affected
2non-pathologic factor get rid of further, the SaO higher with the deficiency of vital energy degree of association can be obtained
2value, regarded as the standard quantizing deficiency of vital energy degree.
table 4. the SaO under ambient oxygen partial pressure, age effects
2range of normal value
Wherein, n is default number of degrees, can need setting according to the identification of Chinese physician.SaO
2minfor intervention states, as hypoxia stimulate, blood oxygen saturation minima under the dry preformed maximum tolerance limit degree such as to hold one's breath.
By environmental information corresponding for measured value being included in one by one, measured value will have comparability with repeatable.Realize quantizing state measurement accurately.For the ease of the state evaluation of clinical doctor of Chinese medicine to the degree of the deficiency of vital energy,
table 4by the deficiency of vital energy standard atmosphere pressure 5-50 year crowd in the scope of 100-90, be divided into n level.The careful degree of classification depends on stability and the diagnostic value of the information obtained under stable measuring state.The degree of stability of data is higher, can the ability of levels of sub division larger, but meticulous classification having little significance for diagnosis and prescriptions, therefore needs balance consideration.
The data set that in practical application, device obtains can associate with corresponding with the carrying out between any disease of the traditional Chinese medical science.By the data analysis that form is corresponding, the TCM syndrome realizing quantizing is expressed, and does not enumerate at this.
3. apparatus design method
Device comprises sensor group, acquisition of information and analysis circuit and corresponding peripheral hardware and software.
The information that device obtains comprises PPG ripple, SaO
2value, detects part thickness H, TPW, APW, ECG-II etc., for coordinating the data set detecting and obtain and can quantize the deficiency of vital energy, blood deficiency.Data conversion, by obtaining information analytical calculation, is become PWV, SaO by device
2, LCR, LHQ, LCO, LKEL, LBV, ABV, CIO
2, TBH, SaO
2minequivalence, then by the software design with compatible apparatus and comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument hardware, realizes the knowledge data base information of acquisition being included in the traditional Chinese medical science, for the degree of the traditional Chinese medical science evaluation deficiency of vital energy, blood deficiency provides the data set of quantification.
The design feature of device is:
(1) portable harvester design: front end photoelectric probe integrated near infrared emission receiving terminal, range sensor and pressure transducer.On efferent pathway, compatibility has pressure of the radial artery force transducer.Device is combined with detachable standard I I and leads electrocardio conductor, for realizing multiple data quantity chemical combination ginseng under portable design premises.The space of acquisition of information is improve several times by such integrated design, not only achieves the measuring and calculating to multiple physiological parameter, and provides possibility for the conjunction ginseng between information.Use the accurate measurement to detecting distance, realize the certain capacity of resisting disturbance under dynamic environment measurement, improve again the comparability of the data between different experimenter further.
(2) diversified measuring method: the retrievable information of device comprises static measurement and dynamic measuring method two parts, even static measurement user is measured under quiet as far as possible state, obtain one group of data that there is health status and evaluate, comprise the information extrapolated by PPG wavy curve with according to SaO
2information two parts that value is extrapolated.
Can quantize to obtain by PPG wavy curve:
(1) oximetry value SaO
2(%);
(2) the content LHQ of the hemoglobin at position is detected;
(3) regional flow's kinetic energy loss LKEL (j);
(4) local stroke volume LCO (ml/b);
(5) peripheral circulation resistance LCR (PRU).
Dynamic measuring method, according to the setting of this patent, is to be held one's breath tolerance test by standard, gathers the measurement data of Real-time and Dynamic.Comprise:
(1) blood oxygen saturation minimum SaO
2min(%): after holding one's breath, measure the minima in the blood oxygen real time value obtained;
(2) per minute blood zmount of oxygen consumption CIO
2(ml/min): for representing the wear rate of blood oxygen in the process of holding one's breath;
(3) breath hold TBH (s): the time being whole process lasts of holding one's breath;
(4) blood flow rate BV (s/cm): refer to the flowing average speed of pulmonary capillary blood vessel to right hand middle fingertip;
(5) oxygen reserve O
2S(ml): refer to the oxygen content be stored in histoorgan;
(6) oxygen consumption slope TanOt (%/min): the speed of blood oxygen consumption rate in process of namely holding one's breath.
Known dynamic measuring method can obtain the comparatively more data of static measurement, but requires that user has certain tolerance of holding one's breath, and patient with severe symptoms and old people should not use.
