Clinical Study On The Acoustic Characteristics Of Cunkou Pulse In Chronic Calculous Cholecystitis

Objective: This study intends to use the acoustic pulse detection system to collect the abnormal acoustic wave of pulse in patients with chronic calculous cholecystitis and compare with non-patient group of subjects,observe the level and point of abnormal acoustic wave in patients with chronic calculous cholecystitis,analyze the difference of acoustic pulse and the quantitative score of abnormal acoustic wave and TCM symptom classification,and the correlation of liver function indicators.Methods: Song’s Hydroacoustics Pulse Diagnostic Instrument was used to collect the acoustic pulse information of bilateral radial artery from patients with chronic calculous cholecystitis and non-patient group of subjects,and MATLAB software to conduct waveform superposition processing,wavelet transform analysis,HHT analysis,multi-scale entropy analysis,explore the level,point position and frequency range of characteristic sound waves,Comparing patients with chronic calculous cholecystitis and non-patient group of subjects,whether the shannon entropy and energy of the original pulse image,the Shannon entropy and energy after the wavelet decomposition,and the multiscale entropy value and energy of the IMF component obtained by EMD decomposition differ,Then analyze the frequency of characteristic acoustic waves in chronic calculous cholecystitis patients and the correlation of TCM symptom grading quantification score,original pulse entropy and energy and the correlation of liver function indicators,Finally,a diagnostic model was established for a diagnostic test to evaluate its diagnostic value.Results: 1.Through the analysis and comparison of the waveform time domain,most patients with chronic calculous cholecystitis have characteristic sound waves in the HI segment of the second heart sound in the third layer of the right pass.2.Through wavelet transform analysis,compared with the control group,can be found in the HI signal,especially in the d6-d9 layer,the range is 15.625Hz-250 Hz,is a low frequency audible sound wave;The shannon entropy and energy of the third layer of the right pass of the two groups of research subjects were statistically significant;The Shannon entropy and energy of the third layer of the right pass were decomposed into approximate components a1,a2,a3,a4,a5 and detail components d1,d2,d3,d4,d5,The results showed that the Shannon entropy of a1,a2 and a5 in the third layer of the right gate,and the entropy of a1(P<0.01),The two groups were statistically different in the energy proportions in a1,a2,a3,a4,d1 and d2,and the energy proportions in a1,a2,a3 and d1(P<0.01).3.According to the Hilbert-Huang transform analysis,it was found the time domain characteristics of the IMF component of the two groups were significantly different in layer 4 and layer 5,and the instantaneous frequency of IMF4 and IMF5 components in the test group was significantly higher than that of the control group,while in the frequency domain,the energies of IMF1-IMF10 in the right-off third layer were statistically different between the two groups by statistical analysis,and the energies of IMF3 and IMF5 were statistically significantly different.4.The results of multi-scale entropy analysis between the two groups showed that the multi-scale entropy of the two groups was statistically different in IMF1,IMF2,IMF4,IMF5,IMF6,IMF7,IMF8 and IMF10,and the multi-scale entropy values of the two groups were statistically different in IMF1,IMF2,IMF5,IMF6,IMF7 and IMF10(P<0.01).5.In the correlation analysis,there was a positive correlation between the quantitative score of TCM symptom classification and the frequency of characteristic sound waves,and the Shannon entropy and energy in the third layer of the right pass of the test group were significantly correlated with the TBIL in the liver function index.6.In the diagnostic test,the sensitivity of the preliminary diagnosis of chronic calculous cholecystitis was 85.42% and the specificity was 90.48% by the Song’s hydroacoustic pulse diagnostic instrument;After the ROC curve analysis,the area under the curve was 0.878 and the Yoden index was0.7589,indicating the diagnostic value of this test model for the diagnosis of chronic calculous cholecystitis.Conclusion: Compared with the non-patient group,patients with chronic calculous cholecystitis are significantly different in the right level,and the characteristic sound waves appear in the HI segment of the third layer of the right level,which is low frequency audible sound waves.