JP3047712B2 - Pulse wave diagnostic device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a diagnostic device based on a pulse wave.

[0002]

2. Description of the Related Art Conventionally, in Chinese medicine, a method in which a diagnostician's finger is pressed along three radial arteries on a subject's arm (size, seki, shaku) to perform a pulse diagnosis (size method) )It has been known. In addition, Japanese Patent Publication No. 57-52054 discloses a pulse detector which automatically performs diagnosis by a sizing method using a piezoelectric element.

On the other hand, in India, a tradition medicine called Ayurveda has been known since ancient times. The outline will be described with reference to FIGS. First, the examiner gently presses his / her finger on the part of the subject's arm along the radial artery. Here, the diagnosis points are the three points shown in FIG. 16 (a), and are Vata (V) and Pitta (P), respectively.
And Kapa (K), which are similar to the dimensions, seki and shaku in Chinese medicine. That is, in FIG. 16A, the examiner presses the second finger on the vata (V), the third finger on the pitta (P), and the fourth finger on the kapha (K).

[0004] Next, as shown in FIG. 16B, the examiner diagnoses the condition and strength of the subject's pulse at points 1 to 4 of "4" per finger to determine the medical condition. . Therefore, the diagnosis points for three fingers are a total of "12" points.

[0005]

By the way, the pulse examination by the squeezing method does not require a special characteristic for learning, and as disclosed in the above-mentioned Japanese Patent Publication No. 57-52054. Can be configured relatively easily. However, the medical examination that can be performed by the technology described in this publication is only to detect three pulse waves in the process of simply increasing the pressure of the sensor and gradually reducing the pressure. There is a problem that it is difficult.

On the other hand, in pulse diagnosis by Ayurveda, it is considered that more accurate diagnosis can be made because a large amount of data is obtained. However, those who can perform a pulse check with Ayurveda are limited to those who have extremely sensitive sensations at the fingertips, and need the qualities that are said to be one in thousands and one in tens of thousands. Further, even a person having such a sensitive sensation cannot make an accurate diagnosis without years of training.
The present invention has been made in view of the above circumstances, and has as its object to provide a pulse wave diagnostic apparatus that can easily perform highly accurate pulse diagnosis.

[0007]

According to a first aspect of the present invention, there is provided a pulse wave detecting means for detecting a pulse wave, and calculating a distortion from the pulse wave detected by the pulse wave detecting means. And a determination means for determining the form of the pulse wave from the distortion calculated by the distortion calculation means. Also, the invention according to claim 2 is a method according to claim 2, wherein
Is a pulse wave detected by the pulse wave detection means,
It is characterized by judging whether it is a normal pulse or a string pulse
You. Further, the invention according to claim 3 is a pulse wave detection method for detecting a pulse wave.
Output means, and distortion from the wave detected by the pulse wave detection means.
And a strain calculating means for calculating
To obtain parameters related to circulatory dynamics from the measured pulse wave
And a parameter calculating means. Ma
The invention according to claim 4 is the dynamic parameter calculating means.
Is the central vascular
Resistance, peripheral vascular resistance, blood inertia, compliance
Is calculated.

Further, the invention according to claim 5 is a pulse wave detecting means for detecting a pulse wave, a distortion calculating means for calculating a distortion from the pulse wave detected by the pulse wave detecting means, and a calculating means for calculating the distortion by the distortion calculating means. Determination means for determining the form of a pulse wave from the strain, and dynamic parameter calculation means for obtaining a parameter related to circulatory dynamics from the strain calculated by the strain calculation means,
Diagnostic means for diagnosing from both the form of the pulse wave obtained by the determining means and the dynamic parameters obtained by the dynamic parameter calculating means. Also, in the invention according to claim 6, the determining means includes:
The pulse wave detected by the pulse wave detecting means is a smooth pulse, a flat pulse, a string
Kinetic parameter calculation
The means may include a central part as a parameter relating to the circulatory dynamics.
Vascular resistance, peripheral vascular resistance, blood inertia, compliance
The method is characterized in that the distance is calculated.

[0009]

According to the first aspect of the present invention, a pulse wave is detected, and a distortion of the pulse wave is obtained from the detected pulse wave. From this distortion, the form of the pulse wave is determined and a diagnosis is made. According to the third aspect of the present invention, the dynamic parameters are obtained from the pulse wave distortion, and the diagnosis is performed based on the obtained dynamic parameters. Further, according to the invention of claim 5 , the form and dynamic parameters of the pulse wave are obtained from the distortion, and the diagnosis is performed from both of them.

