肺结节中医证候与语音信号诊断特征研究  

Diagnostic features of voice signals in patients with pulmonary nodules and its correlation with traditional Chinese medicine syndromes

作　　者：陆洲 沙娇娇 江涛 周基安 许家佗[1] LU Zhou;SHA Jiaojiao;JIANG Tao;ZHOU Ji'an;XU Jiatuo(School of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Acupuncture and Moxibustion,Huadong Hospital,Fudan University,Shanghai 200040,China;Department of Respiratory and Critical Care Medicine,Huadong Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]上海中医药大学中医学院,上海201203 [2]复旦大学附属华东医院针灸科,上海200040 [3]复旦大学附属华东医院呼吸与危重症医学科,上海200040

出　　处：《上海中医药杂志》2024年第2期46-51,共6页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82104738);国家重点研发计划项目(2017YFC1703301);上海市卫健委中医药科研项目(2022QN013);中国博士后科学基金面上项目(2023M732337);上海市科委地方院校能力建设计划项目(21010504400);上海市人力资源和社会保障局“超级博士后”激励计划项目(2022509)。

摘　　要：目的 研究肺结节患者的语音信号诊断特征,探讨不同中医证候肺结节患者语音信号指标的差异,探索肺结节声诊客观化、定量化、标准化研究思路与方法。方法 通过问诊形式采集肺结节患者(肺结节组)、健康对照者(健康对照组)的年龄、性别、吸烟史、CT影像学等一般资料,以及肺结节患者的中医四诊信息,并进行中医辨证分型。借助SONY A10线性PCM录音设备采集所有研究对象的语音信号资料,采用OpenSMILE工具包获取[a]、[e]、[i]、[o]、[u]5个元音的扩展的日内瓦极简声学参数集(eGeMAPS),比较肺结节患者与健康人群的语音特征指标,以及不同中医证型肺结节患者的语音特征;进一步根据结节数量将肺结节患者分为孤立性肺结节组、多发性肺结节组,根据肺结节大小分为小直径组、中直径组、大直径组,比较各组语音特征指标。结果 (1)共纳入肺结节患者156例、健康对照者62例;肺结节患者中,孤立性肺结节73例、多发性肺结节83例,小直径92例、中直径49例、大直径15例。(2)156例肺结节患者中,气虚证49例、阴虚证31例、痰湿证42例、其他证型34例。(3)在频率特征指标方面,肺结节组5个元音F0值高于健康对照组,元音[i]的Jitter、F3 frequency值低于健康对照组(P<0.05);在能量/振幅特征指标方面,肺结节组元音[a]、[e]、[o]的HNR值高于健康对照组,元音[a]的F1 amplitude值高于健康对照组,元音[i]的H1-A3值低于健康对照组(P<0.05);在谱特征指标方面,肺结节组元音[e]、[o]的MFCC1,元音[e]、[i]、[o]、[u]的MFCC2,元音[a]、[e]的MFCC4,元音[e]、[i]、[u]的Hammarberg index值低于健康对照组,元音[i]、[u]的Alpha ratio值高于健康对照组(P<0.05)。(4)孤立性肺结节组与多发性肺结节组语音特征指标差异无统计学意义(P>0.05)。(5)大直径组元音[i]的F2 amplitude值高于小直径组、中直径组(P<0.05),中直径组元音[i]的Slope 500~1 500值�Objective To study the diagnostic features of voice signals in patients with pulmonary nodules(PN),compare the differences in voice signals among PN patients with different traditional Chinese medicine(TCM)syndromes,and explore the objective,quantitative,and standardized research ideas and methods for lung nodule acoustic diagnosis.Methods Through a questionnaire survey,general information such as age,gender,smoking history,and CT imaging results were collected from PN patients(pulmonary nodule group)and healthy controls(healthy control group).In addition,the TCM four diagnostic information of PN patients was collected and classified according to TCM syndromes.Using a SONY A10 linear PCM recorder,voice signal data were collected from all study subjects,and the extended Geneva minimalistic acoustic parameter set(eGeMAPS)for the five vowels/a/,/e/,/i/,/o/and/u/was extracted with the OpenSMILE toolkit.Voice features were compared between PN patients and healthy individuals,as well as between PN patients with different TCM syndromes.Additionally,the PN patients were divided into solitary PN group and multiple PN group based on the number of nodules,and into small diameter group,medium diameter group,and large diameter group based on the size of the nodules.Voice features of each group were compared.Results①A total of 156 PN patients and 62 healthy controls were included.Among the PN patients,73 cases were found having a solitary pulmonary nodule and 83 cases were found having multiple pulmonary nodules.There were 92 cases of small diameter,49 cases of medium diameter,and 15 cases of large diameter.②Among the 156 PN patients,there were 49 cases of qi-deficiency syndrome,31 cases of yin-deficiency syndrome,42 cases of phlegm-dampness syndrome,and 34 cases of other syndromes.③In terms of frequency features,the F0 values for the five vowels were higher in the PN group than those in the healthy control group.The Jitter and F3 frequency values for vowel/i/were lower in the PN group than those in the healthy control g

关 键 词：肺结节 中医声诊 中医证候 语音信号 智能诊断 

分 类 号：R259[医药卫生—中西医结合]