中醫診斷學術之實證研究子計畫(5)---利用現代語音科技發展中醫聞診輔助儀器

張榮森
中央大學
中醫聞診以患者聲音的變化為診斷的依據，是臨床辨證重要的一環，然而傳統中醫聞診診斷缺乏客觀化，每個中醫師對聲音的感覺不盡相同，此種差異容易造成過於主觀的判斷，因此如何使聞診的診斷能夠客觀及量化，以提供臨床應用與教學，成為一個重要的課題。　　首先我們擷取來自於中國醫藥大學附設醫院中醫內科門的診虛證患者語音信號並將語音參數分析、量化，其步驟包含時域(平均過零點數A1、峰谷值變化A2)、頻域(共振峰頻率變異值A3、低頻能量比A4、高頻能量比A5、梅爾倒頻譜係數)及碎形維度分析，在分析比較完虛證與非虛患者參數的差異後，發展擁有檔案儲存及資料庫功能的存儲系統，將所分析的結果建立一資料庫，以供查尋之用。　　在本計畫中聲音的分析上，使用了若干個分析參數，分別定義為A1~A5、梅爾倒頻譜係數及碎形維度值，然後以動態時間扭曲(DTW)路徑演算法量化分析。然後將儀器比較辨識結果進行驗證與分析，最後與臨床中醫師共同建立使用儀器辨症的臨床方法與程序標準，使聞診之診療在臨床上達到客觀、正確及科學化，完成發展儀器輔助中醫臨床診斷之目的。
關鍵字：聞診；診斷方法；診斷標準

The Development of Objective Auscultation for Traditional Chinese Medical Diagnosis Using Modern Speech Technology

Rung-Sen Iang
National Central University
Speech is not only a kind of tools for human to communicate and express emotion, but also to reflect the health condition. Speech variation is important for clinical examinations of auscultation in traditional Chinese medicine. However, this diagnosis of auscultation is lack of objective assessment. Doctors of traditional Chinese medicine don？？t have the same sense of voice and it influences the diagnostic accuracy in clinical practice. The main purpose of this study is to use modern speech analytical approaches to develop a platform of objective auscultation for traditional Chinese medical diagnosis. Firstly, speech signals will be recorded from deficient patients who are recruited from the outpatient department of rheumatology at China Medical University Hospital. Speech parameters will be quantified and analyzed the from speech signals. The parameters include temporal parameters, e.g. zero-crossing (A1), variations on peaks and valleys (A2), and spectral parameters, such as variations of formant frequencies (A3), low spectral energy ratio (A4), high spectral energy ratio (A5), and mel-frequency cestrum. Database for results of the speech parameters analysis will be established by analyzing the difference between the vacuity patients and the non-vacuity patients.
關鍵字：Auscultation；Diagnostic Method；Diagnostic Criteria