| 摘要: | 摘 要 脈診在傳統中醫的診斷上扮演了重要的角色。脈診需要經驗的累積及高度的技巧，但卻有著主觀性，無法定量化、系統化的缺點。所以應用脈波儀研究各種疾病的脈波表現，將有助於臨床的診斷及治療。 初期感冒的病人，不論屬於風寒型或風熱型，其寸脈大部分都有浮起的表現。臨床上，風寒型外感的病人，除了有符合外感風寒的表徵，如：較惡風寒、頭項強痛、鼻流清涕等症狀外，我們發現其寸部的脈位均有向拇指方向偏移的現象。因此，我們希望探討此一寸部偏移的脈位是否有臨床上診斷的意義，及是否與外感風寒有相關性，以便能提供臨床上診斷及用藥的參考。 以對照組40人、風寒組22人、非風寒有項背症狀10人及非風寒無項背症狀組8人四組，以汪氏脈波儀測定寸部太陽項背點與寸步脈波比值 (H1/h1)的脈波參數比較。結果對照組的脈波參數平均值為0.46 (±0.29)，風寒組的脈波參數平均值為1.17 (±0.34)，非風寒有項背症狀組的脈波參數平均值為0.67 (±0.09)，非風寒無項背症狀組的脈波參數平均值為0.4 (±0.19)。研究結果顯示四組的脈波參數，在統計學上有顯著差異 (F值=33.14，p=0.0001)。Tukey’s 檢定顯示對照組與風寒組有顯著差異，風寒組與其他三組有顯著差異。由於風寒組22人中，有21人有項背症狀，表示有項背症狀者之脈波參數 (H1/h1)比無項背症狀的對照組及非風寒組皆為高。符合有項背症狀者，太陽項背點的脈會比較明顯。 經由變異數分析，三個組別(風寒組、風熱有項背症狀組、風熱組無項背症狀組)在項目3 (酸痛)、5 (惡風)、11 (口乾)、12 (咳嗽)、13 (喉嚨痛)上有顯著差異(分別為p=0.046、p=0.005、p=0.017、p=0.041、p=0.0003)。而在項目2 (頭痛)、4 (怕冷)、6 (發熱)、7 (清涕)、8 (濁涕)、9 (鼻塞)、10 (反胃)上無顯著差異。在項目3 (酸痛)上以LSD檢定，三個組別有顯著差異(p=0.046)，風寒組與風熱無項背症狀組兩組之間有顯著差異。在項目5 (惡風)上，經LSD檢定三個組別有顯著差異(p=0.005)；三個組別中，風寒組與風熱無項背症狀組兩組之間有顯著差異。在項目11 (口乾)上經LSD檢定，三個組別有顯著差異(p=0.017)，風寒組與風熱無項背症狀組兩組之間有顯著差異。在項目12 (咳嗽)上，經LSD檢定三個組別有顯著差異(p=0.041)，風寒組與風熱有項背症狀組兩組之間及風寒組與風熱無項背症狀組兩組之間皆有顯著差異。在項目13 (喉嚨痛)上，經LSD檢定三個組別有顯著差異( p=0.0003)，風寒組與風熱有項背症狀組兩組之間及風寒組與風熱組無項背症狀兩組之間有顯著差異。 關鍵詞：中醫脈診，脈波儀，外感，風寒，風熱。; An Investigation of Radial Sphygmogram in Patients with Common Cold Lu, Shih-Ming Institute of Chinese Medical Science, China Medical College Abstract The pulse has long been used as a fundamental tool for diagnosis in traditional Chinese medicine. It requires long experiences and a high level of skill to get a precise pulse diagnosis since it is not objective, quantitative,and systematic. Therefore it will be helpful by using the sphygmography to classify the pulses of diseases. Patients with the characteristics of wind-heat or wind-cold usually have a floating pulse when they have a cold. In clinic, patients with pathogenic wind- cold not only has the typical syndrome of aversion to wind and cold, stiff neck, headache and running nose but also has a pulse migration to the thumb side at cun (tai-yang point). In this experiment we wanted to discuss the meaning of the tai-yang point, and the relationship between the tai-yang point and exogenous wind cold, which is helpful for the diagnosis and prescription. We compared the ratio of the height of the maximum amplitude at the tai-yang point and cun (H1/h1) in four groups, the control group (n=40), the wind-cold group (n=22), the wind- heat group with stiff-neck syndrome (n=10), and the wind-heat group without stiff-neck syndrome (n=8). The average value of the ratio in control group was 0.46(±0.29), the wind- cold group was 1.17(±0.34), the wind-heat group with stiff -neck syndrome was 0.67(±0.09) and the wind- heat group without stiff-neck syndrome was 0.4(±0.19). The result shows a significant difference in the wind-cold group (p=0.0001). As for the thirteen items of the questionnaire, the three groups, the wind-cold group, the wind-heat group with stiff-neck syndrome and the wind-heat group without stiff-neck syndrome, had significant differences in the item 3 (generalized pain), item 5 (aversion to wind), item 11 (drymouth), item 12 (cough), item 13 (sore throat) (p=0.046, p=0.005, p=0.017, p=0.041, p=0.003) but no differences in item 2 (headache), item 4 (aversion to cold), item 6 (fever), item 7 (watery rhinorrhea ), item 8 (purulent rhinorrhea ), item 9 (nasal congestion), item 10 (vomit) by variation analysis (LSD test). In item 3 (generalized pain), item 5 (aversion to wind), item 11 (dry mouth) they had a significant difference between the wind- cold group and the wind-heat group without stiff-neck syndrome. In item 12 (cough), item 13 (sore throat), they had significant differences between the wind-cold group and the wind-heat group with stiff-neck syndrome, and between the wind- cold group and the wind- heat group without stiff-neck syndrome. Key words：sphygmography, |
