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研究生:姜禮能
研究生(外文):Chiang Li-Neng
論文名稱:中醫語音聞診於上消化道疾病之探討
論文名稱(外文):A Study of Acoustical Method in Traditional Chinese Medicine for the Upper GI Disorder Patients
指導教授:張永賢張永賢引用關係徐良育徐良育引用關係翁清松翁清松引用關係
指導教授(外文):Yung-Hsien ChangLiang-Yu ShyuChing-Sung Weng
學位類別:碩士
校院名稱:中原大學
系所名稱:醫學工程研究所
學門:工程學門
學類:綜合工程學類
論文種類:學術論文
論文出版年:1998
畢業學年度:86
語文別:中文
中文關鍵詞:中醫聞診語音處理音高越零率共振峰
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四診之法,各司其職,各有其重要之地位。然而於實際的診療過程之中,聞診之臨床技巧應用,常因為中醫師們對古書體驗不同,而有明顯的差別。甚至於學術研究上,聞診也是常被學者們所忽略的研究領域。因此本研究想利用語音處理技術來為中醫聞診中之聲音部份提供實驗佐證與語音資料的保存。 本研究之主要研究目的與方法是探討上消化道疾病患者,經由語音之分析處理過程,比較其語音與健康人語音之間的差異。影響的語音參數,包括音高、越零率與共振峰三方面。上消化道疾病患者取樣人數為47人;健康人為年輕、有活力之中原大學學生52人。受測者統一發母音(/a/、/i/、/u/、/e/、/o/)持續五秒鐘左右,所得各語音數據經由單因子變異數與二因子變異數之統計分析,結果發現:(1)音高部份:男性健康人的音高低於男性上消化道患者的音高;女性健康人的音高高於女性上消化道患者的音高(P<0.05)。(2)越零率方面:經由二因子變異數統計結果,母音(/a/、/i/、/o/)有顯著的統計差異。另外本研究也發現,越零率是繼音高外,另一項分辨性別的語音參數(P<0.001)。(3)共振峰方面:上消化道病患的母音(/a/、/i/、/o/)第一共振峰值與母音(/u/)第二共振峰值均高於健康人(P<0.05)。 本研究所得到統計結果會有明顯的差異,可能是因上消化道病患有腹部隱痛、脹痛、鈍痛、臉色發白、冒冷汗、脈搏跳動次數增加、壓迫感、胃氣上逆、陰液不足與便血等症狀,造成肺部吐氣量、聲帶的激發次數與氣虛、氣實的相關性,進而影響發音所致。 另外本研究經統計結果,把最具有明顯差異的母音/o/,經軟體PRW(Pattern Recognition Workbench)的類神經倒傳遞理論把男性音高、越零率與第一共振峰做訓練,以辨識上消化病患語音與健康人語音之不同,得到軟體模擬辨識率達90%以上。 根據語音參數、統計結果與類神經辨識等過程,母音/o/的音高、越零率、與第一共振峰可作為判別上消化道疾病的指標。與健康人的語音比較之,胃炎患者一般是屬「真熱假寒」證,臨床症狀白苔、口乾等,因此其音高偏低,越零率與第一共振峰偏高。屬實「熱」證十二指腸患者,臨床症狀黃苔、舌紅等,其音高偏高,越零率與第一共振峰也偏高。至於胃潰瘍患者,兩名男性患者,其病因是因藥物引起,加上胃潰瘍患者總人數取樣太少,故於本研究中只提供參考。
For the doctor of traditional Chinese medicine, four major diagnostic methods, inspection, auscultation, questioning and palpation, are the perfect ways to getpathology. Nevertheless, the skills of auscultation are usually to be omitted by youngdoctors and there are few scholastic papers about auscultation with digital processing of speech signals. Accordingly, in this thesis, we used digital processing techniques of speech signals to give scientific evidences for auscultation. The purpose of this thesis was to find out the speech differences between theupper GI disorder patients and the healthy people. In order to search the speechcharacteristic features about them, we used speech parameters, including pitch, zerocrossing rates and formants, to compare the speech pattern of healthy people with upperGI disorder patients. The vowel (/a/, /i/, /u/, /e/, /o/) sounds were chosen for two subjectgroups to pronounce for 5 minute. There were 52 healthy people and 47 patients withthe upper GI disorder involved in this research. Experimental results showed that:(1)The pitches of healthy males were lower thanthe upper GI disorder patients'' and the pitches of healthy females were higher(P<0.05).(2)The zero crossing rates for vowel (/a/, /i/, /o/) were significantly different between the upper GI disorder patients and healthy people. In addition, the zerocrossing rates were able to distinguish between sex (P<0.001).(3)The first formant forvowel (/a/, /i/, /o/) and the second formant for vowel (/u/) of healthy people were lowerthan the upper GI disorder patients''(P<0.05). For this thesis, why the experimental results showed significant differences? The reasons for the significant differences were the upper GI disorder patients with sharppain on abdomen, cold sweat, accelerated heartthrob, oppression, egesta with blood, andthirsty made correlations between exhalation, the excitation of vocal cords and qivacuity, qi solidity. The statistical results showed that vowel (/o/) were the most representative to distinguish between the diseased and the healthy subjects. The pitch, zero crossing ratesand the first formant of vowel (/o/) of males were used to carry out Back-propagation algorithm of neural network training by PRW (Pattern Recognition Workbench) andreached an accuracy rate above 90% to distinguish between two subject groups. After the processes of speech analysis, statistics and recognition, we made aconclusion that pitch, zero crossing rates, and the first formant of vowel (/o/) were theindices to distinguish between the diseased and the healthy. The pitches of gastritis werelower than the healthy peoples'', but the zero crossing rates and the first formant werehigher than the healthy peoples''. The pitches of some peptic ulcers who are pyrexiogenic were higher than the healthy peoples''; the zero crossing rates and the first formant were also higher than the healthy peoples''.
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