JP2020054639A - Electronic sphygmomanometer and blood pressure measurement system - Google Patents

Abstract

To guide a subject to a meditation state while continuously detecting pulse waves without giving the subject any pain or discomfort by using a cuff and to notify a change of blood pressure value before and after that as an effect of meditation induction.SOLUTION: An electronic sphygmomanometer detects pulse waves and cuff pressure of a subject at a part where the cuff is worn, determines blood pressure value of the subject on the basis of the detected cuff pressure and pulse waves, determines lowest pressure that can detect pulse waves through the cuff, guides the subject to a meditation state in the state that the cuff pressure is held in the lowest pressure, analyzes the pulse waves detected during meditation induction, calculates largest Liapunov index showing fluctuation level of the subject's heartbeat interval, determines on the basis of the largest Liapunov index whether the subject has negative feelings, feeling cerebral fatigue, anxieties or depression or positive feelings, feeling no cerebral fatigue, anxieties or depression, performs blood pressure measurement and meditation induction in order of blood pressure measurement, meditation induction and blood pressure measurement, and notifies a result of feeling determination and a result of blood pressure measurement before and after the meditation induction.SELECTED DRAWING: Figure 3

Description

  The present invention relates to an electronic sphygmomanometer and a blood pressure measurement system.

  Patent Literature 1 teaches a user a breathing training pattern, detects biological information (pulse wave information) of the user, and controls detection of biological information at a timing related to a training period in which the training pattern is guided. A feature amount (blood pressure value) that reflects a training index that is a target of respiratory training is calculated based on the detected biological information, and an effect index (degree of drop in blood pressure value) that indicates the effect of respiratory training based on at least two feature amounts. And a respiratory trainer that calculates and informs the user.

  Patent Literature 2 discloses a sphygmomanometer that holds a cuff pressure at a constant pressure lower than a diastolic blood pressure (diastolic blood pressure) by a predetermined pressure (about 10 mmHg) and calculates a basal pulse rate from an output from a pulse wave detecting unit during that time. Have been. Patent Literature 3 discloses a blood pressure measurement device that detects a pulse wave in a state where the pressure of the cuff is maintained at a predetermined pressure value lower than the average blood pressure value determined by the blood pressure value determining means.

JP 2007-190275 A JP 2003-265420 A JP-A-6-292660

  In the case of stressful hypertension, when taking a deep breath or listening to music and entering a meditation state, the effect of stabilizing the autonomic nerve and lowering the blood pressure can be obtained. For this reason, the subject is guided to a meditation state by a sphygmomanometer or a device linked to the sphygmomanometer, and the effect (result) of the subject's autonomous training to stabilize the autonomic nervous system is the change in blood pressure value before and after the meditation guidance. Showing is useful.

  If the effect of meditation guidance (autonomous training) is obtained, the subject's emotions initially change from negative feelings of brain fatigue, anxiety or depression to positive emotions without brain fatigue, anxiety and depression. I do. Also, these positive and negative emotions have a correlation with the fluctuation degree of the interval between pulse waves. For this reason, in order to see the effect of meditation guidance, the subject's pulse wave is continuously monitored during meditation guidance, instead of simply performing respiratory training and observing the change in blood pressure before and after that as in the respiratory trainer of Patent Document 1. Must be detected and analyzed.

  A general oscillometric blood pressure monitor is a device that detects a pulse wave. The wrist or upper arm is pressed by a cuff, and a blood pressure value is measured based on a change in a pulse wave peak value during decompression. For this reason, if meditation guidance is performed while detecting a pulse wave using a general blood pressure monitor, the subject will continue to be tightened with a cuff for several minutes during the guidance, and the subject will feel pain, and the autonomic nervous system will suffer. Stability is hindered and autonomous training cannot be established. Even if the cuff pressure is kept lower than the minimum blood pressure or the average blood pressure by a certain amount as in the sphygmomanometers of Patent Literatures 2 and 3 during the meditation guidance, the cuff pressure to be held is also high when the blood pressure of the subject is high. Therefore, the subject eventually feels pain.

  In order to detect pulse waves without giving the subject pain and discomfort during the execution of meditation guidance (autonomous training), an electrode for pulse wave detection and a sensor for detecting microwaves are separately prepared and used together. To measure pulse waves and electrocardiograms. However, in this case, the manufacturing cost of the device increases, the subject keeps holding the electrodes during the autonomous training, the power of the mobile phone is turned off for countermeasures against jamming, and the handling of the sensor for pulse wave detection is performed. There is a risk that the psychological burden of worrying about and will increase.

  Therefore, the present invention provides a method for guiding a subject to a meditative state while continuously detecting a pulse wave without causing pain and discomfort to the subject using a cuff. It is an object to provide an electronic sphygmomanometer and a blood pressure measurement system that are notified as "."

  A cuff, a pressurizing unit that pressurizes the cuff, a depressurizing unit that depressurizes the cuff, a pressure detecting unit that detects a cuff pressure that is a pressure of air in the cuff, a control unit that includes a control circuit, and a notification unit. A control unit includes a pulse wave detection unit that detects a subject's pulse wave at a site where the cuff is worn, and a blood pressure determination unit that determines a subject's blood pressure value based on the detected cuff pressure and the pulse wave. Unit, a minimum pressure determining unit that determines a minimum pressure at which a pulse wave can be detected through the cuff, a meditation guiding unit that guides the subject to a meditating state while the cuff pressure is kept at the minimum pressure, and meditation by the meditation guiding unit. Based on the pulse wave analysis unit that analyzes the pulse wave detected during the execution of the guidance and calculates the maximum Lyapunov exponent indicating the degree of fluctuation in the heartbeat interval of the subject, based on the maximum Lyapunov exponent, the subject is cerebral fatigue, anxiety or Whether you are in negative emotions of depression Is an emotion determination unit that determines whether there is a positive emotion that does not feel brain fatigue, anxiety and depression, and an operation control unit that executes blood pressure measurement, meditation guidance, and blood pressure measurement in the order of blood pressure measurement, meditation guidance, and blood pressure measurement by the blood pressure determination unit. The notification unit includes an electronic sphygmomanometer that notifies the determination result of the emotion determination unit and the result of blood pressure measurement before and after meditation guidance.

