基于红外热像图的Bell面瘫客观评估与选穴方法研究

发布时间：2018-03-29 03:37

本文选题：面瘫　切入点：温度分布　出处：《燕山大学》2013年博士论文

【摘要】：Bell面瘫是一种临床上常见多发的面神经疾病，其主要症状为口眼歪斜，由于该病病因尚未完全明确，因此部分患者无法彻底治愈，引发面部肌肉运动功能失常的后遗症，严重影响患者的正常生活和人际交往。但在发病初期客观的评估病情，合理的选择穴位进行针刺治疗，绝大多数患者能够痊愈，将后遗症的发病率降到最低。因此，研究一种客观高效的Bell面瘫病情严重度评估以及针灸治疗穴位选择方法不论对于Bell面瘫患者个人还是整个社会均具有重大意义。面部温度分布左右不对称是Bell面瘫最新发现的症状之一，红外热像图可以直观的显示和记录Bell面瘫患者的面部温度分布特征，本文依据Bell面瘫的面部温度分布不对称特征，提出了利用红外热像图辅助Bell面瘫严重度客观评估和针灸选穴的新方法，主要工作如下：首先，基于面部温度分布特征，提出了融合温度特异性和边缘检测，先局部定位后整体细化的面部红外热像图穴位自动定位算法，该方法综合利用了面部温度的相关性与突变性，结合灰度投影法与面部穴位分布的先验知识自动定位面部的主要穴位。通过实验证明，本算法运算速度快，抗干扰能力强，且穴位定位准确率高，为临床Bell面瘫客观选穴奠定了基础。其次，在临床实验观察的基础上，提出了两种新的面部温度分布特征的表示方法：1)面部温度分布不对称度，即面部红外热像图健患双侧的局部二值模式的直方图距离；2)有效热面积比，即计算面部特定区域与对侧区域的温差乘以温度异常区面积与总面积之比。新的表示方法，不仅包括传统热像图中的温度分布信息，更加突出了Bell面瘫面部温度左右不对称这一分布规律。利用这两种特征，结合BP神经网络和形式概念分析，提出了Bell面瘫严重度定量和定性两种客观评估方法。实验结果表明，面部温度分布不对称特征与Bell面瘫的严重程度正相关，，有统计学意义，对Bell面瘫严重度的分类精度完全符合临床应用标准。因此利用红外热成像提取面部温度分布不对称特征可以为临床诊治Bell面瘫提供客观评价指标。最后，提出利用红外热像选择左右两侧温差最大的前五个穴位进行针刺治疗的Bell面瘫临床选穴新方案。在临床单盲随机对照实验中表明，红外热像选穴组比常规辨证选穴组的治疗疗程缩短，临床疗效提高了18.27%，有统计学意义。因此，红外热像选穴法有助于Bell面瘫的针灸治疗，更是为其他面部神经类疾病的针灸选穴提供了新思路，这是对中医针灸选穴现代化的有力补充。
[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 .

【学位授予单位】：燕山大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R245;TP391.41

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