WO2014181467A1 - 診断装置、診断方法及びプログラム - Google Patents
診断装置、診断方法及びプログラム Download PDFInfo
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- WO2014181467A1 WO2014181467A1 PCT/JP2013/063174 JP2013063174W WO2014181467A1 WO 2014181467 A1 WO2014181467 A1 WO 2014181467A1 JP 2013063174 W JP2013063174 W JP 2013063174W WO 2014181467 A1 WO2014181467 A1 WO 2014181467A1
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- pulsation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
- A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0048—Detecting, measuring or recording by applying mechanical forces or stimuli
- A61B5/0053—Detecting, measuring or recording by applying mechanical forces or stimuli by applying pressure, e.g. compression, indentation, palpation, grasping, gauging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/02108—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics
- A61B5/02116—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics of pulse wave amplitude
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/02444—Details of sensor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/0255—Recording instruments specially adapted therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4854—Diagnosis based on concepts of traditional oriental medicine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6843—Monitoring or controlling sensor contact pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7271—Specific aspects of physiological measurement analysis
- A61B5/7282—Event detection, e.g. detecting unique waveforms indicative of a medical condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/04—Arrangements of multiple sensors of the same type
- A61B2562/046—Arrangements of multiple sensors of the same type in a matrix array
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/16—Details of sensor housings or probes; Details of structural supports for sensors
- A61B2562/164—Details of sensor housings or probes; Details of structural supports for sensors the sensor is mounted in or on a conformable substrate or carrier
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
Definitions
- the present invention relates to a diagnostic device, a diagnostic method, and a program.
- oriental examination interview, inquiry and cutting (or palpation) in Oriental medicine
- Oriental medicine including Kampo.
- the patient's physique, complexion, tongue, etc. are observed with the naked eye to make a diagnosis of heat, water, abnormal blood circulation or disease momentum.
- the patient's medical condition is diagnosed by listening to the patient's voice, cough, breathing sound and belly by hearing, and smelling the patient's body odor, bad breath, urine and secretions, etc. by smell.
- interview diagnosis is made by listening to the patient for minor symptoms such as climbing, cold body, stiff shoulders, and pain.
- the examiner examines the nature and shape of the patient's pulse by hand (so-called pulse examination), and directly touches the abdomen to check the abdominal wall tension or responsiveness to the stimulus (so-called abdominal examination). Make a diagnosis.
- pulse examination the nature and shape of the patient's pulse by hand
- abdominal examination directly touches the abdomen to check the abdominal wall tension or responsiveness to the stimulus
- make a diagnosis the examiner directly touches the patient's biological information by hand.
- the diagnosis method of oriental medicine is a subjective method in which an examiner conducts an examination based on patient information obtained with the five senses and prescribes appropriate Chinese medicine according to the patient's age, physique and the like. For this reason, the examiner is required to have a great deal of knowledge and skill.
- the diagnosis result may be different for each examiner and lack of objectivity.
- the examiner directly touches the patient's biological information with his / her hand by hand, the diagnosis result of the cut depends greatly on the examiner.
- the examiner in order to palpate the pulsation, the examiner must accurately identify (or specify) the position of the part called the patient's dimensions, functions and scales based on experience, etc., and palpate the pulsations. I must.
- the pulsation depth floating to sinking
- the pulsation amplitude imaging to real
- the pulsation cycle number to slow
- Pulsation conditions such as pulsation length and width (large to small), pulsation flow rate (smooth to astringency), and pulsation tension (tight to loose) must be accurately determined based on experience.
- the diagnosis result of the cut-off is the pulsation determined by the examiner, for example, the accuracy of the position of the patient identified by the examiner, the function and the scale, and the examiner placing the index finger, middle finger and ring finger against the patient's dimension, function and measure. It depends on the accuracy of the state. In other words, the diagnosis result of the screening based on the five senses of the examiner greatly depends on the examiner performing the diagnosis.
- the diagnosis result greatly depends on the examiner.
- an object of the present invention is to provide a diagnostic device, a diagnostic method, and a program that can perform a diagnosis based on pulsation without greatly depending on the examiner.
- a plurality of sensors provided in a matrix form that detect the pulsation in a state where pressure is applied to the region via a sensor within a region where the pulsation of a diagnosis target is detected.