  The minimum pressure determining unit is configured to reduce the cuff pressure in a period from the point at which the attenuation of the peak value of the pulse wave superimposed on the cuff pressure is saturated to the point at which the pulse wave disappears in the process of reducing the cuff pressure by the pressure reducing unit. It is preferable to determine the pressure.

  The control unit further includes a body motion determination unit that determines whether the subject has moved his or her body based on the magnitude of the fluctuation of the pulse wave detected during the execution of the meditation guidance. When the body motion determining unit determines that the user has moved, it is preferable to alert the subject to stand still.

  It is preferable that the meditation guiding unit generates, as meditation guidance, a breathing pattern for performing a deep breath in which the subject inhales and exhales slower than the inhaling speed. It is preferable that the meditation guidance section reproduces music including a phrase longer than the respiratory cycle as meditation guidance.

  It is preferable that the notification unit notifies, after the meditation guidance is completed, the frequency at which the emotion determination unit determines that the subject has a positive emotion during the meditation guidance period. It is preferable that the notification unit notifies the determination result of the emotion determination unit at regular intervals during the execution of the meditation guidance.

  Also, a blood pressure measurement system including an electronic sphygmomanometer and a terminal device, wherein the electronic sphygmomanometer includes a cuff, a pressurizing unit that pressurizes the cuff, a depressurizing unit that depressurizes the cuff, and a pressure of air in the cuff. A pressure detection unit that detects the cuff pressure, a pulse wave detection unit that detects the subject's pulse wave at the site where the cuff is worn, and determines the subject's blood pressure value based on the detected cuff pressure and pulse wave The terminal device has a control unit configured by a control circuit and a communication unit with the electronic sphygmomanometer, and the control unit can detect the pulse wave through the cuff by the electronic sphygmomanometer. A meditation guidance unit that guides the subject to the meditation state while maintaining the cuff pressure at a minimum pressure, and a pulse wave detected during execution of the meditation guidance by the meditation guidance unit, and fluctuations in the heartbeat interval of the subject Pulse wave analysis unit that calculates the maximum Lyapunov exponent indicating the degree Based on the maximum Lyapunov exponent, an emotion determination unit that determines whether the subject has a negative emotion of feeling brain fatigue, anxiety or depression, or a positive emotion of not feeling brain fatigue, anxiety or depression, and blood pressure determination. A blood pressure measurement and a meditation guidance by the unit, an operation control unit for executing the blood pressure measurement, the meditation guidance and the blood pressure measurement in this order, wherein either the electronic sphygmomanometer or the terminal device determines the determination result of the emotion determination unit and before and after the meditation guidance A blood pressure measurement system for notifying the result of the blood pressure measurement in the computer is provided.

  The above electronic sphygmomanometer and blood pressure measurement system use a cuff to guide a subject to a meditative state while continuously detecting a pulse wave without causing pain and discomfort to the subject, and changes in blood pressure values before and after that. Can be reported as an effect of meditation guidance.

FIG. 2 is a schematic diagram illustrating an appearance of the electronic sphygmomanometer 1. FIG. 2 is a block diagram of the electronic sphygmomanometer 1. 4 is a graph for explaining cuff pressure control in the electronic sphygmomanometer 1. 5 is a graph for explaining a function of a pulse wave analyzer 42. FIG. 4 is a diagram illustrating an example of a display screen of a display unit 13. 5 is a flowchart illustrating an operation example of a control unit 30 of the electronic sphygmomanometer 1. 1 is an overall configuration diagram of a blood pressure measurement system 1 '.

  Hereinafter, an electronic sphygmomanometer and a blood pressure measurement system will be described with reference to the drawings. However, it should be understood that the invention is not limited to the drawings or the embodiments described below.

  FIG. 1 is a schematic diagram illustrating an appearance of the electronic sphygmomanometer 1. The electronic sphygmomanometer 1 has a main body 10 and a cuff 60, and headphones 70 are connected to the main body 10. The electronic sphygmomanometer 1 is an autonomous training meditation device that guides the subject to a meditative state in order to perform autonomous training for the subject to stabilize the autonomic nervous system. Is reported as the effect of autonomous training. As meditation guidance, the electronic sphygmomanometer 1 performs both respiration guidance and music playback, but may perform only one of these. The electronic sphygmomanometer 1 determines the minimum cuff pressure at which a pulse wave can be detected at the time of blood pressure measurement before meditation guidance, and keeps the cuff pressure during meditation guidance at the minimum pressure, thereby causing pain to the subject during meditation guidance. The pulse wave is detected without giving any discomfort, and the result of the emotion determination of the subject by analyzing the pulse wave is also reported.

  The cuff 60 has a built-in air bag for storing air sent from the main body 10. This air bag is connected to the main body 10 via an air pipe 61. The air pipe 61 is a pipe for sending air from the main body 10 to the cuff 60. The cuff 60 is wrapped around the subject's upper arm at the time of use, for example, and is fixed to the upper arm by a hook-and-loop fastener provided on the surface of the cuff 60. The electronic sphygmomanometer is not limited to the upper arm, and may be used by attaching it to another part of the body such as a wrist.

  The headphones 70 are for the subject to listen to the music played during the meditation guidance. The subject may use earphones instead of headphones, or may install a speaker for music reproduction on the main body 10.

  FIG. 2 is a block diagram of the electronic sphygmomanometer 1. The main body 10 includes a power switch 11 (see FIG. 1), an operation unit 12, a display unit 13, a pressure unit 21, a pressure reduction unit 22, a cuff pressure detection unit 23, a control unit 30, and a memory 50. The pressurizing unit 21, the depressurizing unit 22, and the cuff pressure detecting unit 23 are connected to the cuff 60 via the air pipe 61. The functional blocks of the electronic sphygmomanometer 1 are roughly divided into a blood pressure measurement unit 20 and an autonomous training unit 40. The blood pressure measurement unit 20 includes an operation unit 12, a pressure unit 21, a pressure reduction unit 22, a cuff pressure detection unit 23, and a control unit 30, and the autonomous training unit 40 includes a display unit 13, a control unit 30, and a memory 50. Is done.

