左右寸關尺橈動脈壓力波特性之研究

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题名:	左右寸關尺橈動脈壓力波特性之研究 The Characteristics of Radial Pressure Pulse at the Right/Left Three Pulse Diagnosis Positions
作者:	黃進明
贡献者:	中醫學系博士班
关键词:	傳統中醫;脈診;冷熱試驗;薑茶;運動 Traditional Chinese Medicine (TCM);pulse diagnosis;thermal stress;Ginger Tea;exercise
日期:	2010-12-29
上传时间:	2011-10-17 16:05:05 (UTC+8)
出版者:	中國醫藥大學
摘要:	本論文研究不同因素對橈動脈壓力波的影響，以探討左右寸關尺橈動脈壓力波的特性。共設計四項研究，第一項試驗以左手分別浸45o C熱水與7o C冷水各2分鐘，再檢測右關部脈搏，觀察冷熱對脈象的影響，第二項試驗觀察血壓正常者與高血壓者其脈象差異，第三項試驗研究喝熱薑茶前後脈象的變化，第四項試驗探討運動前後脈象的動態變化。結果顯示，熱刺激顯著減少橈動脈增大指數與升高10-50 Hz能量(p < 0.05)，冷刺激作用則相反(p < 0.05)，0-10 Hz頻譜能量無顯著差異。10-50 Hz能量比(EP10-50Hz)在血壓正常組與高血壓組的左右寸關尺間有顯著差異，而橈動脈增大指數在高血壓組無顯著差異，高血壓組之EP10-50Hz只有在左寸明顯低於正常組(p < 0.05)。飲用薑茶後只有右關部之橈動脈脈壓及0-10Hz頻譜能量顯著下降，而EP10-50Hz顯著上升(p < 0.05)。運動後增大指數顯著下降，而10-50 Hz頻譜能量與EP10-50Hz顯著增加(p < 0.05)，運動後休息十分鐘，後二者回復至運動前狀態。結論：1) 10-50 Hz頻譜能量只佔脈波總能量一小部分，卻比0-10 Hz表現出更多的生理特點；2) 左右寸關尺之EP10-50Hz有顯著差異，顯示六部血流特徵不同，而EP10-50Hz在左寸能分辨高血壓組與正常組脈象的不同；3) 飲用薑茶後僅右關的脈象變化有顯著差異；4) 運動前、後與休息十分鐘後10-50 Hz頻譜能量與EP10-50 Hz比增大指數更具動態的特性；5) EP10-50Hz比10-50 Hz頻譜能量更能表現出生理的變化。 The factors influencing the radial Pressure Pulse (RPP) were studied to investigate the characteristics of RPP at the right/left three diagnosis positions by four series of experiments. For the first series, each subject had immersed his/her left hand into 45℃ and 7℃ water for two minutes separately, and the RPP of Right Guan was detected to investigate the influences of heat and cold stress. The second series of experiments was for investigating the differences between the RPP in the normotensives and the hypertensives. The influences of Ginger Tea on RPP and the dynamic influences of exercise were investigated in the third and the fourth series of experiments, respectively. The results showed that the heat stress significantly reduced radial augmentation index (AIr) (p < 0.05) and enhanced the spectral energy of 10-50 Hz (SE10-50Hz) (p < 0.05), but the effects of cold stress were contrary (p < 0.05) and the spectral energy of 0-10 Hz (SE0-10Hz) had no statistical difference. The results of the second series showed a significant difference in the energy proportion, 10-50 Hz% (EP10-50Hz), between the six positions within each group, and a significant reduction at only Left Chun in both hypertensive groups. But the AIr showed no significant difference. The results of the third series of experiments showed that early systolic pressure (p1), later systolic pressure (p2) and SE0-10Hz were significantly reduced (p < 0.05) after the intake. Relatively, EP10-50Hz was significantly increased (p < 0.05). These significant changes occurred only at Right Guan. The results of the fourth showed that AIr and p2 significantly decreased after the exercise (p < 0.05). And SE10-50Hz and EP10-50Hz significantly increased after the exercise and then recovered to the preexercise level after a 10-minute rest (p < 0.05). In conclusion, our study demonstrates the following results: 1) SE10-50Hz presented more physiological characteristics than SE0-10Hz did under thermal stresses. 2) EP10-50Hz significantly varied at the six positions, revealing the specific characteristics of RPP. And the Left Chun is qualified to discriminate the differences of RPP between the normotensives and hypertensives. 3) The influences of Ginger Tea on RPP revealed only at the Right Guan. 4) SE10-50Hz and EP10-50Hz presented more dynamic characteristic than AIr did in the preexercise, immediately after the exercise and after a 10-minute rest. And EP10-50Hz better revealed the physiological variations than SE10-50Hz did.
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