- a sensor unit having a sensor cell; means for acquiring a pulse wave distribution based on a sensor signal indicating a pulsation detected by the sensor unit in a state where the pressure is constant; and the region based on the pulse wave distribution Means for identifying a plurality of observation positions and identifying a pulse wave having a maximum amplitude at the plurality of observation positions identified by increasing the pressure, and a pulsation at each observation position having a maximum amplitude at each observation position A means for calculating a numerical score based on the pressure when a pulse wave is obtained; and a score at the plurality of observation positions; and a diagnostic pair for the score based on the integrated score
- diagnostic device diagnostic method, and program, it is possible to perform a cut-off based on pulsation without greatly depending on the examiner.
- FIG. 3 is a plan view illustrating an example of a sensor of a sensor unit 11.
- FIG. It is a figure explaining the state of a sensor and a patient's hand.
- It is sectional drawing which shows the 1st example of a structure of a sensor cell.
- It is sectional drawing which shows the 2nd example of a structure of a sensor cell.
- a plurality of sensors provided in a matrix form that detect pulsation in a state where pressure is applied to the region through the sensor within the region in which the pulsation to be diagnosed is detected
- a sensor unit having a sensor cell is used.
- Acquire pulse wave distribution based on the pulsation detected by the sensor while the applied pressure is constant identify multiple observation positions within the region based on the pulse wave distribution, and increase the applied pressure
- the pulse wave having the maximum amplitude is identified at the plurality of observation positions identified as described above.
- a score obtained by quantifying the pulsation at each observation position based on the pressure when a pulse wave having the maximum amplitude is obtained at each observation position is calculated, and the scores at a plurality of observation positions are integrated.
- the state of the diagnosis target is inferred by referring to the database in which the state of the diagnosis target with respect to the score is stored in advance, and the diagnosis result for the diagnosis target is obtained from the state of the diagnosis target estimated. Generate and output.
- FIG. 1 is a block diagram illustrating an example of a computer system.
- a computer system 20 shown in FIG. 1 has a configuration in which a CPU (Central Processing Unit) 21, which is an example of a processor, a storage unit 22, an input unit 23, a display unit 24, and an interface (I / F) 25 are connected by a bus 26.
- a CPU Central Processing Unit
- storage unit 22 an example of a processor
- input unit 23 an example of a processor
- I / F interface
- the connection of each part in the computer system 20 is not limited to the connection by the bus 26 shown in FIG.
- a DSP Digital Signal Processor
- the CPU 21 controls the entire computer system 20, and can execute diagnostic processing described later by executing a program, or can realize the function of the diagnostic device together with the sensor unit 11.
- the storage unit 22 stores a program executed by the CPU 21, an intermediate result of an operation executed by the CPU 21, a program executed by the CPU 21, data used in the operation, a database, and the like.
- the database is based on well-known Oriental medicine theories such as abnormalities, constitutions, pathological conditions (evidence), diseases, treatment effects, etc. Stores similar analogy results.
- the storage unit 22 can be formed of a computer-readable storage medium.
- the computer-readable storage medium may be a semiconductor storage device.
- the storage unit 22 can be formed by a reader / writer that reads and writes information from and on the loaded recording medium.
- the input unit 23 can be formed with a keyboard or the like, and is used to input commands, data, and the like to the computer system 20.
- the display unit 24 displays a message to the operator, data related to diagnostic processing, and the like.
- the I / F 25 can communicate with an external device including the sensor unit 11 by wire or wirelessly.
- the diagnostic device in one embodiment can be formed by the computer system 20 and the sensor unit 11.
- FIG. 2 is a diagram for explaining the dimensions of a patient's hand, the position of the hand, and the scale.
- the dimensions, functions, and scales of the patient's right hand 15R are at positions indicated by 12R, 13R, and 14R, respectively.
- the dimension, the function, and the scale of the patient's left hand 15L are at positions indicated by 12L, 13L, and 14L, respectively.
- pulsation conditions such as the period (number to slow), pulsation length and width (large to small), pulsation flow rate (smooth to astringency), and pulsation tension (tight to slow), ie, pulsation Based on the six pairs of element parameters, abnormalities, constitutions, pathological conditions (evidence), diseases, therapeutic effects, etc.
- FIG. 3 is a diagram illustrating an example of a pulse wave at a certain observation position.
- the vertical axis indicates the pulsation response in arbitrary units
- the horizontal axis indicates time in arbitrary units.
- (a) shows a pulse wave of a patient who is in a good health state
- (b) shows a pulse wave in a state where the health state of the same patient is decreasing.
- FIG. 3 from the state of the smooth vein 18 in FIG. 3 (b), for example, a patient's swallowing, stagnation, actual fever, etc. can be analogized and diagnosed according to the well-known Oriental medicine theory.
- FIG. 4 is a plan view showing an example of the sensor of the sensor unit 11.
