中风证脉图参数变化分析

Study on the Changes of Pulseogram Parameter and the Relevance to TCM in Apoplexy

目的通过观测中风患者脉图参数变化,探讨该病证型脉象变化机理及其客观化。方法选择75例经CT明确诊断的中风住院患者,并以健康老年人20例做对照,采用ZM-III型智能脉象仪进行脉图检测并对检测结果进行统计学处理和临床分析。结果风痰瘀血痹阻脉络和痰热腑实风痰上扰两型脉图参数与对照组之间无统计学意义;而肝阳暴亢风阳上扰、气虚血瘀、阴虚风动和中脏腑四型脉图参数与对照组以及这四型之间均有特征性的变化;其中肝阳暴亢风阳上扰型以h1、h3、h4和A参数值均非常显著高于其它三型相应参数值;气虚血瘀型和阴虚风动型h3、h4和A则界于肝阳暴亢,风阳上扰型和中脏腑型之间,而h4/h1值均显著高于其它两型;气虚血瘀型h5/h1值显著小于阴虚风动型的h5/h1值;中脏腑型中h1、h3、h4、h3/h1、h4/h1、A及PR均与对照组中相应的参数有明显的差异,而h3/h1值显著小于其它三型的h3/h1值。结论中风证脉图参数变化提示老年人群中风发病多见于在肝阳暴亢风阳上扰、气虚血瘀、阴虚风动和中脏腑型上,表明中风的病因病机以“虚”为主。

Objective To study the objectivity of the pulse variations in the diagnosis of this syndrome, the significance of the changes of pulseogram parameter to the clinical treatment of this disease, the relevance of apoplexy to the cerebral CT and the physiological changes of age in the light of pulseogram. Methods 75 patients with apoplexy confirmed by CT were compared with 20 health old people. The pulseogram of all subjects was examined by ZM-m Intellectual Pulse Instrunent, and the results was analyzed by statistics and clinical methods. Results There was no statistical significance in the pulseogram parameters （in the types of blockage of the collaterals due to wind-phlegm and blood stasis as well as retention of phlegm-heat in the Fu-organs and upward disturbance of wind-phlegm） between cases and controls; while there was specific changes in the parameters of the types of acute exuberance of liver yang, upward disturbance of wind-yang, blood stasis due to qi asthenia, endogenous wind due to yin asthenia and attack of viscera as well as the control group; the h1, h3, h4 and A parameter in the types of acute exuberance of liver yang and upward disturbance of wind-yang were significantly higher than that in the other three types; the level of h3, h4 and A parameter in the types of blood stasis due to qi asthenia and endogenous wind due to yin asthenia were between that of the types of acute exuberance of liver yang and upward disturbance of wind-yang as well as attack of viscera, but the value of h4 ／ h1 were lower than that of the other two types; the value of h5/h1 were significantly lower than that in the type of endogenous wind due to yin asthenia; changes of h1, h3, h4, h3/h1, h4/h1, A and PR in the type of visceral attack and that in the control group were significantly, but h3/h1 were lower than that in the other three types. Conclusion The changes of the pulseogram parameters in apoplexy indicated that such changes have further confirmed that pathogenesis of apoplexy is asthenia; so supplementing therapy should be used to treat this syndrome.