EPO is additional metrical information, and device described in patent cannot obtain the value of EPO.But the numerical information of EPO can be analyzed in a database and participate in the state description of other information realizations to measured's body.By adopting the conventional EPO value obtained as method for fast measurings such as spectrum analysis, the detections of electrochemiluminescence immune quantitative, row state description can be entered directly into.
Device can the hardware interface of compatible comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument in hardware designs, the Detection Information of acquisition can and line item Synchronization Analysis.Meanwhile, device software information can implement seamless embedding with the knowledge data base of comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument.All Detection Information and derived value all can participate in the body health state description based on theory of Chinese medical science.
Be provided with continuously real-time surveying record and summarization functions in device, in the process of application separately, its volume is suitable for carrying with and real-time monitoring, and the data collected choose high-quality data storing automatically, generate healthy curve after a certain time.Show the health and fitness information fluctuation of user within a period of time, have good prompt facility for screening for patient group, Timeliness coverage health problem and guides conditioning, takes preventive measures.Be conducive to the monitoring such as chronic disease, partial seizure disease application.Meanwhile, because device is to the measurement of the thickness H at detection position, can the information data realized to a certain extent between use crowd compare.
In the quantification identification of the deficiency of vital energy, the SaO that can will obtain
2, build between the disease that possesses of body anoxia and the traditional Chinese medical science deficiency of vital energy and associate.
as shown in Figure 4.
In foundation
fig. 4after establishing physiological correlate, further by the data basis of the experimental construction identification deficiency of vital energy.The data obtained and close ginseng method structural framing as
fig. 5shown in.By the information obtained, the fuselage state being evaluated people is described.The related data obtained is more, and the physiological correlate between data is stronger, then the judgement conclusion drawn is more accurate.
4. data analysing method
(1) deficiency of vital energy, blood deficiency method for evaluating state 1 is quantized: coordinate traditional Chinese medical doctor directly to quantize state evaluation method.In conjunction with traditional Chinese medical doctor to the Qualitative state evaluation of patient and PPG and SaO
2quantitative information, draw the deficiency of vital energy blood deficiency conclusion of quantification.
(2) deficiency of vital energy, blood deficiency method for evaluating state 2 is quantized: closing very much ginseng assisting in diagnosis and treatment instrument by device being embedded conjunction ginseng four, realizing the state evaluation to deficiency of vital energy blood deficiency.
(3) deficiency of vital energy, blood deficiency method for evaluating state 3 is quantized: realize state evaluation to deficiency of vital energy blood deficiency by the hold one's breath quantity of information of tolerance test expansion and data pattern of standard.Standard tolerance test method of holding one's breath is: make patient at normal suction end shield breath, adhere to, to maximum tolerance limit degree second wind, record real-time SaO according to individual ability to bear
2and PPG shape information.
According to real-time SaO
2the measurement index computational methods obtained are as follows:
1) blood oxygen saturation minimum SaO
2min(%): after holding one's breath, measure the minima in the blood oxygen real time value obtained.
2) per minute blood zmount of oxygen consumption CIO
2(ml/min): for representing the wear rate of blood oxygen in the process of holding one's breath.If the normal blood oxygen levels before experimenter holds one's breath is SaO
2N(%), after holding one's breath blood oxygen saturation detected value by drop to the process of being down to minimum persistent period be TD, ECBV VB (L), rule of thumb algorithm, the body weight ratio that male's ECBV accounts for is about 8%, the body weight ratio that women's ECBV accounts for is about 7%, about containing 200ml O in every ascending artery blood
2.Pass through computing formula:
Per minute blood zmount of oxygen consumption CIO can be calculated
2.CIO
2in theory should be similar to body metabolic oxygen consumption per minute, but the partial parameters used by calculating is empirical value, and measure the index of acquisition by many factors, cause measuring the CIO drawn
2value change greatly.
3) breath hold TBH (s): the time being whole process lasts of holding one's breath.