- the sensor (or sheet sensor) 131 includes a sheet 132 and a plurality of sensor cells 133 provided on the sheet 132 in a two-dimensional matrix.
- the sensor cell 133 has an area sufficient to detect the dimension, the function and the scale when the sheet 132 is attached to the patient's hand, that is, an area where pressure can be detected within a predetermined region to be diagnosed.
- the sensor cell 133 can detect a change in pressure with respect to time and an xy coordinate position on the sheet 132 to which pressure is applied. Therefore, the pulse wave distribution can be detected based on the detection signals of the plurality of sensor cells 133.
- FIG. 1 the sensor (or sheet sensor) 131 includes a sheet 132 and a plurality of sensor cells 133 provided on the sheet 132 in a two-dimensional matrix.
- the sensor cell 133 has an area sufficient to detect the dimension, the function and the scale when the sheet 132 is attached to the patient's hand
- the rough broken line 31 indicates the estimated range of the radial artery of the patient's hand located under the sensor 131
- the fine dashed circles 12, 13, and 14 indicate the patient's hand located under the sensor 131, respectively.
- the estimated range 31 and the size of the radial artery 31 and the estimated ranges 12, 13 and 14 of the relationship and the scale of the radial artery may be set to the average range and size of the human radial artery, respectively, It may be set to a range obtained by adding a predetermined error margin to a general range.
- 32 indicates the estimated width of pulsation
- 33 indicates the estimated length of pulsation.
- the estimated length of pulsation is, for example, about 3 mm.
- the position of the patient, the position and the scale of the patient, and the optimum pulse wave are identified.
- the width and length of the pulsation can be identified based on the sensor information.
- FIG. 5 is a diagram illustrating the state of the sensor and the patient's hand.
- the sensor 131 is attached to the skin 151 of the patient's hand 15 so as to cover the dimension 12, the function 13 and the scale 14 of the patient's hand 15.
- Below the skin 151 is a blood vessel 152 to be measured.
- the examiner 900 applies pressure to the sensor 131 and the blood vessel 142 by pressing the sensor 131 toward the skin 151 with the fingertip.
- the sensor unit 11 mechanically applies pressure. You may make it add.
- the sensor 131 detects the pulsation of the blood vessel 142 and outputs analog sensor information (that is, an analog sensor output signal). Even if the analog sensor output signal is converted to a digital signal by an analog / digital converter (ADC, not shown) in the sensor unit 11 and then output to the computer system 20, a signal processing circuit including an external ADC is used. Via the computer system 20.
- ADC analog / digital converter
- FIG. 6 is a schematic diagram showing the wiring of the sensor.
- the upper layer wiring 135 of the sensor 131 is shown in black, and the lower layer wiring 136 is shown in gray.
- the shape of the sensor cell 133 may not be circular.
- FIG. 7 is a sectional view showing a first example of the configuration of the sensor cell.
- the sensor cell 133 has a configuration in which metal electrode films 52 are formed on the upper and lower surfaces of a sensing thin film 51 made of a sensing material such as a piezo material and an organic electret material, and the whole is covered with an insulating thin film 53.
- the sensing material is preferably sensitive to positive pressure and has a sensitivity close to zero for shear force.
- g33 and d33 are 10 times or more than g31 and d31.
- the sensor 131 may be formed of a thin and flexible (ie, soft) sheet, for example, in FIG. 5 so that it can sufficiently adapt to the movement of the living tissue (ie, skin 151 and blood vessel 152) of the patient's hand 15. preferable. Further, for example, from the viewpoint of facilitating pulsation in the hands of the examiner 900 through the sensor 131 in FIG. 5, the sensor 131 is preferably formed of a thin and flexible sheet.
- the Young's modulus of the sensing thin film 51 is preferably 1 GPa or less, for example, and the film thickness of the sensing thin film 51 is preferably 100 ⁇ m or less, for example.
- FIG. 8 is a cross-sectional view showing a second example of the configuration of the sensor cell.
- a protrusion 54 is formed on the metal electrode film 52 via an insulating thin film 53.
- the protrusion 54 may face the patient's hand 15 or the examiner's hand.
- FIG. 9 is a cross-sectional view showing a third example of the configuration of the sensor cell. 9, parts that are the same as the parts shown in FIG. 7 are given the same reference numerals, and explanation thereof is omitted.
- the sensor cell 133 shown in FIG. 9 the sensor region sandwiched between the metal electrodes 55 is formed of the sensing thin film 51, and the region 56 other than the sensor region is formed of a material having a pressure sensitivity lower than that of the sensor region or a material having no pressure sensitivity. Has been.
