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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
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  • 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.

    論文摘要 I Abstract II 誌謝 IV 目錄 V 圖索引 VII 表索引 XII 第一章 緒論 1 1.1 研究背景 1 1.1.1 癌症的威脅 1 1.1.2 早期偵測的重要性 2 1.1.3 療效評估的用途 3 1.1.4 治療方式 4 1.1.5 循環系統與慢性疾病 5 1.2 研究動機與目的 6 第二章 實驗流程與硬體介紹 7 2.1 實驗流程 7 2.1.1 條件控制 10 2.1.2 實驗步驟 12 2.2 實驗硬體介紹 15 2.2.1 心電訊號描述放大器(Electrocardiography, ECG) 16 2.2.2 動脈血壓波形感測器(Blood Pressure Waveform, BPW) 17 2.2.3 血管光容積感測器(Photoplethysmography, PPG) 20 2.2.4 雷射都卜勒血流儀(Laser Doppler Flowmetry, LDF) 22 2.2.5 資料擷取模組 24 2.2.6 電腦端擷取程式 25 第三章 分析方法與參數介紹 26 3.1 分析流程 26 3.2 BPW、PPG頻域參數 27 3.3 LDF時域、血流參數 29 3.4 參數生理意義 31 3.4.1 BPW、PPG參數之生理意義 31 3.4.2 LDF參數之生理意義 32 第四章 實驗結果 34 4.1 不同癌症的比較 36 4.2 不同癌症之手術前後比較 49 4.3 水腫的不同治療之差別 62 4.4 有無服用寬心飲之比較 96 4.5 無大腸直腸癌組之年齡比較 123 第五章 實驗成果討論 134 5.1 不同癌症的比較 134 5.1.1 BPW之參數討論 134 5.1.2 LDF之參數討論 135 5.1.3 PPG之參數討論 135 5.2 不同癌症之手術前後比較 136 5.2.1 BPW之參數討論 136 5.2.2 LDF之參數討論 137 5.2.3 PPG之參數討論 137 5.3 水腫的不同治療之差別 138 5.3.1 BPW之參數討論 138 5.3.2 LDF之參數討論 139 5.4 有無服用寬心飲之比較 140 5.4.1 BPW之參數比較 140 5.4.2 LDF之參數比較 141 5.4.3 PPG之參數討論 142 5.5 無大腸直腸癌組之年齡比較 143 第六章 結論與未來展望 144 6.1 結論 144 6.2 未來展望 146 第七章 文獻參考 147 第八章 附件 149 附件一、 IRB計畫修正許可書 149 附件二、中醫體質分類與判定自測表 150 附件三、LYMQOL ARM-Scoring System 155 附件四、EORTC QLQ-C30 157

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