4) blood flow rate ABV (cm/s): refer to the flowing average speed of pulmonary capillary blood vessel to right hand middle fingertip.Suppose SaO
2mintime during appearance is TSaO
2min, estimate that pulmonary capillary is L to finger tip blood flow flow-path-length, through anatomic measurement, be about 60% height H by pulmonary capillary to the blood flow beeline LB of middle finger finger tip.Then blood flow rate BV can estimate with following formula:
5) oxygen reserve O
2S(ml): if referred to the real-time SaO of the process of holding one's breath
2value is done regression analysis and is drawn linear relationship formula in the interval of landing, then the difference of this regression line and the hold one's breath Y value corresponding to time that starts and actual value.After this can think and starts from holding one's breath, body consumes oxygen with a constant speed, and SaO
2exceeded in the steady statue time in early stage blood to be flow to finger tip time by pulmonary capillary, so this time had more can think that first body consumes the O of deposit in the middle of tissue with cell
2, as the O consumed
2the decline of body partial pressure of oxygen is too much caused to have influence on blood oxygen pressure PaO
2time, SaO
2will along with PaO
2consumption together reduce, due to the O of 99%
2all carry with the form of HbO2 Oxyhemoglobin, therefore SaO
2along with the continuity of the process of holding one's breath also changes with linear relationship but not the variation of oxygen dissociation curve.Therefore, according to the time T0 started, the SaO of holding one's breath
2start the time T1 declined, and SaO
2mintime T
2, CIO
2deng, can release:
O
2S＝(T1-(T
2-T0))×CIO
2/60…………………………………………3
6) oxygen consumption slope TanOt (%/min): the value SaO namely during the eupnea of blood oxygen
2with minimum SaO
2mindifference than the time T of upper blood oxygen minimum
2deduct the time T1 starting to land.Measure the value that blood oxygen underspeeds, weigh the speed of body consumption oxygen velocity from another angle.Itself and CIO
2similarity be all weigh dependency.But the speed that TanOt declines mainly for body blood oxygen saturation value, with circulation volume, the correlate such as body weight are not close.Therefore this index more can weigh individual anoxia endurance, is equivalent to the average per kilogram relative oxygen consumption wastewater evaluating body.
TanOt＝(SaO
2N-SaO
2min)/(T
2-T1)……………………………4
7) the body surface area S formula that theoretical basis metabolism oxygen consumption OCBMR (Oxygen consumption in Basic Metabolism Rate) (ml/min): by height H, body weight W calculate
S＝0.0061×H+0.0128×W-0.1529……………………………………5
Application of formula again
OCBMR＝(166.2×S×1000)/(20.20×60)………………………………6
Obtain the oxygen milliliter number of the consumption per minute of every experimenter.This value just can realize without the need to the metrical information of device.It is information in contrast, for evaluating CIO
2measured value departs from normal condition height low degree.
More than according to SaO
2the attainable information inference of dynamic change.And compare according to the size of the volume pulsation wave PPG wave amplitude of same individuality and change, the change of integral of pulse shape area, is scaled the change of corresponding blood flow in real time.Also can realize the acquisition of relevant information, and compare between different experimenters.But need to install range sensor additional in PPG probe, accurately measure the thickness at tested position.After converting, carry out the comparison of PPG wave amplitude and the comparison of integral of pulse shape area.The change of wave amplitude is scaled the variable quantity LBV of local circulation blood volume, relevant to blood pressure, local microcirculation feature; The latter represents often the fight variable quantity of microcirculatory blood volume and the product of time, relevant to regional perfusion amount LCO.
Can quantize to obtain by PPG wavy curve:
8) oximetry value SaO
2(%);
9) content of the local hemoglobin LHQ at position is detected:
LHQ＝ρ
0Am/H……………………………………………………………7
Wherein ρ
0for conversion constant, Am=Amplitude, i.e. PPG wave amplitude.According to the area S=1mm of this device test side
2, assuming that be measure (H=10mm) in the blood sample of 10mm at measuring distance, and adjust Am=10mm, the LHQ=ρ after can adjusting
0=1.343 × 10
16individual, namely represent when the thickness at tested position is 10mm, the every 10mm of wave amplitude screen demonstrating PPG ripple represents 1.343 × 10
16individual hemoglobin content also can be converted into 5 × 10
7individual erythrocyte number.And in the tissue, due to the existence of its hetero-organization, measure numerical value and cannot reach such level.Whole Body about has 400 × 10
9root blood capillary, capillary density about has 100-3000 root every cubic millimeter tissue, and blood capillary, finger tip average length about 750 μm, comprises 30-100 erythrocyte of having an appointment in each root blood capillary, under above-mentioned measuring method, the erythrocyte number recorded should be 3 × 10
4-3 × 10
6, at least one order of magnitude fewer than the erythrocyte number directly measured in equal-volume blood.And the flow velocity of blood in blood capillary is 0.3-0.7mm.Then the deducibility time that erythrocyte passes required for blood capillary is under normal circumstances about 1-3s, generally of a specified duration in cardiac cycle.Thus, by the PPG wave analysis of finger tip, coordinate the information such as LCO, LBV of later analysis, roughly can judge the density of blood capillary and the viscosity etc. of blood flow.When measuring finger tip, due to the absorption of various tissue and the variable effect of scattering and measuring distance, all affect the change of the value of HQ.Therefore need to apply mechanically formula
LHQ＝ρAm/H………………………………………………………8
Wherein ρ=ξ ρ
0for the actual conversion coefficient under particular organization's scattering.