- FIG. 10 is a cross-sectional view showing a fourth example of the configuration of the sensor cell.
- the configuration shown in FIG. 10 may be formed by removing the sensing thin film 51 in a region other than the sensor region, for example, or may be formed by locally printing the sensor region using a printing method.
- FIG. 11 is a flowchart for explaining an example of the diagnosis process.
- step S2 can be executed by the sensor unit 11
- steps S1, S3 to S7 can be executed by the CPU 21, for example. It is assumed that sensors 131 having the same configuration are similarly mounted on the right hand and the left hand of the patient.
- step S ⁇ b> 1 pressure information (or pressure signal) indicating the pressure applied to the patient's hand 15 via the sensor 131 is input to the computer system 20.
- pressure information may be input from the input unit 23 or a default value stored in the storage unit 22 may be input.
- the sensor part 11 applies a pressure mechanically so that it may mention later, the pressure information stored in the memory
- sensor information or sensor output signal
- step S3 the pulse wave distribution is acquired based on the sensor information.
- step S4 based on the distribution of the pulse wave, the position of the right hand of the patient, the position of the function and the scale, and the size of the left hand of the patient, the position of the function and the scale, that is, the six observation positions are identified and identified. The optimal pulse wave at the six observation positions is identified.
- FIG. 12 is a flowchart for explaining an example of the dimension, function and scale identification process in step S4.
- step S41 sensor information is obtained when a certain pressure is simultaneously applied to the estimated ranges 12, 13, and 14 of the dimensions, functions, and scales of FIG. 4, and in step S42, based on the acquired sensor information.
- the distribution of the amplitude of the pulse wave in the estimated ranges 12, 13, and 14 of the dimension, function and scale is acquired.
- step S43 the position of the maximum point of the amplitude of the pulse wave in each of the estimated ranges 12, 13, and 14 of the dimension, function and scale is acquired.
- FIG. 13 is a diagram showing the amplitude of the acquired pulse wave in the X-axis direction, and the vertical axis shows the amplitude of the pulse wave in arbitrary units.
- FIG. 14 is a diagram showing the amplitude of the acquired pulse wave in the X-axis direction, and the vertical axis shows the amplitude of the pulse wave in arbitrary units.
- the three peaks of the amplitude of the pulse wave correspond to the X coordinate position of each of the dimension, function, and scale.
- three peaks of the amplitude of the pulse wave correspond to the Y coordinate positions of the dimension, function, and scale, respectively.
- FIG. 13 is a diagram showing the amplitude of the acquired pulse wave in the X-axis direction, and the vertical axis shows the amplitude of the pulse wave in arbitrary units.
- the three peaks of the amplitude of the pulse wave correspond to the X coordinate position of each of the dimension, function, and scale.
- three peaks of the amplitude of the pulse wave
- I is a distribution along the Y axis of the amplitude of the pulse wave in the size estimation range 12
- II is a distribution along the Y axis of the amplitude of the pulse wave in the estimation range 13 of Seki
- III is an estimation of the scale. The distribution of the amplitude of the pulse wave in the range 14 along the Y axis is shown.
- step S44 the X coordinate of the right peak in FIG. 13 and the Y coordinate of the left peak in FIG. 14 are defined as the XY coordinate values, and the X coordinate of the central peak in FIG. 13 and the central peak in FIG.
- the Y coordinate is defined as the XY coordinate value of the relation, the X coordinate of the left peak in FIG. 13 and the Y coordinate of the right peak in FIG. 14 are defined as the XY coordinate values of the scale, and the process returns to step S4 in FIG. .
- FIG. 15 is a flowchart for explaining an example of the identification process for the optimum pulse wave of Seki in step S4.
- step S411 the pressure applied to the XY coordinate position of the identified function is increased by a certain amount.
- step S412 the pulse wave of Seki at this time and the pressure applied to the Seki are stored in the storage unit 22.
- step S413 it is determined whether or not the amplitude of the pulse wave has increased. If the determination result is YES, the process returns to step S411, and if the determination result is NO, the process proceeds to step S414.
- step S414 the pulse wave having the maximum amplitude among the pulse waves stored in the storage unit 22 is identified as the optimum pulse wave when the Seki is pressurized alone.
- FIG. 16 is a diagram showing an example of the relationship between the amplitude of the pulse wave and the pressure applied to the observation position such as the relationship, size, and scale.
- the vertical axis indicates the amplitude of the pulse wave in arbitrary units
- the horizontal axis indicates the pressure applied to the observation position such as the function, size, and scale in arbitrary units.