[0010]

Embodiment A. Relationship between strain and pulse wave form, dynamic parameters Before giving a specific description of the pulse wave diagnostic apparatus embodying the present invention, the relationship between strain and pulse wave form, dynamic parameters was obtained by the inventor. The findings will be described with reference to the drawings.

In the following embodiments, the distortion d is determined as follows. The amplitude of the fundamental wave obtained by Fourier analysis of the pulse wave is A1, the amplitude of the second harmonic is A2,..., And the amplitude of the nth harmonic is An. In this case, the distortion d is d =
√ (A2 ² + A3 ² +... + An ² ) / A1.

There are many types of pulse waves in addition to a flat pulse, a smooth pulse, a chord pulse, and the like. FIG. 5 shows a typical pulse waveform of a typical pulse wave, a smooth pulse, and a chord pulse among pulse waves. The pulse is
FIG. 5 (A) shows an example of a waveform of a “normal person”, that is, a normal healthy person. This waveform example is a pulse wave of a 34-year-old man. Peace rhythms are slow and relaxed, and are characterized by a constant rhythm and little disturbance. Smooth vein is caused by abnormal blood flow condition, and is caused by diseases such as sputum ingestion, food stagnation, and real fever. FIG. 5 (B) shows a typical waveform of a smooth pulse. This waveform example is a pulse wave of a 28-year-old man. The waveform of the synovial vein rises sharply and then falls quickly, with the aortic notch being cut deeply and the subsequent diastolic peak being much higher than usual.

[0013] The chord vein is caused by an increase in the tone of the blood vessel wall, and appears in diseases such as hepatobiliary disease, various pains, and sputum ingestion. This is considered to be due to the fact that the blood vessel wall was tensioned due to the tension of the autonomic nervous system, the elasticity was reduced, and the effect of the pulsation of the pumped blood became less apparent. Figure 5 shows a typical waveform example
It is shown in (C). This waveform example is a pulse wave of a 36-year-old man.
The characteristic feature of the pulse waveform is that it rapidly rises, does not immediately fall, and maintains a high pressure state for a certain period of time. In the graph of FIG. 5, the vertical axis represents blood pressure BP (mmFg), and the horizontal axis represents time (seconds).

FIG. 6 shows the relationship between the above-mentioned strain and the normal pulse, the smooth pulse, and the chord. A rough guide can be predicted from the shape of the pulse wave described above, but the details are as shown in FIG. FIG. 6 shows the results of analysis of 35 cases of normal veins, 21 cases of smooth veins, and 22 cases of chord veins. In FIG. 6, the strain of the heartbeat is about 0.907, and there is a deviation of about 0.053 in the vertical direction. The smooth vein has a greater strain than that of a normal vein, with a center of 1.013 and a deviation of 0.148 above and below. String distortion is the smallest of the three, with an average of 0.734 and a vertical deviation of about 0.064. In addition, as a result of testing the magnitude relationship between the strains of the flat vein, the smooth vein and the chord vein by the t-test, a significant difference was recognized when the risk factor was 0.05 or less.

As kinetic parameters relating to circulatory dynamics (parameters relating to the dynamic state of blood circulation), central vascular resistance Rc, peripheral vascular resistance Rp, blood inertia L, and vascular wall compliance C are defined. Central vascular resistance R
c is a resistance when blood flows in a blood vessel in the central part of the artery, and is represented by [dyn · s / cm ⁵ ]. Peripheral vascular resistance Rp is the resistance when blood flows through the blood vessels in the peripheral part of the artery and is expressed in [dyn · s / cm ⁵ ]. The inertia L is the inertia of blood in the central part of the artery, and is [dyn · s ² / cm ⁵ ].
Expressed by The compliance C is a quantity indicating the flexibility of the blood vessel wall in the central part of the artery, and is expressed in [cm ⁵ / dyn]. These dynamic parameters Rp, Rc, L, and C are the same as those in the model described in Patent Application No. 5-1431, for example, a four-element lumped parameter model.

