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研究生: 邱汗兮
Han-Si Chiou
論文名稱: 循環量測應用於五十肩 復健效應之研究
Study of noninvasive circulatory measurements in the rehabilitation effect in patients with adhesive capsulitis
指導教授: 許昕
Hsin Hsiu
口試委員: 許昕
Hsin Hsiu
鮑建國
Jian-Guo Bau
廖愛禾
Ai-Ho Liao
學位類別: 碩士
Master
系所名稱: 應用科技學院 - 醫學工程研究所
Graduate Institute of Biomedical Engineering
論文出版年: 2018
畢業學年度: 106
語文別: 中文
論文頁數: 102
中文關鍵詞: 五十肩沾黏性關節囊炎復健效應循環量測動脈血壓波形光血容積訊號儀雷射都卜勒血流儀
外文關鍵詞: Adhesive Capsulitis, Rehabilitation Effect, Photoplethysmograph
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五十肩疾病所帶來的疼痛以及肩關節的活動受限造成患者在生活中及工作上的諸多不便與困擾,本研究設計將利用本實驗室自行開發之量測系統對五十肩患者進行量測,並探討五十肩患者與正常組之差異、復健過程中患者循環生理參數的改變等等之比較。
除了復健科的復健方式如熱敷、電療、徒手治療等等,中醫的針灸也是五十肩患者可以選擇之復健方式,這些方式多為增進血液循環、刺激穴道,改善周邊循環系統,故希望透過此研究的進行,由循環去觀察五十肩這個疾病,觀察五十肩患者在循環系統上的差異及改變。本研究中,驗證本實驗室自行開發的系統對於五十肩復健效應的解析能力,期望能達到即時監控且客觀評估的目的,並能提供醫師做患者病況的評估及復健方式的選擇,也能使患者更了解自身改善狀況。
本實驗室所開發之微循環量測系統所包含的設備有心電圖訊號放大器(ECG)、動脈血壓波形模組(BPW)、光血容積訊號儀(PPG)、雷射都卜勒血流儀(LDF),分別可量測到心臟端、動脈端、動脈端與部分微循環端及微循環端。
在BP、PPG及LDF之生理循環參數與部分諧波趨勢整理及顯著差異上皆能看出不同的差異,代表此量測系統對復健效應所對患者造成的改善具有相當的解析能力,詳細比較可參見第五章成果討論,此結果代表此套量測能以非侵入、即時且客觀的方式對患者復健效果進行量測評估。


The pain and shoulder movement restriction caused by adhesive capsulitis can inflict severe inconvenience and suffering upon the patients in their work and everyday life. In this study, an assessment system developed in our lab was used to evaluate patients with adhesive capsulitis and to compare the difference between these patients and normal control group. In addition, the changes in physiological parameters of the circulatory system in the patients during rehabilitation were investigated.
In addition to the rehabilitation methods typically provided by the rehabilitation department, such as thermotherapy, electrotherapy, and manipulative therapy, the acupuncture from traditional Chinese medicine may also be a rehabilitation option for patients with adhesive capsulitis. Most of these treatments are used to promote blood circulation, stimulate acupuncture points (acupoints) or improve peripheral vascular system. Therefore, this study investigated the effects of adhesive capsulitis on the circulatory system and observed the differences and changes in the circulatory system of patients with adhesive capsulitis. In this study, the assessment system developed in our lab was tested for its ability to analyze the effectiveness of adhesive capsulitis rehabilitation. Our goal was to realize real time monitoring and objective evaluation, to provide doctors with assessment method for patient symptoms and assistance in choosing rehabilitation treatments, and to help patients better track their own improvement.
The devices in the microcirculatory measurement system developed by our laboratory includes ECG, BP, PPG, and LDF, which can respectively measure the heart, arteries, arteries and some microcirculation, and microcirculation.
Differences were found by comparing the systemic circulatory parameters and part of the harmonic trend of blood pressure, photoplethysmography (PPG), and laser-Doppler flowmetry and analyzing the significance. We found that the assessment system has considerable analytical power in evaluating patient improvement over rehabilitation. Detailed comparisons are shown in section 5 (Results and Discussion). The results suggest that this assessment system can provide a non-invasive, real time, and objective evaluation of the effectiveness and efficiency of patient rehabilitation.

論文摘要 I ABSTRACT II 目錄 V 圖目錄 VII 第一章 緒論 1 第1節 研究背景 1 1.1.1 五十肩疾病 1 1.1.2 五十肩與循環系統 1 1.1.3 現有臨床上困境 3 第2節 研究動機與目的 4 第二章 實驗介紹與流程 6 第1節 實驗硬體介紹 6 2.1.1 心電訊號描述放大器 ECG (Electrocardiography) 7 2.1.2 動脈血壓波形感測器 BPW (Blood Pressure Waveform) 8 2.1.3 血管光容積感測器 PPG (Photoplethysmography) 11 2.1.4 雷射都卜勒血流儀 LDF (Laser Doppler Flowmetry) 13 2.1.5 類比數位擷取卡 15 2.1.6 電腦端擷取程式 16 第2節 實驗流程 17 2.2.1 受測者納入及排除條件 19 2.2.2 研究量測順序 20 第三章 循環血流參數介紹 24 第1節 BPW時域參數及頻域參數 24 第2節 PPG頻域參數 27 第3節 LDF時域參數 27 第四章 實驗結果 30 第1節 M0 vs. 正常 32 第2節 患健側 vs.正常 56 第3節 M0~M3之比較 64 第4節 男女患者55歲前後之比較 84 第5節 BPW與PPG的相關性比較 85 第五章 實驗討論與未來展望 89 第1節 循環參數對應之生理意義 89 第2節 成果討論 92 第3節 結論與未來展望 98 文獻參考 101  

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