- the pulse wave at the pressure P1 has the maximum amplitude, and P3 ⁇ P1 ⁇ P2.
- FIG. 17 is a diagram showing an example of the relationship between pulsation response and time when different pressures P1, P2, and P3 are applied to the observation positions such as Seki, Dimension, and Measure.
- the vertical axis indicates pulsation response in arbitrary units
- the horizontal axis indicates time in arbitrary units.
- step S414 the pulse wave in the case of the pressure P1 shown in FIG. 17 is identified as the optimum pulse wave of the related function.
- FIG. 18 is a flowchart for explaining an example of the process for identifying the optimum pulse wave of the size in step S4.
- step S421 the pressure applied to the XY coordinate position of the identified size is increased by a certain amount.
- step S422 the pulse wave of the size at this time and the pressure applied to the size are stored in the storage unit 22.
- step S423 it is determined whether or not the amplitude of the pulse wave has increased. If the determination result is YES, the process returns to step S421, and if the determination result is NO, the process proceeds to step S424.
- step S424 the pulse wave having the maximum amplitude among the pulse waves stored in the storage unit 22 is identified as the optimum pulse wave when the dimension is independently pressurized.
- FIG. 19 is a flowchart for explaining an example of the process for identifying the optimum pulse wave of the scale in step S4.
- step S431 the pressure applied to the XY coordinate position of the identified scale is increased by a certain amount.
- step S432 the pulse wave and the pressure applied to the scale at this time are stored in the storage unit 22.
- step S433 it is determined whether or not the amplitude of the pulse wave has increased. If the determination result is YES, the process returns to step S431, and if the determination result is NO, the process proceeds to step S434.
- step S434 the pulse wave having the maximum amplitude among the pulse waves stored in the storage unit 22 is identified as the optimum pulse wave when the scale is pressed alone.
- FIG. 20 is a flowchart for explaining an example of the identification process of the optimum pulse wave of the function, dimension, and scale in step S4 when the function, dimension, and scale are simultaneously pressurized.
- step S441 as described above, the pressure, at which the maximum amplitude appears when the dimension, the scale and the scale are independently pressed, is pressurized as the initial value, and the observation positions of the dimension, the dimension and the scale are pressurized.
- the pressure applied to the observation positions of Seki, Dimension and Scale is increased or decreased by a certain amount.
- the pulse wave and the pressure applied to each observation position of Seki, Seki, and Seki at each observation position of Seki, Seki, and Saku at this time are stored in the storage unit 22.
- step S443 it is determined whether or not the pulse wave at each observation position of Seki, Dimension and Scale has a maximum amplitude (an amplitude greater than the maximum amplitude of the pulse wave when the Seki, Dimension and Scale are individually pressurized). If the result is YES, the process returns to step S442, and if the determination result is NO, the process proceeds to step S446. In step S446, among the pulse waves stored in the storage unit 22, the pulse wave having the maximum amplitude at each observation position of Seki, Dimension, and Seki is set as the optimum pulse wave when the Seki, Dimension, and Measure are simultaneously pressurized. Identify.
- step S5 a score is calculated for pulsations at a total of six observation positions, that is, the dimensions of both the left and right hands of the patient, the function and the scale. That is, the pulsation at each observation position is digitized according to a predetermined algorithm based on the pressure applied when the optimum pulse wave is obtained at each observation position.
- pulsation depth floating to sinking
- pulsation amplitude imaging to real
- pulsation cycle number to slow
- pulsation length and width large to small
- pulsation flow rate sliding
- Scores are calculated according to a predetermined algorithm for pulsation states (that is, element parameters) such as ⁇ astringency) and pulsation tension (tight to loose). For example, by storing a table in which the score for the pressure applied when the optimum pulse wave is obtained at the observation position is stored in the storage unit 22, in step S5, by referring to this table, a total of six observation positions can be obtained. Can score against pulsation.
- step S6 the scores at a total of six observation positions are integrated, and the state of the patient is inferred by referring to the database based on the integrated score.
- the database stores analogy results in accordance with well-known Oriental medicine theories such as abnormalities, constitutions, pathological conditions (evidence), illnesses, and therapeutic effects of the patient's viscera (internal organs) for the pulsation element parameter scores ing.
- the database preferably stores at least one analogy result among the patient's visceral (visceral) abnormality, constitution, pathological condition (evidence), disease, therapeutic effect, etc., with respect to the pulsation element parameter score, More preferably, two or more analogy results are stored for the pulsation element parameter score among the abnormalities of the patient's viscera (internal organs), constitution, pathological condition (evidence), disease, therapeutic effect, and the like.
