發(fā)布時間：2018-03-29 03:37

  本文選題：面癱　切入點：溫度分布　出處：《燕山大學》2013年博士論文

【摘要】：Bell面癱是一種臨床上常見多發(fā)的面神經(jīng)疾病，其主要癥狀為口眼歪斜，由于該病病因尚未完全明確，因此部分患者無法徹底治愈，引發(fā)面部肌肉運動功能失常的后遺癥，嚴重影響患者的正常生活和人際交往。但在發(fā)病初期客觀的評估病情，合理的選擇穴位進行針刺治療，絕大多數(shù)患者能夠痊愈，將后遺癥的發(fā)病率降到最低。因此，研究一種客觀高效的Bell面癱病情嚴重度評估以及針灸治療穴位選擇方法不論對于Bell面癱患者個人還是整個社會均具有重大意義。 面部溫度分布左右不對稱是Bell面癱最新發(fā)現(xiàn)的癥狀之一，紅外熱像圖可以直觀的顯示和記錄Bell面癱患者的面部溫度分布特征，本文依據(jù)Bell面癱的面部溫度分布不對稱特征，提出了利用紅外熱像圖輔助Bell面癱嚴重度客觀評估和針灸選穴的新方法，主要工作如下： 首先，基于面部溫度分布特征，提出了融合溫度特異性和邊緣檢測，先局部定位后整體細化的面部紅外熱像圖穴位自動定位算法，該方法綜合利用了面部溫度的相關性與突變性，結合灰度投影法與面部穴位分布的先驗知識自動定位面部的主要穴位。通過實驗證明，本算法運算速度快，抗干擾能力強，且穴位定位準確率高，為臨床Bell面癱客觀選穴奠定了基礎。 其次，在臨床實驗觀察的基礎上，提出了兩種新的面部溫度分布特征的表示方法：1)面部溫度分布不對稱度，即面部紅外熱像圖健患雙側的局部二值模式的直方圖距離；2)有效熱面積比，即計算面部特定區(qū)域與對側區(qū)域的溫差乘以溫度異常區(qū)面積與總面積之比。新的表示方法，不僅包括傳統(tǒng)熱像圖中的溫度分布信息，更加突出了Bell面癱面部溫度左右不對稱這一分布規(guī)律。利用這兩種特征，結合BP神經(jīng)網(wǎng)絡和形式概念分析，提出了Bell面癱嚴重度定量和定性兩種客觀評估方法。實驗結果表明，面部溫度分布不對稱特征與Bell面癱的嚴重程度正相關，，有統(tǒng)計學意義，對Bell面癱嚴重度的分類精度完全符合臨床應用標準。因此利用紅外熱成像提取面部溫度分布不對稱特征可以為臨床診治Bell面癱提供客觀評價指標。 最后，提出利用紅外熱像選擇左右兩側溫差最大的前五個穴位進行針刺治療的Bell面癱臨床選穴新方案。在臨床單盲隨機對照實驗中表明，紅外熱像選穴組比常規(guī)辨證選穴組的治療療程縮短，臨床療效提高了18.27%，有統(tǒng)計學意義。因此，紅外熱像選穴法有助于Bell面癱的針灸治療，更是為其他面部神經(jīng)類疾病的針灸選穴提供了新思路，這是對中醫(yī)針灸選穴現(xiàn)代化的有力補充。
[Abstract]:Bell facial paralysis is a kind of recurrent facial nerve disease in clinic , its main symptom is mouth distortion , because the cause of the disease is not completely clear , some patients can ' t cure completely , cause facial muscle movement disorder sequela , most patients can cure , the incidence of sequelae is reduced to the lowest . Therefore , it is of great significance to study an objective and high - efficiency evaluation of Bell facial paralysis and acupuncture treatment point selection method , whether for patients with Bell facial paralysis or the whole society .

The asymmetry of facial temperature distribution is one of the most recent symptoms of Bell ' s facial paralysis . The infrared thermal image can display and record the facial temperature distribution characteristics of Bell facial paralysis . Based on the asymmetry characteristics of facial temperature distribution of Bell facial paralysis , this paper proposes a new method to evaluate the severity of Bell ' s facial paralysis by using infrared thermal image . The main work is as follows :

First , based on the feature of facial temperature distribution , the authors put forward an algorithm for automatic localization of facial infrared images based on fusion temperature specificity and edge detection . The method comprehensively utilizes the correlation and mutation of facial temperature , and combines the prior knowledge of gray projection method and facial acupuncture point distribution to automatically locate the main acupuncture points of the face .

Secondly , on the basis of clinical experimental observation , two new expressions of facial temperature distribution are presented : 1 ) the asymmetry of facial temperature distribution , that is , the histogram distance of local binary pattern on the two sides of facial infrared thermal image .
2 ) The effective heat area ratio , that is , the ratio of the temperature difference between the face specific area and the opposite side area multiplied by the area of the temperature abnormal area and the total area . The new expression method not only includes the temperature distribution information in the traditional thermal image map , but also highlights the distribution law of the Bell facial paralysis severity quantitative and qualitative two objective evaluation methods . The experimental results show that the asymmetry characteristic of the facial temperature distribution is related to the severity of Bell facial paralysis . The experimental results show that the classification accuracy of the severity of Bell facial paralysis is fully consistent with the clinical application standard . Therefore , the asymmetry characteristic of the facial temperature distribution can be extracted by infrared thermal imaging , and the objective evaluation index can be provided for clinical diagnosis and treatment of Bell facial paralysis .

Finally , it is suggested that the new scheme of acupuncture treatment of Bell facial paralysis by using the infrared thermal image to select the top five acupuncture points with the maximum temperature difference between the left and right sides is proposed . In the clinical single blind randomized controlled experiment , the treatment course of the infrared thermal image selection point group is shortened and the clinical curative effect is improved by 18.27 % . Therefore , the infrared thermal image selection point method can help the acupuncture and moxibustion treatment of Bell facial paralysis , and provide a new idea for the acupuncture and moxibustion treatment of other facial nerve diseases , which is a powerful supplement to the modernization of the acupuncture and moxibustion selection of the traditional Chinese medicine .

【學位授予單位】：燕山大學
【學位級別】：博士
【學位授予年份】：2013
【分類號】：R245;TP391.41

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