基于证素分析的慢性胃炎阵列式气体传感器气味图谱研究

Smelling examination is a part of TCM four diagnostic methods. However due to the inconvenience of information collection and technical limitations of the gas sensor, the smelling examination attending its studies is difficult to get the attention it deserves. Our group carried out the objectification study of smelling examination in prophase. Odor response patterns of oral breath of human body were collected by the electronic nose based on the gas sensors array for the first time and the overall information of odor was grasped. The odor characteristics of exterior cold syndrome patients and exterior heat syndrome patients could be distinguished sensitively and accurately. The sensitivity of the electronic nose is better than 0.1 ppm, and it is the original invention in China. This study is based on the early work. Each of 120 cases of qi stagnation, damp-heat, qi deficiency and yin deficiency patients of chronic gastritis would be selected by the differentiation of syndrome elements and 120 healthy persons would also be selected. Odor response patterns of oral breath would be collected by the electronic nose based on the gas sensors array and breath hydrogen test would be done. And the gastroscopy and 14C-urea breath test would be done for chronic gastritis patients. Parameters of odor response patterns of the selected persons would be abstracted, the correlation among characteristics of odor response patterns of different syndrome elements, fasting breath hydrogen content and gastroscopy image, helicobacter pylori infection would be analyzed by data mining techniques. The purpose is to explain smelling examination information by audio-visual pictures and objective data, to provide basic research for objectification of smelling examination, and to provide a kind of new method for the diagnosis of diseases and syndromes of chronic gastritis.

嗅诊是四诊的组成部分，然而由于信息采集的不便和气体传感器技术的限制，嗅诊及其研究难以得到应有的重视。本课题组在前期开展的嗅诊客观化研究中，首次运用基于阵列式气体传感器技术的电子鼻采集人体口腔呼气气味图谱，把握气味整体信息，能够较为敏感和准确地辨识表证患者的气味特征及其寒热病性，其灵敏度高于0.1PPM（千万分之一），为国内首创。本研究拟在此基础上，采用证素辨证方法，选择慢性胃炎患者，以临床常见气滞、湿热、气虚、阴虚4组患者各120例为观察对象、健康者120例为对照，运用阵列式气体传感器采集口腔呼气气味图谱并进行呼气氢试验，同时对慢性胃炎患者进行胃镜检查和14C-尿素呼气试验，采用数据挖掘技术，提取受试者的气味图谱参数，分析不同证素相关气味图谱特征及空腹呼气氢含量与胃镜像、幽门螺杆菌感染的相关性。目的在于以客观的图谱和数据阐释嗅诊信息，为嗅诊客观化提供基础研究，为慢性胃炎病证诊断提供新方法。

本项目采用证素辨证的方法，选择618例慢性胃炎患者，以临床常见气滞、湿热、阴虚、气虚证患者为对象，相应年龄段的120例健康者为对照，探讨慢性胃炎阵列式气体传感器气味图谱特征。.一、主要研究内容.1.规范采集四诊信息，应用证素辨证的方法，分析慢性胃炎患者的证素特点。.2.运用基于薄膜型气体传感器阵列技术的医用电子鼻（ENO11103-A）采集慢性胃炎患者和健康者的口腔呼气的气味图谱。.3.采用人工神经网络和改进的支持向量机等数据挖掘方法，分析健康者和慢性胃炎患者不同证素相关口腔呼气的气味图谱特征。.4.通过对慢性胃炎患者进行胃镜检查、14C-尿素呼气试验、空腹呼气氢试验，分析慢性胃炎不同证素相关气味图谱特征及空腹呼气氢含量与胃镜像、Hp 感染的相关性。.二、研究的重要结果.1.分析了慢性胃炎的证素特征，认为慢性胃炎的病位主要涉及胃、脾、肝；病性上以虚实夹杂、寒热错杂为主，实性病理改变主要为热、气滞、湿、痰，虚性病理改变主要为阴虚、气虚、阳虚。热、气滞、湿是本病的重要致病因素和病理特点。.2.建立了运用基于阵列式气体传感器技术的医用电子鼻采集口腔呼气气味图谱的规范方法。.3.提取了健康者的口腔呼气气味图谱参数，分析了慢性胃炎不同证素相关气味图谱特征，探讨了图谱曲线响应与机体内在病理变化的相关性，实现了以直观的图谱和客观的数据来阐释中医嗅诊信息。.4.得出运用电子鼻从整体上把握气味信息，能识别慢性胃炎患者口腔呼气的气味图谱特征，并能初步判断慢性胃炎常见病性、病位证素，可以为中医病证诊断提供参考，为中医嗅诊客观化研究提供新的工具。.三、科学意义.运用基于阵列式气体传感器技术的电子鼻采集口腔呼气的气味图谱，为嗅诊的客观化研究提供新的手段和方法。通过直观的图谱和客观的数据来阐释嗅诊信息，为嗅诊的客观化提供基础研究。通过分析健康者和慢性胃炎患者不同证素相关气味图谱特征，为慢性胃炎的中医病证诊断提供客观依据和新方法。