  As shown in FIG. 1, the power switch 11 is provided, for example, on a side surface of the upper body 10 as viewed from the front. The electronic sphygmomanometer 1 is operated by a battery (not shown), but the power supply is not limited to the battery, and may be an AC power supply. The operation unit 12 includes, for example, a measurement button 12A, a setting button 12B, and a selection button 12C. In the illustrated example, the operation unit 12 is provided on the lower front side of the main body 10. The measurement button 12A is a button for the user (subject) to instruct start / stop of blood pressure measurement, and the setting button 12B is a button for the user to input information necessary for the operation of the electronic sphygmomanometer 1. It is. The selection buttons 12C are a + button and a − button for the user to select an input item.

  The display unit 13 is an example of a notification unit, and includes, for example, a liquid crystal display panel (LCD). The display unit 13 displays the measurement result of the blood pressure value during measurement, the systolic blood pressure value, the diastolic blood pressure value, and the pulse, information necessary to indicate the timing of breathing to the subject at the time of breathing guidance, emotion determination result, meditation guidance Various messages indicating the effect of (autonomous training) are displayed (see FIG. 5 described later). The display unit 13 may be a touch panel display. In this case, the power switch 11 and the operation unit 12 may be integrated with the display unit 13. Note that the notification unit may be a sound output unit such as a headphone 70 or a speaker in place of the headphone 70, or a communication unit or a connection terminal for outputting data to an external device.

  The pressurizing unit 21 includes a pressurizing pump that pressurizes the inside of the air bag of the cuff 60 by sending air into the cuff 60, and a driving circuit that drives the pressurizing pump based on a control signal of the control unit 30. You. For example, the pressure reducing unit 22 exhausts the pressurized air in the cuff 60 at a constant speed (low speed) during the blood pressure measurement, stops the leak at a predetermined pressure, keeps the pressure at a constant pressure, and An electromagnetic slow leak valve for forcibly exhausting (completely exhausting) the air in the cuff 60 when the cuff 60 is stopped, and a drive circuit for opening and closing the electromagnetic slow leak valve based on a control signal of the control unit 30. The cuff pressure detecting unit 23 is an example of a pressure detecting unit, and includes a pressure sensor that detects the pressure in the air bag of the cuff 60 (cuff pressure), and a control unit that converts a detection signal generated by the pressure sensor into a frequency signal. And a detection circuit for outputting the signal to the detection circuit 30. The cuff pressure is calculated from the change in the frequency.

  FIGS. 3A to 3C are graphs for explaining the control of the cuff pressure in the electronic sphygmomanometer 1. The horizontal axis t of the graph represents time, and the vertical axis P (mmHg) represents pressure. A curve a indicates a time change of the cuff pressure, and a bar graph b indicates a time change of a pulse wave (differential pulse wave) detected by being superimposed on the cuff pressure. FIG. 3A is a graph at the time of blood pressure measurement before meditation guidance, FIG. 3B is a graph at the time of meditation guidance, and FIG. 3C is a graph at the time of blood pressure measurement after meditation guidance. The reason why the horizontal axes of the graphs are continuous in FIGS. 3A to 3C is that the meditation guidance and the blood pressure measurement before and after the meditation are continuously performed temporally.

  The electronic sphygmomanometer 1 pressurizes the subject's upper arm with the cuff 60, gradually exhausts the air in the cuff 60 from the absence of the pulse wave, and obtains the differential pulse wave superimposed on the cuff pressure curve a at the time of decompression. This is an oscillometric sphygmomanometer that calculates a systolic blood pressure value and a diastolic blood pressure value from a peak value difference ΔP. As shown by a curve a in FIG. 3A, the cuff pressure at the time of blood pressure measurement first rises by pressurization, then gradually decreases by constant-speed exhaust, and finally rapidly by forced exhaust. . As shown by the bar graph b in FIG. 3A, the pulse wave at the time of blood pressure measurement is not detected at first because it is excessively pressurized, but is gradually detected in the process of depressurization. If it goes on, it cannot be detected again, so it disappears.

Reference symbol P1 in FIG. 3A indicates a time point at which the peak value of the pulse wave does not change (saturates) during the decompression process, and reference symbol P2 indicates a time point at which the pulse pressure disappears due to further decompression. During code P1, P2 indicated by the arrow T _A is a detectable region is not under almost cuff pressure pulse wave, when continued even more normal exhaust after determination of the systolic and diastolic blood pressure Can be seen. In this region, air remains in the air bag of the cuff 60. However, since the elastic force of the cuff 60 and the atmospheric pressure are balanced, the subject does not feel pressure on the skin. Usually, after the determination of the blood pressure value need not be continued any more normal exhaust, in a general sphygmomanometer, to force the exhaust air in the cuff at the time the blood pressure value is determined, the area T _A is seen I can't. In contrast, the electronic blood pressure monitor 1 is in practice before the blood pressure measurement meditation induction area to continue normal exhaust even after determining the systolic and diastolic blood pressure T _{A (pulse} wave detected minimum pressure zone) Then, forced evacuation is performed, and the measurement is completed.

Arrow T _B in FIG. 3 (B) shows a period during implementation meditation induction. During practice of meditation induction, electronic blood pressure monitor 1 is maintained at a pressure Px in the region T _A of obtaining the cuff pressure first. That is, the electronic sphygmomanometer 1 continues to pressurize the cuff 60 with the minimum pressure Px at which the pulse wave can be detected, and performs the meditation guidance while detecting the pulse wave without any pain or discomfort due to the tightening of the cuff 60 for the subject. Do.

  Further, as shown in FIG. 3C, the electronic sphygmomanometer 1 performs the blood pressure measurement again after the meditation guidance is performed. The second blood pressure measurement is the same as the measurement using a general blood pressure monitor.

