研究生: |
陳均曄 Chun-Yeh Chen |
---|---|
論文名稱: |
非侵入式循環訊號量測系統應用於不同癌症之偵測與評估 Non-invasive circulatory signal measurement system for detection and evaluation of different cancers |
指導教授: |
許昕
Hsin Hsiu |
口試委員: |
許昕
Hsin Hsiu 許中華 Chung-Hua Hsu 許維君 Wei-Chun Hsu 鮑建國 Jian-Guo Bau |
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: | 2019 |
畢業學年度: | 107 |
語文別: | 中文 |
論文頁數: | 174 |
中文關鍵詞: | 非侵入式量測 、循環訊號系統 、早期偵測 、療效評估 、癌症 、脈波 |
外文關鍵詞: | Non-invasive measurement, Circulatory signal system, Early detection, Efficacy evaluation, Cancer, Blood Pulse Wave |
相關次數: | 點閱:237 下載:0 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
癌症一直是全球主要的死亡原因,透過早期偵測的方式,提高患者存活率及降低復發的可能性。另一方面,對於病患後續的療效評估也很重要,現今仍舊欠缺較為客觀、即時且數據化的評估方式,來幫助病患一同對抗癌症。
本次實驗重點分為兩部分:早期偵測、療效評估
一、 早期偵測
1. 病患與健康者的比較(大腸直腸癌組、乳癌組)
2. 不同癌症的比較(大腸直腸癌組vs乳癌組)
二、 療效評估
1. 不同癌症之手術前後比較(大腸直腸癌組vs乳癌組)
2. 水腫的不同治療之差別(針灸組vs貼珠組)
3. 有無服用寬心飲之比較(NK組、K組、K2組)
4. 無大腸直腸癌組之年齡比較
本實驗室開發的非侵入式循環訊號量測系統,其設備包含了心電圖訊號放大器(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),分別對於心臟端、動脈端、動脈端至部份微循環、微循環端進行量測,期望可以從中找出癌症對於人體循環系統心血管及血流特性的變異,幫助達到早期偵測與療效評估的目的。
實驗結果發現,BP、PPG、LDF的生理循環參數在部分諧波參數或血流參數有顯著上的差異,代表此量測系統對於癌症造成的改變是有一定程度的解析能力,詳細內容參見第五章成果討論。代表未來臨床上,可以縮短早期偵測病情所需時間,也幫助醫師進行療效評估,更能擴展非侵入式穿戴式裝置的普及,受益更多的病患。
Cancer has always been a major cause of death in the world, and its early detection can improve the survival rate of patients and reduce the possibility of recurrence. Conversely, it is also important to evaluate the efficacy of patients’ subsequent treatments. However, an objective, real-time data-based evaluation method to help patients to fight cancers is still lacking.
The key points of this experiment are divided into 2 parts: early detection and efficacy evaluation:
I. Early detection
1. Comparison between patientsand healthy subjects (colorectal cancer group and breast cancer group)
2. Comparison between different cancers (colorectal cancer group vs. breast cancer group)
II. Efficacy evaluation
1. Comparison before and after surgery in patients with different cancers (colorectal cancer group vs. breast cancer group)
2. Differences between different treatments for edema (acupuncture group vs. beads group)
3. Comparison between groups with or without taking Kuan-Sin-Yin (NK, K, and K2 groups)
4. Age comparison of patients in a group with no colorectal cancer
A non-invasive circulatory signal measurement system was developed in this laboratory, which includes ECG, BPW, PPG, and LDF. The system is used at the heart, arteries, and microcirculation for measurement. We hope to identify changes in characteristics of blood vessels and blood flow of the human circulatory system caused by cancers and to achieve the goals of early detection and efficacy evaluation.
The results showed that there are significant differences in partial harmonic parameters or blood flow parameters of BP, PPG, and LDF as well as physiological parameters, indicating that this measurement system has certain resolution capabilities for detecting changes caused by cancers. Please refer to the discussion of results in chapter 5 for detailed content. This means that the system can shorten the time needed for early detection of cancer and assist physicians in efficacy evaluation in future clinical practice. It can also expand to popular non-invasive wearable devices and benefit more patients.