- the database may be stored in the storage unit 22 or may be stored in an external storage unit (not shown).
- step S7 a diagnostic result is generated and output from the analogy result obtained in step S6, and the diagnostic process ends.
- the diagnosis results may include scores at a total of six observation positions, visceral fistula (internal organs), constitution, pathological condition (evidence), therapeutic effect (prognosis), and the like.
- the diagnosis result may be output and displayed on the display unit 24, stored as part of the electronic medical record in the storage unit 22, or output to an external device (not shown) via the I / F 25. good.
- FIG. 21 is a diagram illustrating an example of database learning processing.
- steps S11 to S17 are executed interactively by the computer 20 with the examiner.
- steps ST1 and ST2 are executed by the examiner.
- an analog sensor output signal from the sensor 131 is input to the computer 20 via the signal processing circuit 19.
- the signal processing circuit 19 performs signal processing, such as amplification, filtering, and ADC, on the analog sensor output signal, and outputs the digital sensor output signal to the I of the computer system 20 via a wired, wireless, or wired / wireless network. / F25 (not shown).
- step S11 in step S11, the dimensions of the left and right hands of the patient, the XY coordinate positions of the functions and the scale are identified in step S11, and in step S12, the patient is identified as step S4 in FIG.
- the optimal pulse wave at the XY coordinate position of the identified dimension, function and scale of both left and right hands is identified.
- step S13 as in step S5 of FIG. 11, a score is calculated for pulsations at a total of six observation positions of the dimensions of the left and right hands of the patient, the function, and the scale.
- the examiner inputs supplementary information about the patient obtained by, for example, tongue examination, abdominal examination, medical inquiry, etc. in step ST1, and uses the calculated score as supplementary information. Correction may be performed based on the score or the score may be classified.
- step S14 as in step S6 of FIG. 11, the scores at a total of six observation positions are integrated, and the state of the patient is inferred by referring to the database based on the integrated scores.
- the examiner may input the analogy result by the examiner himself in step ST2, for example, from the input unit 23, and correct the analogy result obtained from the database.
- step S14 the examiner selects one analogy result by operating the input unit 23 from the plurality of analogy results displayed on the display unit 24 in step ST2. You may make it select. If the analogy result is corrected in step S14, the process returns to step S13, and score calculation, classification, and the like are performed again.
- step S15 as in step S7 in FIG. 11, a diagnostic result is generated based on the analogy result and displayed on the display unit 24, for example.
- the diagnosis results may include scores at a total of six observation positions, visceral fistula (internal organs), constitution, pathological condition (evidence), therapeutic effect (prognosis), and the like.
- step S16 it is determined whether or not to correct the diagnosis result.
- the examiner may input the diagnosis result of the examiner himself at step ST2 from the input unit 23, for example, and correct the diagnosis result.
- the examiner operates one of the plurality of diagnosis results displayed on the display unit 24 in step ST2 by operating the input unit 23. You may make it select. If the diagnosis result is corrected in step S16, the process returns to step S15 to generate the diagnosis result again.
- step S17 the diagnosis result is stored as a part of the electronic medical record, for example, in the storage unit 22, thereby updating the electronic medical record database.
- the examiner holds the sensor 131.
- the patient's pulsation can be palpated through.
- acquisition of the pulse wave by the sensor 131 and palpation of the examiner can be performed at the same time, and the numerical value in the pressure diagnosis of the examiner can be obtained. That is, since the pulsation is transmitted to the examiner's hand via the sensor 131, both the sense of the examiner's fingertip and the electrical signal of the pulse wave are obtained, and at the same time the examiner touches useful information from the fingertip.
- the diagnostic conditions (pressure position, pressure, etc.) of the examiner and the biological reaction (pulse wave, hardness, pressure, etc.) indicated by the pulsation can be converted into electrical signals and recorded.
- the examiner performs the operation of searching for the position of the dimension, the function and the scale through the sensor 131 while feeling the pulsation by placing the fingertip on the radial artery of the patient, so that the examiner can detect the dimension identified by the diagnostic apparatus.
- the accuracy of the examiner's operation and the like can be confirmed by comparing the positions of the function and the scale with the position felt with the fingertip.
- the examiner applies an optimal pressure (pressure at which the pulsation is felt to the maximum) to the patient's radial artery with the fingertip, and performs an operation of palpating the pulsation through the sensor 131, so that the examiner The accuracy of the examiner's movement and the like can be confirmed by comparing the optimum pulse wave identified by the pressure with the pressure felt at the fingertip.