10) local stroke volume LCO (ml/min)
11) peripheral circulation resistance LCR (N/V):
R＝(P1-P
2)/Q…………………………………………………10
P1 and P
2refer to the pressure differential of the area on the wrist over the radial artery where the pulse is felt for diagnosis radial artery and finger tip volume pulsation respectively, Q refers to blood flow.Utilize the LCO derived
Above-mentioned formula can be become
R＝60(P1-P
2)/HR×LCO……………………………………11
HR is heart rate.
For circulation resistance measurement for exploration the hypertensive origin cause of formation and state all helpful.
12) regional flow's kinetic energy loss LKEL (J) computational methods:
The diameter of d---circular straighttube, m; L---the length of circular platform straight tube, m;---coefficient of friction, (without unit).
The density p of coefficient of friction λ and fluid and viscosity, mu, caliber d, flow velocity u is relevant with tracheid shape properties ε.
λ＝f(Re，ε/d)……………………………………………13
Record λ and Re data by experiment, empirical curve can be marked and drawn on log-log coordinate.As Re < 2000, coefficient of friction λ and tube wall relative roughness have nothing to do.When fluid is turbulent flow in straight tube, λ is not only relevant with Reynolds number, and relevant with tube wall relative roughness.
LKEL and LCR works in coordination with, and can draw the loss of blood circulation resistance, blood kinetic energy, and infer the information such as blood flow viscosity and microcirculating state.In this, as the assessment of the blood vessels caliber to measuring point, and the frictional force assessment between blood and tube wall provides data.
13) according to the PPG rhythm and pace of moving things obtained, the rhythm and pace of moving things information such as heart rate HR (n/min) are extracted.
Between the typical deficiency of vital energy, blood deficiency disease patient, carry out extended measurements, obtain above data and carry out the examination of common feature.Draw the data set of corresponding AD HOC.
5. quantize the measuring method of subjective feeling:
According to SaO
2realize the measures of quantization to subjective information sense uncomfortable in chest.First SaO under record user eupnea state
2value, then requires that user carries out standard and to hold one's breath tolerance test, obtains the blood oxygen saturation minimum SaO under himself healthy tolerance limit
2min, then according to the SaO under same ethnic same age
2normal value, by the blood oxygen saturation minimum SaO obtained under itself and own health tolerance limit
2minquantification subregion is carried out, SaO under observation user eupnea state in the interval formed
2interval position residing for value, the quantitatively evaluating deficiency of vital energy forms the intensity of disease uncomfortable in chest.Concrete numerical value can be consulted
table 4.
6. use and specification:
In use, quantize the deficiency of vital energy, blood deficiency method for evaluating state 1, quantize the deficiency of vital energy, blood deficiency method for evaluating state 2, be applicable to the measures of quantization of the deficiency of vital energy that mid-aged population and disease occur together, blood deficiency.Quantize the deficiency of vital energy, blood deficiency method for evaluating state 3 to need experimenter to carry out standard to hold one's breath tolerance test, be applicable to the deficiency of vital energy of subhealth state and non-serious change, blood deficiency patient.For daily quick health evaluating.
Affect NIRS and measure the SaO obtained
2and relevant information is worth because have: ambient oxygen partial pressure, blood pressure, skin color, sex, tested position blood perfusion amount, age and current metabolism rate etc.Get rid of the impact of pathologic factor, wherein need the most important non-pathology effects factor considered to be then ambient oxygen partial pressure and age.While measurement deficiency of vital energy degree, need to obtain age, blood pressure, body temperature and the information such as height, body weight, first estimate its influence factor, will SaO be affected
2non-pathologic factor get rid of further, the SaO higher with the deficiency of vital energy degree of association can be obtained
2value, regarded as the standard quantizing deficiency of vital energy degree.
