臺灣博碩士論文加值系統

多囊性卵巢症(polycystic ovarian syndrome,PCOS)，是一種成因未明的內分泌異常疾病，典型症狀包含月經週期不規則、體態豐腴、青春痘、多毛或男性化表徵，嚴重甚至導致不孕，成為婦女健康的一大威脅。至今詳細致病機轉尚不明確，前人曾研究發現PCOS會造成供血異常而導致許多微循環相關病變，使患者容易伴隨心血管併發症，因此，我們初步推測PCOS所導致全身性微循環供血異常根源，可能來自卵巢本身供血異常所致。
本研究以4個月中藥療程搭配三次局部體表微循環血流量測(Baseline與兩次服藥期間效應)，使用雷射都卜勒血流計、生理訊號放大器，量測左、右腳體表三陰交穴位的血流訊號，透過時域波形參數分析技術，試圖以科學化診斷篩選與生理參數量測，希望能得知患者在經不同中藥治療過程中，探討末端狀態與局部血流變化。　
分析量測結果發現下列現象，一、Baseline觀察：患者局部體表部位供血效率較正常人差，可能與卵巢供血異常有關，使得氧氣、養份無法即時供給，妨礙正常生理機能運作；回歸圖也得知患者臨床指標與某些微循環血流波形指標，彼此是具有連動關係。二、療效觀察:綜合體表血流指標和回診定量表之結果互相比較，A藥都較B藥具有更快與明顯改善效果，B藥則觀察到有較強烈微循環端調控活動，卻無法實質幫助組織達到良好血流供應。
研究成果對PCOS患者進行LDF非侵入性體表量測，可由微循環血流脈波波形訊號分析來反應生理狀態變化情形，提供具備臨床實用解析能力之相對性指標，達到早期偵測與療效評估應用，期盼未來能朝向「居家照護」、「遠距醫療」層面開發，為世人帶來深遠的貢獻。

Polycystic ovary syndrome(PCOS) is a heterogeneous endocrine disorder but the detailed etiology of PCOS remains unknown. Polycystic ovary syndrome may result in several health complications such as menstrual dysfunction, infertility,
hirsutism, acne, obesity, and metabolic syndrome. Some studies suggested that PCOS contributes to the development of cardiovascular disease. The present aim is to verify if laser doppler measurement and time-domain waveform analysis can help to monitor the microcirculatory conditions in PCOS patients.
We performed four months of the Traditional-Chinese-Medicine treatment and three times Laser Doppler flowmetry (LDF) measurement. The locations of LDF measurement sites are the bilateral SanYinJiao(SP-6) acupoints. Time-domain parameters of LDF waveform were calculated to elucidate the microcirculatory effects induced in PCOS patients.
The present result revealed:
1.The time-domain LDF index can help to discriminate the PCOS and control subjects.
2.The time-domain LDF index can help to monitor the microcirculatory-blood-supply condition of flux-flow in PCOS patients following Chinese-herb administration.
The present finding may have meaning in noninvasive early detection and disease-progress monitoring for PCOS.

圖目錄
表目錄
第一章 緒論
1.1 背景 ………………………………………………………………1
1.2 研究動機 …………………………………………………………1

第二章 實驗方法
2.1 量測方法 …………………………………………………………7
2.1.1生理訊號放大器 ………………………………………………7
2.1.2雷射都卜勒血流計 ……………………………………………8
2.1.3 血壓波形感測計 ……………………………………………10
2.1.4 電子血壓計 …………………………………………………11
2.2 實驗設計 …………………………………………………………11
2.3 實驗步驟 …………………………………………………………12
2.3.1 實驗前置 ……………………………………………………12
2.3.2 實驗中操作 …………………………………………………14
2.3.3 實驗結束量測 ……………………………………………… 14
2.4 分析方法 …………………………………………………………16
2.4.1 參數介紹與定義 ……………………………………………17

第三章 實驗結果
3.1.空白組數據結果 ………………………………………………………22
3.1.1患者組與正常組比較 ……………………………………………22
3.1.2患者組患/健側比值與生理數據關係……………………………23
3.1.2.1 FRT與LH/FSH回歸圖 ……………………………………24
3.1.2.2 FDT與BMI回歸圖 ………………………………………25
3.2. 治療組數據結果
3.2.1全部患者治療後結果 ……………………………………………27
3.2.2藥品分類結果 …………………………………………………28

第四章 結論與未來展望
4.1 參數結果 ……………………………………………………………30
4.2 時域波形參數生理意義 ………………………………………………31
4.3 結果討論 ……………………………………………………………32
4.3.1 空白組-患者與正常組結果討論 ………………………………32
4.3.2空白組-患者組患/健側比值與生理數據回歸圖結果討論 ……32
4.3.3治療組-患者治療後結果討論 …………………………………33
4.3.4治療組-藥品分類之患者治療效果比較 ………………………33
4.4 結論 ……………………………………………………………………34
4.4.1生理狀態解析能力 ………………………………………………34
4.4.2時域波形參數優點 ………………………………………………35
4.5 未來展望 ………………………………………………………………35

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