- the diagnostic device is applied to the education of the examiner who manually performs the operation of manually identifying the positions of the dimensions, functions, and scales and the operation of manually identifying the optimum pulse wave at the dimensions, functions, and scales. It is also possible.
- FIG. 22 is a diagram illustrating an example of a sensor unit attached to a patient's hand.
- FIG. 23 is a diagram illustrating the configuration of the sensor unit illustrated in FIG.
- the sensor unit 11 is attached to a portion including the dimensions, functions, and scales of the patient's hand 15.
- the sensor unit 11 includes a pressurizing unit 111.
- the pressurizing unit 111 pressurizes the pressurizing region 112.
- the sensor unit 11 has a belt 113 that can be connected by a connection unit 113 ⁇ / b> A, and is mounted around a patient's hand (arm) 15.
- the belt 113 is provided with an airbag 115 and a sensor 131 attached to the airbag 115.
- the airbag 115 only needs to have a structure that independently pressurizes three regions corresponding to dimensions, functions, and scales, and may be formed of three separate airbags.
- the air bag 115 is infused with air by a pump 116 provided on the belt 113, and the pressure for pressurizing the hand 15 is controlled.
- the pump 116 may have three pump parts capable of injecting air independently into three regions corresponding to the dimensions, functions and scales of the airbag 115.
- the pump 116 can be controlled by the CPU 21, and the CPU 21 can independently control the pressurization of the hand 15 by the three regions of the airbag 115.
- the airbag 115 and the pump 116 are an example of a pressurizing unit.
- the pump 116 may be configured separately from the belt 113 and externally connected to the belt 113.
- the air from the pump 116 may be supplied to the airbag 115 via a tube connected to the belt 113, for example.
- the pressurizing means is not limited to the airbag 115 and the pump 116.
- a mechanism for directly applying pressure to the hand by a pump or the like can be used, and mechanical means for applying pressure to the patient's hand 15 mechanically. If it is, it will not specifically limit.
- the computer system 20 automatically positions the dimensions, functions, and scales without bothering the examiner. And an operation for identifying the optimum pulse wave at the dimension, function, and scale.
- Sensor unit 20 Computer system 21 CPU 22 storage unit 23 input unit 24 display unit 25 I / F 26 Bus 131 Sensor
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Abstract
Description
20 コンピュータシステム
21 CPU
22 記憶部
23 入力部
24 表示部
25 I/F
26 バス
131 センサ
Claims (17)
- 診断対象の脈動を検知する領域内で、センサを介して前記領域に圧力が加えられた状態で前記脈動を検知する、前記センサにマトリクス状に設けらた複数のセンサセルを有するセンサ部と、
前記圧力が一定の状態で前記センサ部で検知された脈動を示すセンサ信号に基づき、脈波の分布を取得する手段と、
前記脈波の分布に基づき、前記領域内の複数の観察位置を同定すると共に、前記圧力を増加して同定した複数の観察位置において最大振幅を有する脈波を同定する手段と、
