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基于精细脉象的体肺循环多元同步检测与定量分析的研究
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摘要
人体脉象源于心动,是反映生命活动的重要体征之一。在脉波搏动中蕴藏着丰富的生理、病理信息,不仅古代中医很早就已靠号脉来诊病,国外也远在古希腊时代就有关于检测人体脉波的记载。中医著作《内经》、《脉经》和《濒湖脉学》等是古代脉诊技术发展的典型代表,随着现代医学的进步,无创检测技术有了迅猛的发展,分析技术也已经从定性走向了定量。相关研究已不限于传统中医理论,正在向生理学、病理学、解剖学、生物力学、血流动力学、计算机学和机械电子学等多学科综合研究发展,这使得脉学研究已逐步成为一门系统工程。
     在当前的脉象检测技术中,脉象传感器的设计与脉象信息的分析是二个关键。传感器设计主要有两方面不足,一是脉象信息的采集手段比较单一,传感器一般只局限于对压力脉搏图的描记,尚不能实现脉象信息三维的、动态的采集;二是检测以接触式压力传感器为主,不仅对脉象有干扰,而且精度低,稳定性差,这对于静脉波的检测尤为突出。本文在此基础上,首先较深入地讨论了激光法进行脉象非接触检测的原理,在大量实验的基础上,特别强调了针对右心系统脉象检测和研究的重要性。首次针对右心系统选择以右中心静脉处的右“三脉球"(即右颈内静脉、右颈外静脉和右锁骨下静脉汇合形成的膨大球囊状管)作为理想的激光静脉信号采样点,并且系统地探讨了激光脉象检测技术的相关问题,创新设计了三种较为实用的非接触激光脉象传感器,可以解决“呼吸干扰”等难题,获得国家自然科学基金资助。
     此后,本文针对“三脉球”静脉波进行了数学描述与分析,提出了逐波分段归一化方法,通过高斯函数进行了静脉波拟合,取得了较好效果;同时描述了静脉波及其特征点的生理内涵。这为静脉波的深入研究提供了一种思路。
     在现代检测理论与技术中,由张大祥首创的“脉图法”被视做一个阶段性标志。本文在张大祥及其团队原有的研究基础上,针对精细脉象呈现的病理突变,引入了多尺度小波等非线性方法来研究多维信号的提取、特征点自动捕捉、定位和分析。在采用小波实现脉波降噪的同时,采用新方法提取了有效的特征信号并实现了特征点的自动定位。较之现有方法,该方法进行的特征点定位更准确,为进一步分析脉波的病理畸变打下了基础。
     最后,本文提出了“体、肺循环系统多元、同步、无创检测与定量分析仪”的设计思想,采用了基于动脉、静脉、心电、心音多元同步技术的特征点小波定位和非线性分析的手段,设计了验证性仪器系统硬件和基于Windows平台的软件,主要包括:1)自行设计和制作了实时脉象信号处理分析主板和原理性样机;2)提出了DSP+ARM架构下的多元信号同步处理方案和小波信号提取算法,提高了代码效率;3)编制了主机处理程序,实现了心电、心音、动静脉波等指标的同步采录分析和波形特征点的智能标识以及32个参数计算输出,结果表明该原理性测试分析系统较之现有仪器具有更高的精度、舒适性和可靠性。
The pulse condition of human body comes from heartbeats,which is one of the important body characteristics,and reflects the life activity.Containing abundant physiological and pathologic information in the pulsation of pulse waves,not only the ancient Chinese medicine had already diagnosed a disease by feeling the pulse very early,but also the ancient Greek had recorded the human body pulse wave going far back to ancient times abroad.The Chinese medicine works:《Inner Canon of Huangdi》,《Canon of Pulse》and《Study of Vein by Binhu》are the typical technical development representatives of the ancient vein diagnoses.With the progress of modem medicine,Noninvasive detection technique has a rapid development.People's research to the pulse wave is more scientific and thorough,not only the detecting means have been diversified,but also the analytic techniques already have headed from qualitative analysis to quantitative analysis.Related researches have already been unlimited at the traditional Chinese medicine theories, which are developing to integrative research in multi-fields such as physiology, pathology,anatomy,biomechanics,hemodynamics,computer science,mechanics and electronics etc.The study of vein has already become a systems engineering gradually,which was subjected to a high value of the medical science field inside and outside.
     Within the current pulse-condition detection methods,the pulse transducer design and its signal information analysis are two sticking points.On the one hand, the means of pulse-condition collection are more single,the design of its transducer generally is limited to recording a press sphygmogram and still falls through the collection of pulse-condition's 3D information dynamically;On the other hand,the detecting sensors give priority to a pressure type.Not only its placement is more troublesome,but also the problems still have not been easy to resolve,such as disturbing pulse-condition,low accuracy and bad stability etc.Especially to the detection of venous pulse wave,these problems are still outstanding.This paper more and thoroughly discusses the principle of non-contact pulse-condition detection with laser,which based in great quantities of experiments,and particularly presents a special accentuation of the importance to detect and research the right heart system.For the first time,choosing the TRI-PULSE-BALL(where the right internal jugular vein,right external jugular vein and right subclavian vein converge at a saccate ball located in the right central venous.) as the ideal sampling dot of vein pulse signal,which is optimal and the nearest point of vein system in the whole body to detect right atrium system.It systematically explored the laser detection technology of pulse,and invent three practical non-contact vein transducers,which can solve the conundrum of "Breath Interference" and has been supported by a grant from the National Natural Science Foundation of China.
     This thesis has carried on mathematical description and analysis in a view of TRI-PULSE-BALL venous pulse wave.For the first time,the one by one wave sub- normalized method is used to fit the venous pulse wave of TRI-PULSE-BALL with Gauss function simply,which achieved good results; Meanwhile,the physiological connotation of the venous pulse wave and its characteristics is studied.It accordingly offers a line of thought to the in-depth research of venous pulse wave.
     Among current techniques of sphygmus wave analysis,the detection theory and technique of "Pulse Diagram Method" which had been created by Zhang Daxiang is regarded as a milestone of phase.Aiming at the pathological mutation of a fine pulse-condition,this thesis gives some nonlinear methods as multiwavelets to carry out multidimensional signals distilling,the characteristic point of pulse-condition catching,signing and analyzing,which based on the research of Zhang Dazing and his team.It can restrain the noise,pick up the useful signal and realized the feature point automatic signing with the wavelet methods. Compare with existing methods,the feature point located by the new method is more accurately,and settles a base for analyzing the pathologic aberrance effectively.
     In the end,the paper advances the feature point marking and its nonlinear analysis method with wavelet,which based on a multi-signal synchronous detection such as artery pulse wave,vein pulse wave,electrocardio and cardiac sound.In the light of the foregoing research about pulse laser transducer and multidimensional nonlinear analysis,the paper gives the design of a new instrument to detect and analyze the systemic,pulmonary circulation system with a multi-signal,synchronous,noninvasive detection and quantitative analysis method,by the way,designed the instrument system motherboards.The main works include:
     1) Designed the PCB of signal processing board,the analyzing board and a prototype of the instrument;
     2) Put forward wavelet arithmetic methods to deal with multi-signal synchronization and wavelet singal extraction algorithms under the DSP+ARM structure to raise the code efficiency;
     3) Writed the host procedure,carried out the detection,record,sign and analysis of artery pulse wave,vein pulse wave,electrocardio and cardiac sound.
     Meanwhile,it computed and outputted 32 parameters.The results show that the prototype of the testing system has higher accuracy,more comfort and higher reliability.
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