Measure SaO
2in process, tested position needs to be in relaxation state, prevents muscular tone or position compressing from forming regional perfusion not smooth, affects the accuracy of measured value.SaO in measurement
2the stability of value also describes the oxygen acquisition state of body, SaO to a certain extent
2value is on the low side for a long time and fluctuation range can think deficiency of vital energy prolonged illness patient, SaO within 2%
2the larger phenomenon of value fluctuation is usually that the factor affecting blood distribution and oxygen exchange due to physics compressing or dysfunction of ventilation etc. causes, and needs the laggard one step surveying of stable fuselage state.
Accompanying drawing explanation
Fig. 1 is apparatus design sketch;
Fig. 2 is probe designs schematic diagram;
Fig. 3 is measuring point and portable non-invasive acquisition of information schematic diagram;
fig. 4 is the theoretical basis block schematic illustration of physiological correlate between deficiency of vital energy extent description and SaO2 value;
fig. 5 is that data close ginseng method.
Wherein exist
fig. 1in:
1.NIRS technology quantizes the real-time PPG signal, the dynamically SaO that obtain
2the information acquisition devices such as value, finger tip pressure pulse wave TPW, radial artery pressure pulse wave RPW and standard ecg-II;
2. the comprehensive analysis of the data gained by the four methods of diagnosis information of traditional Chinese medical doctor's identification acquisition;
3. the digitized of comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument, the four methods of diagnosis information of quantification;
4. standard hold one's breath tolerance test identification realize information delta;
5. the traditional Chinese medical science deficiency of vital energy, the blood deficiency extent description that quantize;
6. traditional Chinese medical doctor's identification conclusion of body typical disease;
7. the identification conclusion of the comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument of body typical disease;
8. the diagnosis of Traditional Chinese Medicine doctor coordinates quantification, has had the reference standard in diagnosis, for accurate herbal formula medication provides the quantitative basis of diagnosis;
9. to realize subjective and objective associating dialectical for measures of quantization, the quantitatively evaluating of health and fitness information.
?
fig. 2in:
1.1 distances, pressure transducer;
1.2 distances, pressure measxurement end;
1.3 photosignal transmitting terminals;
1.4 photosignal receiving terminals.
?
fig. 3in:
2.1 real-time PPG signals, dynamically SaO
2value, finger tip pressure pulse wave TPW measure;
2.2 radial artery pressure pulse wave RPW, standard ecg-II test side;
2.3 urine detection EPO concentration.
Detailed description of the invention
Below enumerate three kinds of implementation methods.
1. clinical application method 1:
Ginseng SaO is closed in the qualitative identification of traditional Chinese medical doctor
2quantization method:
First rely on traditional Chinese medical doctor to carry out traditional Chinese medical science state evaluation to patient, obtain diagnosis qualitatively.Then whether assess patient belongs to the deficiency of vital energy or blood deficiency, when having the deficiency of vital energy or blood deficiency state, obtains PPG information and SaO by NIRS technology Quick Measurement
2value, obtains LHQ, SaO according to the software design function of device
2deng, and contrast the difference between parameters and standard value, the degree of quantitatively evaluating deficiency of vital energy blood deficiency.
The method for evaluating state quantizing the deficiency of vital energy can according to the four methods of diagnosis information to experimenter, contrast the dialectical reference standard of the authoritative deficiency of vital energy, as continued to use " the dialectical reference standard of Chinese medicine deficiency-syndrome " and the revised standard in 1986 of the widest national combination of Chinese and Western medicine deficiency syndrome and senile disease control academic conference formulation, identification is carried out to experimenter.Everyly to meet " syndrome of deficiency of QI: spiritlessness and weakness, weak breath or lazy speech, spontaneous perspiration, enlarged tongue or have tooth to print, deficient pulse unable (weak or soft or moisten).Above without possessing in item symptom more than three (containing three) " can examine as syndrome of deficiency of QI.Then according to the difference that the deficiency of vital energy of different internal organs shows, the type of the refinement deficiency of vital energy and accompanied symptoms.