  Hereinafter, the remaining components shown in FIG. 2 will be described. The control unit 30 is configured as a control circuit of a microcomputer including a CPU, a RAM, and a ROM, and controls the operation of the electronic sphygmomanometer 1. The blood pressure measurement unit 20 includes a cuff pressure control unit 31, a pulse wave detection unit 32, a blood pressure determination unit 33, a minimum pressure determination unit 34, and a body motion determination unit 35 as functional blocks realized by the CPU of the control unit 30. The autonomous training unit 40 includes a mode control unit 41, a pulse wave analysis unit 42, an emotion determination unit 43, a breath guidance unit 44, a music reproduction unit 45, and an effect determination unit 46 as functional blocks realized by the CPU of the control unit 30. Have.

  The memory 50 is a non-volatile memory such as an EEP-ROM, and stores information necessary for the operation of the electronic sphygmomanometer 1. In particular, the memory 50 stores the maximum blood pressure value, the minimum blood pressure value, and the pulse determined by the blood pressure determination unit 33, and the result of the emotion determination performed by the emotion determination unit 43.

When the user (subject) operates the measurement button 12A to instruct the start of blood pressure measurement, the cuff pressure control unit 31 applies the cuff 60 to the pressurizing unit 21 until the cuff pressure reaches a predetermined upper limit pressure. The air in the cuff 60 is exhausted at a constant speed to the decompression unit 22 by applying pressure. Then, the cuff pressure control unit 31 causes the pressure reduction unit 22 to forcibly exhaust the air in the cuff 60 after the minimum pressure determination unit 34 determines the minimum pressure Px at which a pulse wave can be detected. The following meditation induction, the cuff pressure controlling portion 31, a cuff 60 pressing 21 until the cuff pressure becomes the minimum pressure Px was pressurized, after holding the cuff pressure during the period T _B of meditation induction Then, the pressure reducing unit 22 is forcibly exhausted. At the time of blood pressure measurement after the subsequent meditation guidance, the cuff pressure control unit 31 causes the pressurizing unit 21 to pressurize the cuff 60 until the cuff pressure reaches the pressurizing upper limit pressure again, and causes the depressurizing unit 22 to exhaust at a constant speed. After the value is determined, the decompression unit 22 is forcibly exhausted.

  Note that the cuff pressure control unit 31 does not have to cause the decompression unit 22 to forcibly exhaust gas before and after the meditation guidance. In this case, the cuff pressure control unit 31 holds the cuff pressure at the minimum pressure Px until the meditation guidance ends and the second blood pressure measurement starts, when the minimum pressure determination unit 34 obtains the minimum pressure Px at the time of the first blood pressure measurement. However, at the time of the second blood pressure measurement, the cuff 60 may be pressurized from the minimum pressure Px to the pressurization upper limit pressure.

  The pulse wave detection unit 32 detects a subject's pulse wave at a site where the cuff 60 is worn based on a change in the frequency of the frequency signal generated by the cuff pressure detection unit 23.

  The blood pressure determination unit 33 uses the oscillometric method based on the cuff pressure detected by the cuff pressure detection unit 23, the start pressure value of each pulse wave detected by the pulse wave detection unit 32, and the measurement time, The maximum blood pressure value, the minimum blood pressure value, and the pulse of the subject are calculated. The blood pressure determining unit 33 displays the determined maximum blood pressure value, minimum blood pressure value, and pulse on the display unit 13 and stores the determined maximum blood pressure value, minimum blood pressure value, and pulse in the memory 50.

The minimum pressure determination unit 34 determines that the pressure reducing unit 22 reduces the pressure of the cuff 60 by constant-speed exhaust during the first blood pressure measurement (before performing the meditation guidance) after the measurement button 12A is operated. Determine the minimum pressure at which a wave can be detected. At this time, the minimum pressure determining unit 34 first superimposes the point where the difference ΔP between the peak values of the differential pulse wave detected by the pulse wave detecting unit 32 becomes less than a predetermined threshold value, that is, the cuff pressure. The point at which the attenuation of the peak value of the pulse wave is saturated (point P1 in FIG. 3A) is detected, and the cuff pressure at that time is stored as P1. Further, the minimum pressure determination unit 34 detects a point at which the difference ΔP becomes equal to or larger than the threshold value again, that is, a point (pulse P2 in FIG. 3A) at which the pulse wave disappears when the cuff 60 is further depressurized. Then, the cuff pressure at that time is stored as P2. Further, the minimum pressure determination unit 34 calculates the average value of cuff pressure P1, P2 (average value of cuff pressure in the region T _A in FIG. 3 (A)), and stores that value as the minimum pressure Px.

  In the control of the minimum pressure determination unit 34, the order in which the values are determined is reversed even in a sphygmomanometer that measures a blood pressure value in the process of pressurizing the cuff (in this case, the cuff pressures P2 and P1 and the average value Px). , Are determined in the order of the blood pressure values).

  The body motion determining unit 35 determines whether the subject has moved his or her body based on the magnitude of the fluctuation of the pulse wave detected by the pulse wave detecting unit 32. The electronic sphygmomanometer 1 can detect the pulse wave through the cuff 60 even during the meditation guidance, and if there is a body motion, the pulse wave varies differently from the time of rest, so that the body motion of the subject can also be detected. Since the body movement hinders meditation guidance (autonomous training), the body movement determination unit 35 determines the presence or absence of the body movement of the subject particularly during execution of the meditation guidance. May be. At this time, the body motion determination unit 35 determines that there is body motion when the difference ΔP between the peak values of the differential pulse wave is equal to or greater than a predetermined threshold value, and determines that the body motion is present when the difference ΔP is less than the threshold value. It is determined that there is no movement. When it is determined that there is a body movement, the body movement determining unit 35 displays a warning message such as “Please do not move!” On the display unit 13 or outputs a sound so that the subject stops. Alert.