1. 衛生福利部統計處. (2018) . 106年國人死因統計結果. Retrieved from https://www.mohw.gov.tw/cp-16-41794-1.html
2. 衛生福利部國民健康署.( 2018) . 乳癌防治. Retrieved from
https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=205&pid=1124
3. 衛生福利部國民健康署. (2018). 大腸癌防治概況. Retrieved from
https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=615&pid=1126
4. 衛生福利部國民健康署. (2017). 癌症防治. Retrieved from
https://www.hpa.gov.tw/Pages/List.aspx?nodeid=47
5. 衛生福利部國民健康署. (2017). 乳癌篩檢簡介. Retrieved from
https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=623&pid=1140
6. 世界衛生組織.(2018). 癌症. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/cancer
7. MDAnderson Cancer Center. The Brief Pain Inventory. Retrieved from
https://www.mdanderson.org/research/departments-labs-institutes/departments-divisions/symptom-research/symptom-assessment-tools/brief-pain-inventory.html
8. MDAnderson Cancer Center. The Brief Fatigue Inventory. Retrieved from
https://www.mdanderson.org/research/departments-labs-institutes/departments-divisions/symptom-research/symptom-assessment-tools/brief-fatigue-inventory.html
9. E.A. Eisenhauera, P.Therasse,J.Bogaerts,L.H.Schwartz,et al.( 2009) New response
evaluation criteria in solid tumours:Revised RECIST guideline. EJC45,228-247.
10.三軍總醫院放射腫瘤科. (2019). 放射治療之基本原理. Retrieved from
https://wwwv.tsgh.ndmctsgh.edu.tw/unit/10026/24286
11.楊靜蘭、吳英黛. (2003). 淋巴水腫的物理治療. 物理治療, 28( 3),157-165.
12.許昇峰. (2002). 針灸醫學介紹. 中醫藥健康資訊服務網. Retrieved from
http://ejournal.nricm.edu.tw/nricm2/pages/frame-book.php?qry_subject=27
13. Tsai-Ju Chien, MD, Chia-Yu Liu, MD, Pin-Hao Ko,and Chung-Hua Hsu, MD,
PhD.(2016)A Chinese decoction, Kuan-Sin-Yin, improves autonomic function and cancer-related symptoms of metastatic colon cancer. Integrative cancer therapies,15(1),113-123..
14.邱汗兮. (2018). 循環量測應用於五十肩復健效應之研究.
15. Folkman,J. (2006). Angiogenesis. Annu Rev Med,57,1-18. Retrieved from
https://www.annualreviews.org/doi/abs/10.1146/annurev.med.57.121304.131306.
16.陳冠彰. (2016). 循環訊號量測應用於乳癌患者病程監控之研究.
17.劉緻柔.( 2018). 乳癌化療與服用寬心飲微循環效應之探討.
18.吳奇燊. (2014). 基於脈象結構開發輔助中醫脈診之行動 APP.
19.林明政, 李名世,王俊民, et al.( 2002). 雷射杜卜勒微流儀之原理與臨床醫學之應
用. 台灣醫檢會報, 17( 5).
20.研華科技Advantech. (2017). USB-4704. Retrieved from
https://www.advantech.tw/products/1-2mlkno/usb-4704/mod_4d0800cc-f6fd-402a-9782-24cd0ffdaf42
21. Lu, W., Cheng, C., Wang, Y. L., et al. (1996). Pulse spectrum analysis of hospital patients with possible liver problems. The American journal of Chinese medicine, 24(03n04), 315-320.
22. Tsai-Ju Chien, Chia-Yu Liua, Chin-Wei Kuo, Yang-Chao Linf , Chung-Hua Hsu. (2016). Therapeutic efficacy of Traditional Chinese medicine, “Kuan-Sin-Yin”, in patients undergoing chemotherapy for advanced colon cancer – A controlled trial. Complementary Therapies in Medicine, 29, 204-212. doi:https://doi.org/10.1016/j.ctim.2016.10.001
23. Hsiu, H., et al., Effects of acupuncture on the harmonic components of the radial arterial blood-pressure waveform in stroke patients. Biorheology, 2013. 50: p. 69-81.
24. Hsiu, H., et al., Complexity analysis of beat-to-beat skin-surface laser-Doppler signals in diabetic subjects. Microvascular Research, 2014. 93: p. 9-13.
25. V.Keeley,S.Crooks,J.Locke,D.Veigas,K.Riches,R.Hilliam. (2010).A quality of life measure for limb lymphoedema.Journal of Lymphoedema,5(1)
26.萬崇華, 陳明清, 張燦珍, et al. (2005). 癌症患者生命質量測定量表 EORTC QLQ-C30 中文版評介. 實用腫瘤雜誌, 20(4), 353-355.