Blood deficiency is further developing of the deficiency of vital energy, every blood deficiency person, and gas must not be complete.Have fever due to deficiency of blood, wind syndrome due to blood-deficiency, the sorting techniques such as QI and blood deficiency, but its identification can with reference to blood deficiency primary symptom: pale complexion; Dim at the moment when standing up; Lip pale tongue; Thready pulse.Meet wherein 3 or more just can be recognized as blood deficiency, then according to the difference that different internal organs show, the type of refinement blood deficiency and accompanied symptoms.When existing with syndrome of deficiency of QI, deficiency of both QI and blood can be recognized as simultaneously.
Then by measurement device, obtain the part thickness H under eupnea state, converted by software and amount to into local stroke volume LCO.Local content of hemoglobin LHQ, SaO
2deng, and contrast with standard value range respectively, find to realize the state description to the deficiency of vital energy by low magnitude portion wherein.
Syndrome of deficiency of blood: appeal measured value extracts the information relevant to circulation volume, PWV, SaO that Main Basis PPG ripple extracts
2, the information such as LCR, LHQ, LCO, LKEL, LBV.As PWV, SaO
2, LCR, LHQ, LCO, LKEL, LBV etc. be abnormal, SaO
2, SaO
2minnormally, simple blood deficiency can be thought, if PWV, SaO
2, LCR, LHQ, LCO, LKEL, LBV etc. and SaO
2, SaO
2minall there is exception, then think QI and blood simulataneous insufficiency and excessive.
Above-mentioned relatively on the low sidely to refer to compared with codomain interval that to measure with Healthy People under the agnate age and obtain.Can foundation
table 3, the numerical intervals shown in 4 realizes the degree identification of fuselage state.
In the crowd of different partial environment and all ages and classes, normal SaO
2scope and quantization method sum up
as table 4shown in.
N is set to 3, corresponding high, normal, basic three sections, specifies the quantitative expression method of subjective feeling degree, avoid subjective exaggeration or express the unclear interference that doctor is caused.
After the factor such as age and ambient oxygen partial pressure of carrying out measured value corrects, reference
table 3with
table 4the normal value listed, when patient is had deficiency of vital energy disease or double disease by diagnosis, just can by measuring SaO
2and by measured value control value, all not within the normal range that form marks, all can by SaO
2as a data target of the deficiency of vital energy quantized, the how many degree to the deficiency of vital energy of difference according to measured value and standard value carries out quantitative evaluation.After having assessed, further corresponding blood deficiency disease, whether quantitatively evaluating blood deficiency.
Then, when there being the value quantized to the deficiency of vital energy, blood deficiency, with this numerical value for foundation, the deficiency of vital energy that quantitatively evaluating traditional Chinese medical doctor identification draws, the degree of blood deficiency.
According to SaO
2the method realizing measuring subjective information degree uncomfortable in chest is:
(1) sensor probe of device is worn the corresponding site to experimenter, enter Dynamic Data Acquiring interface, first observe the SaO under tranquility
2normal value, if within normal range, work as SaO
2be within normal range, but still have corresponding sense of discomfort, namely during sensation of oppression over the chest with shortness of breath symptom, it is uncomfortable in chest that the low value just can getting rid of blood oxygen pressure causes, and finds other reason.If on the low side, then carry out standard and to hold one's breath experiment.
(2) make experimenter carry out standard to hold one's breath tolerance test, tranquil air-breathing end before process is held one's breath in preparation enters the state of holding one's breath, press corresponding timing button simultaneously, terminate after own health tolerance limit of holding one's breath, the standard evaluating own health tolerance limit is: not dizzy, limbs do not tremble, facial color does not occur purplish red, lip color does not occur livid purple, do not hear the heartbeat sound of oneself, do not have the obvious pulsatory feeling of cardia, without subjective sense of discomfort after recovery breathing, whole Process Consciousness is regained consciousness.When any one occurring above-mentioned feature in the process of holding one's breath, then need stopping to hold one's breath, recovering to breathe, when there is not any above-mentioned reaction, then can adhere to can adhering to greatest extent to self-ability.When at breath hold, while recovering to breathe, again press timing button, system records the duration TBH that holds one's breath automatically, after then continuing to wait until that data return to the stable codomain interval before holding one's breath, measures and terminates.
(3) contrast
table 4. judge measured value SaO
2at standard value and SaO
2minbetween position, for assessment of the intensity of subjective feeling.