  The mode control unit 41 is an example of an operation control unit. When the measurement button 12A is operated by the user (subject), another function is performed so that each operation is performed in the order of blood pressure measurement, meditation guidance, and blood pressure measurement. Control the block. That is, the mode control unit 41 causes the cuff pressure control unit 31 and the blood pressure determination unit 33 to execute the first blood pressure measurement, and then causes the cuff pressure control unit 31 to hold the cuff pressure at the minimum pressure Px and determine the emotion. The unit 43, the respiratory guidance unit 44, the music reproduction unit 45, and the like execute emotion determination and meditation guidance, which will be described later, and the cuff pressure control unit 31 and the blood pressure determination unit 33 perform a second blood pressure measurement.

  FIGS. 4A and 4B are graphs for explaining the function of the pulse wave analyzer 42. FIG. 4A shows a waveform example of the pulse wave PW, in which the horizontal axis t is time (millisecond) and the vertical axis A is the amplitude of the pulse wave. As shown in FIG. 4A, the pulse wave PW is a triangular wave reflecting the change in the blood flow due to the pulsation of the heart, and the interval between the peak points P1 to Pn where the blood flow is strongest is defined as the pulse wave interval d1. dn.

  FIG. 4B is a graph showing an example of the fluctuation degree of the pulse wave interval. This graph is called a Lorentz plot, in which the horizontal axis is a pulse wave interval dn, the vertical axis is a pulse wave interval dn-1 (both in milliseconds), and coordinates (dn, dn) for n = 1, 2,. -1) The time series data of the pulse wave interval is plotted above. It is known that the degree of dot variation in the graph of FIG. 4B reflects the positive and negative emotions of the subject and the degree of brain fatigue.

ここで、Ｍは脈波間隔ｄ１〜ｄｎにおける総サンプル時間、ｄは時系列データの時刻ｋと時刻ｋ−１とのパターン間距離（ローレンツプロットにおける２次元平面上の距離）である。 The pulse wave analyzer 42 detects the peak points P1 to Pn of the subject's pulse wave PW during the execution of the meditation guidance, calculates the pulse wave intervals d1 to dn in milliseconds, and further calculates the pulse wave intervals d1 to dn. Generate time series data of pulse wave intervals. Then, the pulse wave analysis unit 42 uses the time series data, that is, the coordinates (dn, dn-1) in the Lorentz plot of FIG. The maximum Lyapunov exponent λ shown is calculated.

Here, M is the total sample time at the pulse wave intervals d1 to dn, and d is the distance between patterns (time on a two-dimensional plane in Lorentz plot) between time k and time k-1 of the time-series data.

Based on the maximum Lyapunov exponent λ calculated by the pulse wave analysis unit 42, the emotion determination unit 43 has the subject in a negative emotion of feeling brain fatigue, anxiety or depression, or does not feel brain fatigue, anxiety and depression. Determine if you have a positive emotion. The maximum Lyapunov exponent λ in Expression 1 is a negative value having a large absolute value when there is a negative emotion, and is 0 or more or a negative value having a small absolute value when there is a positive emotion. Therefore, the emotion determination unit 43 determines that the subject has a negative emotion when the calculated maximum Lyapunov exponent λ satisfies the following equation 2, and when the λ does not satisfy the equation 2, the subject has a positive It is determined that there is emotion.
λ ≦ λt Equation 2
Here, λt (<0) is an appropriate threshold value set for emotion determination.

  During the execution of the meditation guidance, the pulse wave analysis unit 42 and the emotion determination unit 43 calculate the maximum Lyapunov exponent λ and determine the emotion at intervals of several tens of seconds, for example. Each time the emotion determination unit 43 makes a determination, the result (whether the subject is in a negative emotion or a positive emotion) is displayed on the display unit 13 and stored in the memory 50. The emotion determination unit 43 determines the emotional state of the subject according to the magnitude of the maximum Lyapunov exponent λ, for example, “stress-free (positive emotion)”, “active”, “lightly fatigued state (lightly negative emotion)”, and “fatigue”. The state may be divided into a plurality of stages such as “state (negative emotion)”, and the display unit 13 may display which classification the subject belongs to.

  The respiratory guidance unit 44 and the music reproduction unit 45 are examples of a meditation guidance unit, and perform respiration guidance and music reproduction in a state where the cuff pressure is kept at the minimum pressure Px by the cuff pressure detection unit 23. The electronic sphygmomanometer 1 thereby guides the subject to the meditative state, thereby stabilizing the subject's autonomic nervous system and changing a negative emotion into a positive emotion.

  The respiratory inducing unit 44 generates a breathing pattern for performing a deep breath in which the subject inhales and exhales slower than the inhaling speed, and displays the inhaling timing and the exhaling timing in the respiratory pattern on the display unit 13, for example. , The consciousness of the subject is concentrated on breathing. Deep breathing, inhaling quickly and exhaling slowly, stimulates the diaphragm and, as a result, stabilizes the autonomic nervous system, which is effective in improving the emotional state. This deep breathing is preferably extended expiration deep breathing in which the period of exhalation is 2-3 times the period of inhalation, for example, inhaling in 2 seconds and exhaling in 6 seconds. For example, as shown in FIG. 5 described later, the respiration inducing section 44 displays a bar whose length gradually changes from the beginning to the end of the inhalation period and the exhalation period. People have the habit of focusing their consciousness on what is moving or changing, so by following these bar changes with your eyes, your consciousness concentrates on display and breathing, and negative emotions The effect of unconsciousness can be obtained.

  The music reproducing unit 45 focuses the user's consciousness on the music by reproducing music including a phrase longer than the cycle of breathing. The music reproduced by the music reproduction unit 45 has a phrase cycle longer than the cycle of the respiration guidance by the respiration guidance unit 44. This is because, if the phrase cycle is shorter than the cycle of the breathing guidance, the breathing is performed not on the display bar of the display unit 13 but on the tune, and the effect of the breathing guidance is reduced by half.

