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寸、关、尺三诊部位脉象特征的临床研究

A clinical study of the pulse wave characteristics at the three pulse diagnosis positions of chon, gwan and cheok.

机构信息

Constitutional Biology and Medical Engineering Research Center, Korea Institute of Oriental Medicine (KIOM), 461-24 Jeonmin-dong, Yuseong-gu, Daejeon 305-811, Republic of Korea.

出版信息

Evid Based Complement Alternat Med. 2011;2011:904056. doi: 10.1093/ecam/nep150. Epub 2011 May 2.

Abstract

In this work, we analyze the baseline, signal strength, aortic augmentation index (AIx), radial AIx, time to reflection and P_T2 at Chon, Gwan, and Cheok, which are the three pulse diagnosis positions in Oriental medicine. For the pulse measurement, we used the SphygmoCor apparatus, which has been widely used for the evaluation of the arterial stiffness at the aorta. By two-way repeated measures analysis of variance, we tested two independent measurements for repeatability and investigated their mean differences among Chon, Gwan and Cheok. To characterize further the parameters that were shown to be different between each palpation position, we carried out Duncan's test for the multiple comparisons. The baseline and signal strength were statistically different (P < .05) among Chon, Gwan and Cheok, respectively, which supports the major hypothesis of Oriental medicine that all of the three palpation positions contain different clinical information. On the other hand, aortic AIx and time to reflection were found to be statistically different between Chon and the others, and radial AIx and P_T2 did not show any difference between pulse positions. In the clinical sense, however, the aortic AIx at each palpation position was found to fall within the 90% confidence interval of normal arterial compliance. The results of the multiple comparisons indicate that the parameters of arterial stiffness were independent of the palpation positions. This work is the first attempt to characterize quantitatively the pulse signals at Chon, Gwan and Cheok with some relevant parameters extracted from the SphygmoCor apparatus.

摘要

在这项工作中,我们分析了中医三个脉诊部位冲、关、尺的基础值、信号强度、主动脉增强指数(AIx)、桡动脉 AIx、反射时间和 P_T2。脉搏测量使用 SphygmoCor 仪器进行,该仪器已广泛用于评估主动脉的动脉僵硬度。通过双向重复测量方差分析,我们测试了两种独立测量方法的可重复性,并研究了它们在冲、关和尺三个部位的平均值差异。为了进一步描述在每个触诊部位显示出不同的参数,我们进行了邓肯多重比较检验。基础值和信号强度在冲、关和尺三个部位之间存在统计学差异(P <.05),这支持了中医的主要假说,即三个触诊部位包含不同的临床信息。另一方面,主动脉 AIx 和反射时间在冲和其他部位之间存在统计学差异,桡动脉 AIx 和 P_T2 在脉搏部位之间没有差异。然而,从临床角度来看,每个触诊部位的主动脉 AIx 均落在正常动脉顺应性的 90%置信区间内。多重比较的结果表明,动脉僵硬度的参数与触诊部位无关。这项工作首次尝试使用 SphygmoCor 仪器提取的一些相关参数对冲、关、尺的脉搏信号进行定量描述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53e4/3137784/c45729583e87/ECAM2011-904056.001.jpg

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