臺灣博碩士論文加值系統

當代社會中，隨著經濟發展的加速和生活節奏的加快，人們日常生活中所承受的壓力也逐漸增大。現今社會所帶來的種種壓力無疑是一個值得關注的議題，情緒疾病症帶來的問題不僅限於患者本人及家庭，更會造成整體社會的競爭力下降，因此是我們需要去面對的議題。為因應許多患者無法配合後續治療問題，研究能在家治療的智能電刺激設備，每日僅需一小時即可完成治療，使治療簡單化。本論文旨在探討現今社會所帶來的壓力過大對人們心理健康的影響，特別聚焦於失眠和交感神經失調等問題。現今臨床檢測方法是心率變異分析 (Heart Rate Variability, HRV) 檢測、睡眠品質料表。改變HRV最重要的因子就是自律神經活性，當HRV較低時說明患有憂鬱症的機率較大，有更多的證據指向受試者有憂鬱傾向，另計算頻域及時域參數驗證。實驗受試者選擇為，經憂鬱量表所篩選出的有憂鬱壓力傾向受試者，對他們採用耳迷走神經刺激 (transcutaneous auricular vagus nerve stimulation, taVNS) 耳屏，並即時監測光電容積圖 (Photoplethysmography, PPG) 與前額葉功能性近紅外光譜 (functional near-infrared spectroscopy, fNIRS) 的資訊判斷使用者當下狀態。本論文製作了兩塊微型化印刷電路板 (Printed Circuit Board, PCB) 透過微控制器 (Micro Control Unit, MCU) 計算各數據，並將獲得的計算後的指標製成數據庫。在使用者介面 (User Interface, UI) 的部分，提供友善介面的應用程式 (Application, APP) ，讓高齡患者也能輕鬆使用也能讓在各處的家人可以知道患者的治療情況。最終我們將資料進行兩種分析，以個人與統計方式做比較後發現HRV的參數有一定顯著性。

In contemporary society, with the acceleration of economic development and the pace of life, the pressure people bear in their daily lives is gradually increasing. The various pressures brought by today's society are undoubtedly a topic worth paying attention to. The problems caused by emotional disorders are not limited to the patients themselves and their families, but can also lead to a decrease in the overall competitiveness of society. Therefore, it is an issue we need to face. To address the issue of many patients being unable to cooperate with subsequent treatment, research has been conducted on intelligent electrical stimulation devices that can be treated at home. Treatment can be completed in just one hour per day, simplifying the process. This paper aims to explore the impact of excessive stress in today's society on people's mental health, with a particular focus on issues such as insomnia and sympathetic dysfunction. The current clinical testing methods include Heart Rate Variability (HRV) testing and sleep quality assessment. The most important factor in changing HRV is the activity of the autonomic nervous system. When HRV is low, it indicates a higher risk of depression. To provide more evidence that subjects have a tendency towards depression, frequency domain and time domain parameters were calculated for validation. The experimental subjects were selected as those with a tendency towards depression and stress, who were screened through a depression scale. Transcutaneous auricular vagus nerve stimulation (taVNS) was applied to their ear screens, and photoplethysmography (PPG) and functional near infrared spectroscopy (fNIRS) of the frontal lobe were monitored in a timely manner to determine the current state of the users. This thesis produced two miniaturized printed circuit board (PCB) and calculated various data through micro control unit (MCU), and compiled the calculated indicators into a database. In the user interface (UI) section, a user-friendly interface application (APP) is provided to enable elderly patients to easily use it and to let family members know about the patient's treatment status. We finally conducted two types of analysis on the data and found that the parameters of HRV were significant after comparing them in both individual and statistical ways.

摘要 i
Abstract ii
目錄 iii
表目錄 v
圖目錄 vi
第1章 緒論 1
1.1 研究動機 1
1.2 研究目的 1
1.3 研究流程與論文結構 2
第2章 文獻探討 3
2.1 憂鬱症與焦慮症 3
2.1.1 憂鬱症流行病學 3
2.1.2 憂鬱症介紹 5
2.1.3 焦慮症流行病學 6
2.1.4 焦慮症介紹 8
2.2 現行治療方式 9
2.2.1 藥物治療 9
2.2.2 心理治療 10
2.2.3 電刺激 10
2.3 相關研究 12
2.3.1 HRV與情緒的相關性 12
2.3.2 PPG原理與ECG監測HRV比較 13
2.3.3 電刺激對情緒影響相關性 14
2.4 討論 17
第3章 材料與研究方法 18
3.1 系統架構 18
3.2 硬體 19
3.2.1 PPG與電刺激電路設計 19
3.2.1.1 升降壓電路 20
3.2.1.2 控制電路 20
3.2.1.3 PPG電路 22
3.2.1.4 電刺激電路 23
3.2.2 fNIR智能控制電路設計 25
3.2.2.1 控制器電路 27
3.2.2.2 fNIR集成電路 28
3.3 軟體 32
3.3.1 使用者APP 32
3.3.2 雲端資料庫 34
3.4 韌體程式 34
3.4.1 MCU控制fNIR 34
3.4.2 MCU控制藍牙 37
3.4.3 MCU控制電刺激 38
3.5 系統評估 41
3.5.1 PPG與電刺激系統電路評估 41
3.5.2 fNIR智能控制電路評估 43
3.6 實驗架構與流程 44
3.6.1 受試者之篩選條件 44
3.6.1.1 納入條件 44
3.6.1.2 排除條件 44
3.6.1.3 實驗環境 44
3.6.1.4 實驗流程 44
第4章 結果與討論 46
4.1 實驗結果 46
4.1.1 偽組驗證 46
4.1.2 廓清期驗證 46
4.1.3 單極與雙極對於個體差異 47
4.1.4 GEE統計結果 48
4.1.5 fNIR結果 56
4.2 PPG與電刺激系統電路評估結果 57
4.3 fNIR智能控制電路評估結果 62
4.4 比較與討論 63
第5章 結論與未來展望 65
5.1 結論 65
5.2 研究限制 65
5.3 未來展望 65
第6章 參考文獻 66
附件 75

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