FIGS. 7 to 10 show the relationship between the strain d and the dynamic parameters. These relationships were obtained for 120 cases. FIG. 7 shows the relationship between the central vascular resistance Rc and the strain d. When the relational expression between them is obtained, Rc = 58.68
d ** (− 0.394), and the correlation r is r = −0.
807. The symbol “**” indicates a power. FIG. 8 shows the relationship between the peripheral vascular resistance Rp and the strain d. When a relational expression between them is obtained, Rp = 2321.3exp (−0.6
15d), and the correlation r is r = −0.418.
FIG. 9 shows the relationship between the inertia L and the distortion d. When a relational expression between them is obtained, it is represented by L = 162.8 exp (−2.585d), and the correlation r is r = −0.774. FIG. 10 shows the relationship between compliance C and strain d. When a relational expression between them is obtained, C = (− 1.607 + 3.342d) × 10 ⁻⁴ and the correlation r is r = 0.664.

FIGS. 11 to 14 show the relationship between each kinetic parameter and three pulses of a smooth pulse, a flat pulse, and a chord pulse. FIG. 11 shows the relationship between central vascular resistance Rc and three pulses. The vascular resistance of the synovial vein is the smallest (47.048 ± 18.170 dyn · s / c
m ⁵ , the same applies hereinafter).
2.037 ± 36.494), and the greatest vascular resistance of the chord vein (226.093 ± 61.135). FIG. 12 shows the relationship between the peripheral vascular resistance Rp and three pulses. The vascular resistance of the synovial vein is the smallest (1182.1 ± 176.7 dyn · s / c)
m ⁵ , the same applies hereinafter), and then the vascular resistance of the Ping mai was low (1
386.5 ± 228.3), with the greatest vascular resistance in the chord vein (1583.0 ± 251.0).

FIG. 13 shows the relationship between the inertia L of blood and three pulses. The inertia of the smooth vein is the smallest (10.337 ± 2.60)
9dyn · s ² / cm ⁵ , the same applies hereinafter), secondly, the inertia of the normal pulse is small (16.414 ± 4.604) and the inertia of the chord is the largest (27.550 ± 5.393). FIG. 14 shows the relationship between compliance C and three pulses. The compliance of the synaptic vein is the largest (2.030 ± 0.554 × 10
^-4 cm ⁵ / dyn, the same applies hereinafter), followed by a large compliance of the normal pulse (1.387 ± 0.311) and a minimum compliance of the chord vein (0.819 ± 0.20).
7). Although the order of the magnitude relation is reversed only for the compliance, the magnitude relation is the same for all the dynamic parameters if the reciprocal of the compliance is taken. Regarding the magnitude relationship between the above-mentioned kinetic parameters and the three pulses, a significant difference was recognized when the risk factor was 0.05 or less by the t-test.

The distortion is defined as (A2 + A3 + ·
.. + An) / A1 or the like may be used, or a similar result can be obtained by defining it in another form. For example, the distortion d can be obtained by the method shown in FIG. That is, the pulse wave is input to the low-pass filter 51 and the high-pass filter 54 to output the low-frequency signal component v1 and the high-frequency component v2. Rectifier circuits 52, 55
, And then smoothed by the smoothing circuits 53 and 56 to obtain DC signals w1 and w2. The DC signals w1 and w2 are divided by a dividing circuit 57 to obtain a distortion d = w2 / w1.

The dynamic parameters are not limited to those described above, and similar results can be obtained even if other similar models are assumed. In particular, the equations for determining the dynamic parameters are not limited to those described above, and other empirical equations may be employed.

B. First Embodiment FIG. 1 shows a first embodiment of the present invention. In FIG. 1, 11
Is a pulse wave detector, and the detection method is shown in FIG. In FIG. 2, S1 is a pressure sensor mounted on the wrist, and detects a radial artery waveform. S2 is a cuff band attached to the upper arm for detecting blood pressure. The pulse wave detection device 11 calibrates the radial artery waveform based on the blood pressure, and outputs the pulse wave as an analog electric signal. An A / D converter 13 converts an analog electric signal output from the pulse wave detector 11 into a digital signal. Reference numeral 14 denotes a distortion calculator, which includes a Fourier analyzer 15 and a distortion calculator 17. The Fourier analyzer 15 is constituted by a microcomputer or the like, and a program for Fourier analysis is stored in a memory such as a ROM. Further, the Fourier analyzer 15 performs a Fourier analysis on the digital signal output from the A / D converter 13, and calculates the amplitude A1 of the fundamental wave, the amplitude A2 of the second harmonic,..., The amplitude An of the n-th harmonic. Output. n is appropriately determined in consideration of the amplitude of the harmonic.