In addition to the phrase cycle condition, the music played by the music playback unit 45 preferably has at least one of the following three conditions.
(1) The tempo sound of the music is composed of beats of 4 to 6 kHz.
(2) The center of the frequency distribution of the musical scale is 528 Hz.
(3) The sensible BPM (Beats Per Minute) of the tempo of the song matches the BPM of the resting heart rate.
These conditions are common to a plurality of songs that are said to be effective for autonomic nervous stability. (1) is because the frequency of the beat sound that easily resonates with the spine and the brain stem is 4 to 6 kHz, and (2) is because the frequency at which cells self-repair is said to be 528 Hz. The reason (3) is that if the tempo of the music coincides with the heartbeat, it is easy to obtain comfort.

  In order to satisfy the condition (3), the music playback unit 45 may adjust the playback speed of the music to match the heart rate calculated from the pulse wave of the subject. For example, in the case of a song with three beats, the sensory tempo is 0.66 times the physical tempo (actual tempo), so the sensory tempo of a song whose actual tempo is 101.68 BPM is 66.9 BPM. It is. Since the average of the resting heart rate of an adult is about 65 BPM, when playing a song whose actual tempo is 101.68 BPM, the music playback unit 45 needs to fine-tune the playback speed of the song according to the heart rate. I just need.

  After the end of the meditation guidance by the respiration guidance unit 44 and the music reproduction unit 45, the effect determination unit 46 determines whether or not the subject's emotion has changed due to the meditation guidance. For this purpose, the effect determination unit 46 refers to the memory 50, calculates the occurrence rate (occurrence frequency) of positive emotions during the meditation guidance period, and calculates the value as the positive emotion achievement rate (from negative emotions to positive emotions). Is displayed on the display unit 13. The occurrence rate of positive emotion is a value defined by (the number of times that the emotion is determined to be positive) / (the number of times that the emotion determination unit 43 makes a determination). Further, the effect determining unit 46 refers to the memory 50, calculates a difference between the systolic blood pressure values before and after the meditation guidance, and causes the display unit 13 to display the difference (blood pressure improvement value). That is, the effect determination unit 46 feeds back to the user how much the blood pressure value and the emotional state have been improved by the user (subject) performing autonomous training through meditation guidance.

  Further, the effect determination unit 46 determines whether or not the subject has stress hypertension in accordance with the combination of the systolic blood pressure value before the meditation guidance, the positive emotion achievement rate, and the blood pressure improvement value, and also displays a determination message regarding the blood pressure. Display on the unit 13. Table 1 shows an example of the determination message. In particular, if the systolic blood pressure before induction of meditation is high blood pressure of 140 mmHg or more, the positive emotion achievement rate is high, for example, 50% or more, and the systolic blood pressure falls after induction of meditation, the blood pressure is improved by meditation, and the effect is improved. The determination unit 46 determines that the subject has stress hypertension. Conversely, if the systolic blood pressure value before meditation guidance is less than 140 mmHg, it is not hypertension in the first place, and there is no need to associate blood pressure with meditation, and the effect determination unit 46 determines the meditation determination message in accordance with the positive emotion achievement rate. Is displayed.

  FIG. 5 is a diagram illustrating an example of a display screen of the display unit 13. In the illustrated example, the measurement result 101 of the systolic blood pressure value, the diastolic blood pressure value, and the pulse, the respiration guide bar 102, the fatigue level display bar 103, the achievement rate bar 104, the blood pressure improvement value 105, the determination message 106, and the start button 107 are displayed on the screen. Is displayed in.

  The measurement result 101 is a maximum blood pressure value, a minimum blood pressure value, and a pulse value determined by the blood pressure determination unit 33, and is updated each time blood pressure is measured. The respiration guide bar 102 is a circular bar displayed during respiration guidance by the respiration guidance unit 44, and changes so as to extend clockwise from the 12 o'clock position to the 12 o'clock position again in each of the inhalation period and the exhalation period. I do. The fatigue degree display bar 103 is displayed during and after the execution of the meditation guidance, and the stronger the degree of the negative feeling of feeling the brain fatigue, that is, the smaller the maximum Lyapunov exponent λ calculated by the pulse wave analyzer 42 (the negative The larger the absolute value, the longer). Above the fatigue level display bar 103, a judgment category “lightly fatigued state” by the emotion determination unit 43 is also displayed.

  The achievement rate bar 104 is the rate of occurrence of positive emotions during the meditation guidance period calculated by the effect determining unit 46, and is displayed longer as the value is larger. Above the achievement rate bar 104, the numerical value of the positive emotion achievement rate (occurrence rate) is also displayed. The blood pressure improvement value 105 is a difference between the systolic blood pressure values before and after the meditation guidance calculated by the effect determination unit 46, and in the illustrated example, the value is indicated by a point on a number line (the unit is mmHg). ). The determination message 106 is displayed by the effect determination unit 46 selecting from those shown in Table 1. In the illustrated example, the systolic blood pressure before induction of meditation was high blood pressure of 140 mmHg or more, the positive emotion achievement rate was 50% or more, and the systolic blood pressure decreased after induction of meditation. It is displayed that the blood pressure has improved. The achievement rate bar 104 is displayed after the meditation guidance, and the blood pressure improvement value 105 and the determination message 106 are displayed after the second blood pressure measurement.

  The start button 107 is a button for the user (subject) to instruct the start of blood pressure measurement. When the display unit 13 is a touch panel display, the operation buttons may be displayed in the display unit 13 as described above.

  FIG. 6 is a flowchart illustrating an operation example of the control unit 30 of the electronic sphygmomanometer 1. The illustrated operation flow is executed by the CPU of the control unit 30 according to a program stored in the ROM of the control unit 30 in advance.

  When the user (subject) wraps the cuff 60 around the upper arm, for example, and presses the measurement button 12A, blood pressure measurement before the execution of meditation guidance is started (S1). At that time, the cuff pressure control unit 31 causes the pressurizing unit 21 to pressurize the cuff 60 (S2), and then causes the pressure reducing unit 22 to start reducing the pressure of the cuff 60 (S3). The pulse wave disappears at the time of pressurization (S2) and starts to be detected by the start of pressure reduction (S3). During the decompression, the blood pressure determining unit 33 measures the systolic blood pressure value and the diastolic blood pressure value, and stores the systolic blood pressure value Bpb in the memory 50 (S4).

Subsequently, the minimum pressure determination unit 34 calculates a difference ΔP between the peak values of the differential pulse wave (S5). When the difference ΔP becomes smaller than the threshold value, for example, with 0.3 mmHg / sec as a threshold value (S6). And Yes at that time, the cuff pressure at that time is stored as the upper limit pressure P1 of the area T _A (pulse wave detection minimum pressure area) (S7). Further, when the difference ΔP becomes equal to or larger than the threshold value again (No in S8), the minimum pressure determination unit 34 stores the cuff pressure at that time as the lower limit pressure P2 of the area T _A (pulse wave detection minimum pressure area). (S9). Thereafter, the cuff pressure control unit 31 causes the decompression unit 22 to completely exhaust the cuff 60 (S10), and the blood pressure measurement before the execution of the meditation guidance is completed.

  The minimum pressure determination unit 34 calculates an average value Px of the upper limit pressure P1 and the lower limit pressure P2 stored in S7 and S9 (S11), and sets this as a pressure holding point of the cuff 60 during the meditation guidance. When meditation guidance is performed, the cuff pressure control unit 31 causes the pressure unit 21 to pressurize the cuff 60 to the pressure Px (S12), and the pulse wave detection unit 32 starts continuous measurement of pulse waves during meditation guidance. (S13). At this time, the pulse wave analyzer 42 repeats the extraction of the pulse wave interval at regular intervals (S14). In addition, the respiration guidance unit 44 and the music reproduction unit 45 start meditation guidance by respiration guidance and music reproduction (S15). During the meditation induction, the respiration induction unit 44 continues the respiration induction, the music reproduction unit 45 continues the music reproduction, and the emotion determination unit 43 repeats the emotion analysis (emotion determination) at regular time intervals, and the result is used as an induction effect. Is displayed on the display unit 13 (S16).

  Further, during the meditation guidance, the body motion determination unit 35 calculates the difference ΔP between the peak values of the differential pulse wave and sets the difference ΔP to a predetermined threshold value (for example, 0.3 mmHg, which is the same as in S6 and S8). / Sec) or more, it is determined that there is body movement, and a warning message is displayed on the display unit 13 for a fixed time (S16). When the meditation guidance end time comes, the pulse wave analysis unit 42, the emotion determination unit 43, the respiration guidance unit 44, and the music reproduction unit 45 end the operation (S17), and the effect determination unit 46 determines that the positive The emotion occurrence rate (positive emotion achievement rate) is calculated (S18). Thereafter, the cuff pressure control unit 31 causes the decompression unit 22 to completely exhaust the cuff 60 (S19), and the meditation guidance ends.

  Subsequently, the blood pressure measurement after the execution of the meditation guidance is started (S20). At that time, the cuff pressure control unit 31 causes the pressurizing unit 21 to pressurize the cuff 60 (S21), and then causes the pressure reducing unit 22 to start reducing the pressure of the cuff 60 (S22). During the decompression, the blood pressure determining unit 33 measures the systolic blood pressure value and the diastolic blood pressure value, and stores the systolic blood pressure value Bpa in the memory 50 (S23). Thereafter, the cuff pressure control unit 31 causes the decompression unit 22 to completely exhaust the cuff 60 (S24), and the blood pressure measurement after the execution of the meditation guidance is completed. Further, the effect determining unit 46 calculates a difference ΔBp = Bpa−Bpb between the systolic blood pressure values before and after the meditation guidance stored in S4 and S23 (S25), and calculates the difference (blood pressure improvement value), and the correctness calculated in S18. The emotion achievement rate and a judgment message corresponding to them are displayed on the display unit 13 (S26). Thereafter, the user (subject) removes the cuff 60, and the operation of the control unit 30 of the electronic sphygmomanometer 1 ends here.

  The electronic sphygmomanometer 1 does not require an electrode for detecting a pulse wave or a sensor for detecting a microwave. The cuff 60 is used to continuously detect a pulse wave without causing pain and discomfort to the subject. The meditation state is induced, and a change in blood pressure value before and after the meditation state can be reported as an effect of the meditation induction. In addition, the electronic sphygmomanometer 1 can also detect the body movement of the subject from the fluctuation of the pulse wave, so that the effect of the meditation guidance can be enhanced by stopping the movement of the subject during the meditation guidance.

  FIG. 7 is an overall configuration diagram of the blood pressure measurement system 1 '. The blood pressure measurement system 1 ′ includes an electronic sphygmomanometer 2 and a terminal device 3 that can communicate with each other via a communication link 80. The terminal device 3 is, for example, a mobile terminal such as a tablet terminal or a smartphone, or a PC, and includes a communication unit and a control unit for communicating with the electronic sphygmomanometer 2, and a display unit 13 '. Headphones 70 for the subject to listen to meditation-guided music are connected to the terminal device 3. The electronic sphygmomanometer 2 has a cuff 60 and a functional block of the blood pressure measurement unit 20 shown in FIG. 2, and the terminal device 3 has a functional block of the autonomous training unit 40 shown in FIG. However, the functions of the minimum pressure determination unit 34 and the body movement determination unit 35 of the blood pressure measurement unit 20 may be realized by the control unit of the terminal device 3. The communication link 80 may be wired communication, but may be realized by wireless communication such as a wireless LAN or Bluetooth (registered trademark).

  In the blood pressure measurement system 1 ′, when the user presses the operation unit (start button) 12 of the electronic sphygmomanometer 2, normal blood pressure measurement is performed, and the user presses the link button displayed on the display unit 13 ′ of the terminal device 3. When the user presses 12 ', the same blood pressure measurement, meditation guidance, and blood pressure measurement operations as those of the electronic sphygmomanometer 1 are performed. In the blood pressure measurement system 1 ′, for example, the measurement results of the systolic blood pressure value, the diastolic blood pressure value, and the pulse (the measurement result 101 in FIG. 5) are displayed on the display unit 13 of the electronic sphygmomanometer 2 and the other (the respiration in FIG. The guidance bar 102, the fatigue level display bar 103, the achievement rate bar 104, the blood pressure improvement value 105, and the determination message 106) are displayed on the display unit 13 'of the terminal device 3. However, such information may be displayed on either the display unit of the electronic sphygmomanometer 2 or the terminal device 3.

  In the case of the form of the blood pressure measurement system 1 ', the function of the control unit 30 of the electronic sphygmomanometer 1 is performed by software of the terminal device 3, so that the electronic sphygmomanometer can be used by using an existing electronic sphygmomanometer capable of communicating with external devices 1 can realize the same function.

1, 2 Electronic sphygmomanometer 1 'Blood pressure measurement system 3 Terminal device 10 Main body 12 Operation unit 13, 13' Display unit 20 Blood pressure measurement unit 21 Pressurization unit 22 Decompression unit 23 Cuff pressure detection unit 30 Control unit 31 Cuff pressure control unit 32 Pulse wave detection unit 33 Blood pressure determination unit 34 Minimum pressure determination unit 35 Body motion determination unit 40 Autonomous training unit 41 Mode control unit 42 Pulse wave analysis unit 43 Emotion determination unit 44 Respiration induction unit 45 Music playback unit 46 Effect determination unit 50 Memory 60 Cuff 70 headphones

Claims (8)

Cuff,
A pressure unit for pressing the cuff,
A decompression unit that decompresses the cuff,
A pressure detection unit that detects a cuff pressure that is a pressure of air in the cuff,
A control unit including a control circuit;
A notification unit,
The control unit includes:
A pulse wave detection unit that detects a subject's pulse wave at the site where the cuff is worn,
A blood pressure determination unit that determines a blood pressure value of the subject based on the detected cuff pressure and the pulse wave,
A minimum pressure determination unit that determines a minimum pressure capable of detecting a pulse wave through the cuff,
A meditation guiding unit that guides the subject to a meditation state while the cuff pressure is kept at the minimum pressure,
A pulse wave analysis unit that analyzes a pulse wave detected during execution of meditation guidance by the meditation guidance unit and calculates a maximum Lyapunov exponent indicating a degree of fluctuation of a subject's heartbeat interval,
Based on the maximum Lyapunov exponent, the subject is brain fatigue, anxiety or depression is a negative emotion to feel, or brain fatigue, anxiety and emotion determination unit to determine whether there is a positive emotion that does not feel depression,
An operation control unit that executes the blood pressure measurement and the meditation guidance by the blood pressure determination unit in the order of blood pressure measurement, meditation guidance and blood pressure measurement,
The notification unit notifies the determination result of the emotion determination unit and the result of blood pressure measurement before and after the meditation guidance,
An electronic sphygmomanometer characterized in that:   The minimum pressure determining unit is configured to reduce the cuff pressure within a period from a point at which the attenuation of the peak value of the pulse wave superimposed on the cuff pressure is saturated to a point at which the pulse wave disappears in the process of reducing the cuff pressure by the pressure reducing unit. The electronic sphygmomanometer according to claim 1, wherein is determined as the minimum pressure. The control unit further includes a body motion determination unit that determines whether the subject has moved his or her body based on the magnitude of the fluctuation of the pulse wave detected during the execution of the meditation guidance,
The electronic sphygmomanometer according to claim 1, wherein the notification unit alerts the subject to stand still when the body motion determination unit determines that the subject has moved.   The electronic device according to any one of claims 1 to 3, wherein the meditation guidance unit generates, as the meditation guidance, a breathing pattern for performing a deep breath in which the subject inhales and exhales slower than the inhaling speed. Sphygmomanometer.   The electronic sphygmomanometer according to any one of claims 1 to 4, wherein the meditation guidance section reproduces music including a phrase longer than a respiratory cycle as the meditation guidance.   The notification unit according to any one of claims 1 to 5, wherein after the end of the meditation guidance, the frequency at which the emotion determination unit determines that the subject has the positive emotion during the period of the meditation guidance is provided. Electronic blood pressure monitor as described.   The electronic sphygmomanometer according to claim 6, wherein the notification unit notifies the determination result of the emotion determination unit at regular intervals during the execution of the meditation guidance. A blood pressure measurement system including an electronic sphygmomanometer and a terminal device,
The electronic blood pressure monitor,
Cuff,
A pressure unit for pressing the cuff,
A decompression unit that decompresses the cuff,
A pressure detection unit that detects a cuff pressure that is a pressure of air in the cuff,
A pulse wave detection unit that detects a subject's pulse wave at the site where the cuff is worn,
Having a blood pressure determining unit that determines the blood pressure value of the subject based on the detected cuff pressure and the pulse wave,
The terminal device,
A control unit including a control circuit;
A communication unit with the electronic sphygmomanometer,
The control unit includes:
In a state where the electronic sphygmomanometer holds the cuff pressure at a minimum pressure at which a pulse wave can be detected through the cuff, a meditation guiding unit that guides the subject to a meditation state,
A pulse wave analysis unit that analyzes a pulse wave detected during execution of meditation guidance by the meditation guidance unit and calculates a maximum Lyapunov exponent indicating a degree of fluctuation of a subject's heartbeat interval,
Based on the maximum Lyapunov exponent, the subject is brain fatigue, anxiety or depression is a negative emotion to feel, or brain fatigue, anxiety and emotion determination unit to determine whether there is a positive emotion that does not feel depression,
An operation control unit that executes the blood pressure measurement and the meditation guidance by the blood pressure determination unit in the order of blood pressure measurement, meditation guidance and blood pressure measurement,
Any of the electronic sphygmomanometer and the terminal device notifies the determination result of the emotion determination unit and the result of blood pressure measurement before and after the meditation guidance,
A blood pressure measurement system, characterized in that:

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