2. method in clinical application 2
By SaO
2combine with comprehensive analysis of the data gained by the four methods of diagnosis, realize the diagnosis and evaluation comprehensively quantized.
By closing ginseng comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument, realize the quantitative evaluation to all kinds of traditional Chinese medical science typical sign and prescription decision-making.
First, application comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument, obtains the four diagnostic methods information of experimenter, meanwhile, gathers SaO
2value.Then in conjunction with the dialectical dialectical conclusion that draws of comprehensive analysis of the data gained by the four methods of diagnosis and prescriptions, with reference to SaO
2value, the deficiency of vital energy, blood deficiency degree under assessment experimenter specific TCM syndrome, and according to the height of degree, suitably add and subtract into the medicament compatibility in side and dosage, there is under realizing man-machine mutual ginseng the more accurately dosage of quantitative basis.
3. standard is held one's breath tolerance test method (for state evaluation real-time)
When needs are in Working Life during real-time monitoring health status, standard tolerance test method of holding one's breath can be used to carry out rapid evaluation, and accuracy rate is higher than normal measurement.Method: after wearable device, carries out standard and to hold one's breath tolerance test, tested rear wait indices and all returned to the state before holding one's breath, and measures and terminates, extract dynamic SaO
2data in curve, coordinate the general parameters information of body, obtain SaO
2min(%), CIO
2(ml/min), TBH (s), ABV (s/cm), O
2S(ml), TanOt (%/min), extracts the data in PPG waveform, obtains dynamic ABV (ml), LCO (ml).LHQ (mmol/L) etc.Then by pattern recognition, state evaluation also records fuselage state.This method is applied under being used for the prerequisite of self specific disease type known.Be conducive to feature and the state development of the dynamic monitoring state of an illness.The information conclusion obtained, by Radio Transmission Technology, is sent to tutorial communicating terminal.State evaluation according to coming from the pattern feature of characteristic data collection, therefore can not on stricti jurise using this information aggregate as diagnosis, as of a health supervision quantifiable reference index, can only make a definite diagnosis and still need the conjunction of traditional Chinese medical doctor to join.
For same user in continuous print testing process, generate, personal health information change curve, when finding that the value departing from normal range appears in continuous measurement, healthy early warning service can be provided.User is reminded to note health.
In above two kinds of using forestland, all can realize the quantitative evaluation to deficiency of vital energy blood deficiency, its diverse ways adopted can as above be enumerated a lot, but key problem is all by PPG signal and SaO
2include traditional Chinese medical science state evaluation field in, the identification conclusion of the auxiliary traditional Chinese medical science, it part of quantitative expression can not be carried out the expression that quantizes.Therefore, relate to PPG signal and SaO
2it is all the claimed scopes of apparatus and method described in this patent that value includes the method quantizing deficiency of vital energy blood deficiency in.
Claims (9)
1. the present invention uses oximetry value to evaluate the deficiency of vital energy, blood deficiency method and apparatus.Comprise sensor group, acquisition of information and analysis circuit and corresponding peripheral hardware and software.Its hardware components comprises can obtain the integrated range sensor of accurate blood oxygen saturation information, the probe of pressure transducer, and lead electrocardio conductor and interlock circuit, information inventory analysis module and wireless information transfer end of the accurate II of another affix forms.Software section comprises exercisable Data Enter interface program and joins Identification Data storehouse with conjunction, for realizing the deficiency of vital energy, and the identification of blood deficiency degree.
2., according to claim 1, a kind of deficiency of vital energy blood deficiency state measurement strategy of innovation is proposed, by PPG, and SaO
2etc. information, obtain finger tip pressure pulse wave TPW and radial artery pressure pulse wave RPW in conjunction with device described in claim 1 and sensor combinations thereof, the secondary information that the physiologic information directly obtained with standard ecg-II etc. and information integerated obtain as
Pulse wave conduction speed (Pulse Wave Velocity, PWV);
Blood oxygen saturation (O
2saturation in Artery, SaO
2);
Regional vascular resistance (Local Circulation Resistance, LCR);
Local hemoglobin content (Local Hemoglobin Quantity, LHQ);
Regional perfusion amount (Local Cardiac Output, LCO);
Blood flow of the tip speed (Local Blood Volume, LBV) etc., according to Diagnostics of Chinese Medicine Leakage in Value assessment corresponding to information as each disease such as empty, real, cold, hot such as the deficiency of vital energy, blood deficiency.
3. according to claim 1, by the SaO obtained after normal for severe deficiency of vital energy patient wearable device
2value and kindred circumstances under the standard SaO of agnate Healthy People
2decile n part between value, when be applied to filter out have in the crowd of the deficiency of vital energy symptom time, measure by contrast the SaO that obtains
2be worth the position in n the equal portions interval divided, quantize the degree drawing the deficiency of vital energy.In like manner, the PPG value SaO will obtained after normal for severe blood deficiency patient wearable device
2value and kindred circumstances under the standard SaO of agnate Healthy People
2decile n part between value, when being applied in the crowd filtering out blood deficiency symptom, measures the SaO obtained by contrast
2be worth the position in n the equal portions interval divided, quantize the degree drawing blood deficiency.N can be any number between 3-15.
4. according to claim 3, by SaO
2value be combined with insufficiency of heart-QI classical symptom, realize showing the quantification of insufficiency of heart-QI degree; Be combined with insufficiency of lung-QI classical symptom, realize showing the quantification of insufficiency of lung-QI degree; Be combined with deficiency of spleen-QI classical symptom, realize showing the quantification of deficiency of spleen-QI degree; Be combined with deficiency of kidney-QI classical symptom, realize showing the quantification of deficiency of kidney-QI degree; By SaO
2value be combined with deficiency of liver-blood classical symptom, realize showing the quantification of deficiency of liver-blood degree.
5. device according to claim 1, the detection method that can realize a kind of uniqueness is that standard is held one's breath tolerance test method.The hold one's breath operational approach of tolerance test of standard is: make patient at normal suction end shield breath, adhere to, the dynamic parameter information of omnidistance detection record of holding one's breath according to individual ability to bear.
Standard tolerance test method of holding one's breath can realize on the basis of information set as claimed in claim 2, carrying out standard and to hold one's breath tolerance test, obtaining further by making user:
Mean blood flow velocity (Average Blood Velocity, ABV);
Per minute blood zmount of oxygen consumption (Consuming Intensity of O
2, CIO
2);
Breath hold (Breath Holding Time, TBH);
Blood oxygen saturation minimum (the minimum value of O
2saturation inArtery, SaO
2min);
Regional flow's kinetic energy loss (Local Kinetic Energy Lose, LKEL);
Erythropoietin (Erythropoietin, EPO),
Thus realize more fully health evaluating information set.Extended measurements will be carried out between the typical deficiency of vital energy, blood deficiency disease patient, and obtain above data and carry out the examination of common feature.Draw the data set having more distinctive AD HOC.Be applicable to the daily quick health evaluating of the deficiency of vital energy of subhealth state and non-serious change, blood deficiency patient.
6. according to claim 1-5, by SaO
2information includes comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument in, joins with the data acquisition system in comprehensive analysis of the data gained by the four methods of diagnosis knowledge data base, increases the information space of comprehensive analysis of the data gained by the four methods of diagnosis assisting in diagnosis and treatment instrument.For the simple deficiency of vital energy, blood deficiency user provide the deficiency of vital energy blood deficiency degree of quantification.For the user being mingled with deficiency of vital energy blood deficiency feature in specified disease or syndrome provides the identification conclusion of superposition.Namely the identification conclusion of quantification was both provided, had corresponded to coordinating program targetedly.The deficiency of vital energy is provided again in the aspect of health evaluating.The information superposition of blood deficiency degree.
7. according to claim 1-5, according to SaO
2realize the measures of quantization to subjective information sense uncomfortable in chest.First SaO under record user eupnea state
2value, then requires that user carries out standard and to hold one's breath tolerance test, obtains the blood oxygen saturation minimum SaO under its maximum tolerance
2min, then according to the SaO under same ethnic same age
2normal value, carries out quantification subregion by itself and maximum tolerance value interval, SaO under observation user eupnea state
2interval position residing for value, the quantitatively evaluating deficiency of vital energy forms the intensity of disease uncomfortable in chest.
8., according to claim 1, the information conclusion of acquisition, by Radio Transmission Technology, is sent to tutorial communicating terminal.
9. content according to claim 1-8, for same user in continuous print testing process, generates, personal health information change curve, when finding that the value departing from normal range appears in continuous measurement, can provide healthy early warning service.User is reminded to note health.
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