The distortion calculator 17 calculates the distortion d based on the amplitudes A1, A2,..., An output from the Fourier analyzer 15. The distortion d is expressed as d = √ (A2 ² + A3 ² +...
+ An ² ) / A1. 19 is a shape determiner
The form is determined based on the distortion d calculated by the distortion calculator 14. The determination of the form is, for example, 1.161>d> 0.
If it is 960, it is determined to be a smooth pulse, and 0.960>d> 0.85
If it is 4, it is determined to be a normal pulse, and if 0.798>d> 0.670, it is determined to be a string pulse. The form determiner 19 outputs the result of the determination or the determination impossible. Reference numeral 21 denotes an output device for displaying and printing out the output result of the form determination unit 19.

C. Second Embodiment FIG. 3 shows a second embodiment. 3, the same components as those described in the first embodiment (FIG. 1) are denoted by the same reference numerals, and description thereof will be omitted. Reference numeral 23 denotes a dynamic parameter calculator, which is based on the strain d calculated by the strain calculator 14, the central vascular resistance Rc, the peripheral vascular resistance Rp, and the inertia L of the blood.
And the compliance C of the blood vessel wall is calculated. The above parameter calculation of the dynamic parameter calculator 21 is performed by the following relational expression. That is, the central part vascular resistance Rc is Rc = 5.
Calculated from 8.68d ** (−0.394), the peripheral vascular resistance Rp was Rp = 2321.3exp (−0.615).
d), the inertia L is L = 162.8 exp (−
2.585d), and the compliance C is C =
It is calculated from (-1.607 + 3.342d) × 10 ⁻⁴ . The unit of each parameter value is as described above.

The kinetic parameter calculator 23 also determines a pulse wave based on the kinetic parameters. For example,
Central vascular resistance Rc is 28.878-65.218,
The peripheral vascular resistance Rp is 1005.4 to 1358.5,
The inertia L of the blood is 7.647 to 12.994, and the compliance C of the blood vessel wall is (1.476 to 2.58).
4) In the case of x10 ^-4 , it is determined to be a smooth vein, and the central vascular resistance R
c is 55.543 to 128.531, peripheral vascular resistance Rp is 1158.2 to 1614.8, blood inertia L is 11.810 to 21.018, and vascular wall compliance C is (1 (0.076 to 1.698) × 10 ^-4 , it was determined to be a synovial vein and the central vascular resistance Rc was 164.9.
58-287.228, with a peripheral vascular resistance Rp of 133
2.0 to 1834.0, and the inertia L of the blood is 22.157
３２32.943 and vascular wall compliance C
Is (0.612 to 1.026) × 10 ⁻⁴ , it is determined to be a smooth pulse. An output device 21 is a dynamic parameter calculator 2
3 outputs the value of the dynamic parameter and the determination result.

D. Third Embodiment FIG. 4 shows a third embodiment. 4, the same components as those described in the first embodiment (FIG. 1) and the second embodiment (FIG. 3) are denoted by the same reference numerals, and description thereof will be omitted.
Numeral 25 is a comprehensive determiner that comprehensively determines the determination result of the morphological determiner 19 and the determination result based on the calculation result of the dynamic parameter of the dynamic parameter calculator 21 to diagnose a pulse wave. The comprehensive determiner 25 stores, for example, the determination result of the morphological determiner 19, the dynamic parameter and the determination result of the dynamic parameter calculator 21 as a table in a memory,
The table may be referred to. Further, any of the three pulse waves may be output as a diagnosis result, or a disease name belonging to the pulse wave may be output. The output device 21 outputs the determination result of the morphological determiner 19,
The calculation result of the dynamic parameter calculator 21 and the comprehensive determiner 25
Is printed and displayed. Thereby, a user of this apparatus such as a doctor can know the pulse wave or data on the pulse wave of the subject.

As described above, the use of the pulse wave diagnostic apparatus according to these embodiments makes it possible to easily perform a highly accurate pulse diagnosis. In addition, if the data on which the data is based is also displayed, the validity of the judgment result and the more detailed diagnosis result can be estimated.

