基于瞬时波强技术构建濡脉脉象图特征分析

Analysis on Construction of Moisten Pulse Images Based on Wave Intensity Technology

目的基于瞬时波强(WI)技术初步构建濡脉脉象图,丰富中医脉诊客观化研究。方法将研究对象分为濡脉组(28例)与平和脉组(30例),使用ALOKA Prosoundα10彩色多普勒超声仪检测寸口脉象,采集WI脉象图和数据,从压力波(P)、血流波(U)、WI[(d P/dt)(d U/dt)]、时间三维构建濡脉及平和脉的WI脉象图,并对两者进行比较。结果寸口濡脉U波形总体趋势较平和脉起伏平缓,波幅减小,波宽增大,上升支和下降支斜率均较平和脉减小。P波的重搏前波(潮波,h3)靠近主波(h1)或提前出现,与主波融合呈宽大圆钝平顶,或h3超过h1而使波峰有切迹。濡脉前向压缩波(W1)较平和脉减小,前向膨胀波(W2)增大,W2波出现在较远离W1波处,WI波呈星状一角形态,下降支凹面向上。与平和脉组比较,濡脉W1、射血前期时间(R-1st)、射血时间(1st-2nd)、增大指数(AI)减小(P<0.05),W2、WI值推导的脉搏波传导速度(PWV-WI)增大(P<0.05);协方差调整混杂因素后,2组W1、W2、R-1st、1st-2nd、AI、PWV-WI的总体均数间差异有统计学意义(P<0.05)。结论从P波、U波、WI波三维构建的濡脉WI脉图能更准确地反映濡脉波形特点,更好地指导中医临床诊脉。

Objective To enrich the objective study of TCM pulse through constructing preliminary moisten pulseimages by wave intensity(WI)technology.Methods The study subjects were divided into moisten pulse group(28cases)and normal pulse group(30cases).The cunkou pulse conditions were examined by color Doppler ultrasonicdiagnostic equipment(ALOKA Prosoundα10)and wave intensity(WI)pulse images and data were recorded andcollected.WI pulse image of moisten pulse and normal pulse were constructed and compared by three-dimensionallevels of pressure wave(P wave),blood-flow-velocity wave(U wave),WI wave[the product of blood pressurechanges(dP/dt)and blood-flow-velocity changes(dU/dt)],and time.Results The U wave of cunkou moisten pulsebased on WI was characterized by a more flat curve,a smaller amplitude and a wider wave than the wave of normalpulse.The slopes of both ascending and descending branches of U wave were lower than those of normal pulse.Dicrotic wavefront(tide wave,h3)of P wave was closed to the main wave(h1)or arrives earlier to make it integrateswith the main peak into a large round blunt flat top.Even more h3was higher than h1,which come into being a notchin the declined branch.Comparing with cunkou pulse,forward compression wave of moisten pulse(W1)was reduced,and its forward expansion wave(W2)increased,and W2wave appeared at the far from the W1wave.WI wavedisplayed an angle-like-shape and its descending branch concave was upward.W1,pre-ejection period(R-1st),ejection time(1st-2nd)and augmentation index(AI)decreased compared with normal pulse(P<0.05),while W2andpulse wave velocity by WI value deduced(PWV-WI)of moisten pulse increased(P<0.05).After adjustingconfounding factors,the mean difference of W1,W2,R-1st,1st-2nd,AI,and PWV-WI between two groups was stillsignificance(P<0.05).Conclusion Moisten pulse WI pulse image constructed from three-dimensional levels of Pwave,U wave,and WI wave can more accurately reflect characteristics of moisten pulse wave and guide TCMclinical pulse diagnosis better.