各観察位置における脈動を各観察位置で最大振幅を有する脈波が得られる時の前記圧力に基づいて数値化したスコアを演算する手段と、
前記複数の観察位置におけるスコアを統合し、統合されたスコアに基づいて、スコアに対する診断対象の類推された状態を予め格納されたデータベースを参照することで、診断対象の状態を類推する手段と、
前記類推した診断対象の状態から前記診断対象に対する診断結果を生成して出力する手段
を備えたことを特徴とする診断装置。 - 前記複数の観察位置は、橈骨動脈の寸、関及び尺であることを特徴とする、請求項1記載の診断装置。
- 前記演算する手段は、脈動の深さ、脈動の振幅、脈動の周期、脈動の長さと幅、脈動の流利度及び脈動の緊張度を含む脈動状態に対して所定のアルゴリズムに従って前記スコアを演算することを特徴とする、請求項1または2記載の診断装置。
- 前記データベースに予め格納された、前記脈動状態のスコアに対して類推された診断対象の状態は、東洋医学の理論に従った臓腑の異常、体質、病態、疾病及び治療効果のうち少なくとも1つであることを特徴とする、請求項3記載の診断装置。
- 前記センサは、柔軟性を有するシートを有し、前記複数のセンサセルは前記シート上に設けられていることを特徴とする、請求項1乃至4のいずれか1項記載の診断装置。
- 前記センサ部は、前記圧力を加える加圧手段を有することを特徴とする、請求項1乃至5のいずれか1項記載の診断装置。
- 前記加圧手段は、エアバッグを有することを特徴とする、請求項6記載の診断装置。
- コンピュータが実行する診断方法であって、
診断対象の脈動を検知する領域内で、センサを介して前記領域に圧力が加えられた状態で前記脈動を検知する、前記センサにマトリクス状に設けらた複数のセンサセルを有するセンサ部からのセンサ信号を入力する手順と、
前記圧力が一定の状態で前記センサ部で検知された脈動を示すセンサ信号に基づき、脈波の分布を取得する手順と、
前記脈波の分布に基づき、前記領域内の複数の観察位置を同定すると共に、前記圧力を増加して同定した複数の観察位置において最大振幅を有する脈波を同定する手順と、
各観察位置における脈動を各観察位置で最大振幅を有する脈波が得られる時の前記圧力に基づいて数値化したスコアを演算する手順と、
前記複数の観察位置におけるスコアを統合し、統合されたスコアに基づいて、スコアに対する診断対象の類推された状態を予め格納されたデータベースを参照することで、診断対象の状態を類推する手順と、
前記類推した診断対象の状態から前記診断対象に対する診断結果を生成して出力する手順
を前記コンピュータに実行させることを特徴とする診断方法。 - 前記複数の観察位置は、橈骨動脈の寸、関及び尺であることを特徴とする、請求項8記載の診断方法。
- 前記演算する手順は、脈動の深さ、脈動の振幅、脈動の周期、脈動の長さと幅、脈動の流利度及び脈動の緊張度を含む脈動状態に対して所定のアルゴリズムに従って前記スコアを演算することを特徴とする、請求項8または9記載の診断方法。
- 前記データベースに予め格納された、前記脈動状態のスコアに対して類推された診断対象の状態は、東洋医学の理論に従った臓腑の異常、体質、病態、疾病及び治療効果のうち少なくとも1つであることを特徴とする、請求項10記載の診断方法。
- 前記センサ部は、前記圧力を加える加圧手段を有し、
前記加圧手段を制御する手順
を前記コンピュータにさらに実行させることを特徴とする、請求項8乃至11のいずれか1項記載の診断方法。 - コンピュータに診断処理を実行させるプログラムであって、
診断対象の脈動を検知する領域内で、センサを介して前記領域に圧力が加えられた状態で前記脈動を検知する、前記センサにマトリクス状に設けらた複数のセンサセルを有するセンサ部からのセンサ信号を入力する手順と、
前記圧力が一定の状態で前記センサ部で検知された脈動を示すセンサ信号に基づき、脈波の分布を取得する手順と、
前記脈波の分布に基づき、前記領域内の複数の観察位置を同定すると共に、前記圧力を増加して同定した複数の観察位置において最大振幅を有する脈波を同定する手順と、
各観察位置における脈動を各観察位置で最大振幅を有する脈波が得られる時の前記圧力に基づいて数値化したスコアを演算する手順と、
前記複数の観察位置におけるスコアを統合し、統合されたスコアに基づいて、スコアに対する診断対象の類推された状態を予め格納されたデータベースを参照することで、診断対象の状態を類推する手順と、
前記類推した診断対象の状態から前記診断対象に対する診断結果を生成して出力する手順
を前記コンピュータに実行させることを特徴とするプログラム。 - 前記複数の観察位置は、橈骨動脈の寸、関及び尺であることを特徴とする、請求項13記載のプログラム。
- 前記演算する手順は、脈動の深さ、脈動の振幅、脈動の周期、脈動の長さと幅、脈動の流利度及び脈動の緊張度を含む脈動状態に対して所定のアルゴリズムに従って前記スコアを演算することを特徴とする、請求項13または14記載のプログラム。
- 前記データベースに予め格納された、前記脈動状態のスコアに対して類推された診断対象の状態は、東洋医学の理論に従った臓腑の異常、体質、病態、疾病及び治療効果のうち少なくとも1つであることを特徴とする、請求項15記載のプログラム。
- 前記センサ部は、前記圧力を加える加圧手段を有し、
前記加圧手段を制御する手順
を前記コンピュータにさらに実行させることを特徴とする、請求項13乃至16のいずれか1項記載のプログラム。
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JP7143585B2 (ja) | 2017-11-30 | 2022-09-29 | ヤマハ株式会社 | 生体センサ |
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JPWO2014181467A1 (ja) | 2017-02-23 |
EP2995249A4 (en) | 2016-05-18 |
CN105407796A (zh) | 2016-03-16 |
EP2995249A1 (en) | 2016-03-16 |
JP6149929B2 (ja) | 2017-06-21 |
KR20150140787A (ko) | 2015-12-16 |
US20160058393A1 (en) | 2016-03-03 |
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