It should be noted that the present invention is not limited to the above-described embodiment, and can be appropriately modified and implemented without departing from the spirit of the present invention. For example, distortion is not limited to the above definition. The distortion may be defined in another form as described above. Further, the dynamic parameters are not limited to those described above, and may be appropriately changed.

[0028]

As described above, according to the present invention,
There is an effect that highly accurate pulse wave diagnosis can be easily performed.

[Brief description of the drawings]

FIG. 1 is a diagram showing a configuration of a first embodiment.

FIG. 2 is a diagram illustrating a method of detecting a pulse wave.

FIG. 3 is a diagram showing a configuration of a second embodiment.

FIG. 4 is a diagram showing a configuration of a third embodiment.

FIG. 5 is a view showing a representative waveform of a pulse wave. (A) shows a pulse wave, (B) shows a pulse wave, and (C) shows a pulse wave.

FIG. 6 is a diagram showing a relationship between distortion d and three pulse waves.

FIG. 7 is a diagram showing the relationship between central vascular resistance Rc and strain d.

FIG. 8 is a diagram showing the relationship between peripheral vascular resistance Rp and strain d.

FIG. 9 is a diagram showing a relationship between inertia L of blood and strain d.

FIG. 10 is a diagram showing a relationship between compliance C and distortion d.

FIG. 11 is a diagram showing the relationship between central vascular resistance Rc and three pulse waves.

FIG. 12 is a diagram showing a relationship between peripheral vascular resistance Rp and three pulse waves.

FIG. 13 is a diagram showing the relationship between the inertia L of blood and three pulse waves.

FIG. 14 is a diagram showing a relationship between compliance C and three pulse waves.

FIG. 15 is a diagram showing another method of the distortion calculating means.

FIG. 16 is a diagram illustrating the Ayurvedic method (conventional example).

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 11 ... Pulse wave detector 13 ... A / D converter 15 ... Fourier analyzer 17 ... Distortion calculator 19 ... morphological judgment device 21 ... Output device 23 ... Dynamics parameter Calculator 25 ・ ・ ・ Comprehensive judgment device

──────────────────────────────────────────────────続 き Continuation of the front page (56) References JP-A-64-27534 (JP, A) JP-A-3-66357 (JP, A) JP-A-56-43927 (JP, A) JP-A-4-27 15037 (JP, A) JP-A-4-108424 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 5/02-5/0295

Claims (6)

(57) [Claims] 1. A pulse wave detecting means for detecting a pulse wave, a distortion calculating means for calculating a distortion from the pulse wave detected by the pulse wave detecting means, and a pulse wave based on the distortion calculated by the distortion calculating means. A pulse wave diagnostic apparatus comprising: a determination unit configured to determine a form. 2. The method according to claim 1, wherein the determining means includes a pulse wave detecting means.
Pulse wave detected is any of a smooth pulse, a flat pulse, or a chord pulse
2. The pulse wave diagnosis according to claim 1, wherein
apparatus. 3. A pulse wave detecting means for detecting a pulse wave;
Distortion calculation for calculating distortion from the wave detected by the wave detection means
Means for circulating from the pulse wave calculated by the strain calculating means.
A dynamic parameter calculator that calculates dynamic parameters
A pulse wave diagnostic apparatus comprising: a step; 4. The dynamic parameter calculating means according to claim 1 , wherein:
Central vascular resistance and elimination as parameters related to ring dynamics
Calculate vascular resistance, blood inertia, and compliance
The pulse wave diagnostic device according to claim 3, wherein: 5. A pulse wave detecting means for detecting a pulse wave;
Distortion calculation to calculate distortion from pulse wave detected by wave detection means
Output means and a pulse wave from the strain calculated by the strain calculating means.
Determination means for determining the form of
Calculate the parameters related to circulatory dynamics from the applied strain
State parameter calculation means and the determination means
Pulse wave form and the kinetic parameter calculating means
Diagnostic means for making a diagnosis from both the determined kinetic parameters
A pulse wave diagnostic device comprising: 6. The pulse wave detection means according to claim 6 , wherein
Pulse wave detected is any of a smooth pulse, a flat pulse, or a chord pulse
The dynamic parameter calculation means determines whether the circulation
Central vascular resistance, peripheral part as parameters related to dynamics
Calculate vascular resistance, blood inertia, and compliance
The pulse wave diagnostic device according to claim 5, wherein: