基于触觉感知的简化模型研究寸口处脉象差异

Differences in pulse manifestations at Cunkou based on simplified modeling of tactile sensing

目的中医脉诊理论认为腕部桡动脉处(称为寸口)的脉象表征着人体不同脏腑器官的生理病理状况。然而,研究人员对于脉诊技术的客观性存在不同看法,部分研究人员提到在不同的寸口部位未观察到显著的脉象差异,通过寸口脉象辨别不同器官的状态可能存在一定难度。本研究通过对触觉感知特性的简化数学建模来分析寸口处的脉象,从而对上述问题进行探讨。方法基于Weber-Fechner定律,将诊脉过程中的触觉感知变化描述为带宽随不同取脉压力而变化的低通信号滤波器。应用该模型分析本研究组此前采集的临床数据,对14例介入测量得到的主动脉缩窄患者的动脉血压数据进行处理,以模拟不同取脉压力作用于寸关尺部所形成的脉象差异。结果考虑触觉感知特性时,伴随取脉压力的变化诊脉中寸口处不同脉深的脉象存在显著差异;而采用传感器测量时由于不存在触觉感知特性的影响,所得到的脉象则没有这种随脉深的变化。这就解释了为什么中医直接诊脉与现代脉诊学使用传感器测量会对脉象形成不同的理解。此外,采用本研究中建立的触觉感知模型所计算出的寸口处浮中沉不同脉深的脉象特征,与中医脉搏理论中的相关描述一致。结论本研究通过建立触觉感知模型,初步解释了中医脉诊理论中的脉象随取脉压力变化现象。将触觉感知建模引入中医脉诊研究,开启了图象化表达脉象以对其进行定量分析的新的探索窗口,这不仅有效扩展了脉诊研究的范畴,也为现有脉诊仪的技术升级和功能优化提供了科学依据。

Objective In the theories of pulse disgnosis in traditional Chinese medicine(TCM),it is em-phasized that pulse manifestations at the radial artery within the wrist(called Cunkou)signi-fy the physiological and pathological conditions of different internal organs in the human body.However,different opinions exist among researchers about the objectiveness of the pulse diagnosis technique.Some researchers mentioned that no significant differences were observed in pulse manifestations at various Cunkou areas,hence there might be some diffi-culty in evaluating the status of different organs through checking pulse manifestations at Cunkou.This research aims to analyze the pulse response at Cunkou from the aspect of the characteristics of tactile sensing,thus to give a preliminary explanation to the above question.Methods This research utilized the Weber-Fechner law to model the tactile sensing as a dy-namic low-pass signal filter with varying bandwidths under different compression levels dur-ing pulse diagnosis.The model was applied to analyzing the clinical data collected previously by our group.The arterial pressures measured invasively with equipment from 14 patients with aorta coarctation were processed to simulate different pulse manifestations at Cun,Guan,and Chi positions of Cunkou when different compression levels were applied.Results Due to the characteristics of tactile sensing,significant variations were observed in pulse manifestations at different pulse-depths under the application of changing compres-sion levels;while no such changes in pulse manifestations were observed from the employ-ment of transducer only,without tactile sensing involved.The results explained why different understandings on pulse manifestations were formed between direct pulse-taking technique in TCM and modern sphygmography using transducers.The features of pulse manifestations at Cunkou,using direct pulse-taking technique but at different depths,superficial,middle,and deep positions,respectively,predicted by the developed tactile sensing model were in line with those described in TCM pulse theories.Conclusion Based on the developed tactile sensing model,this study preliminarily explains the phenomenon that pulse manifestation at Cunkou changes in response to the compression force applied during TCM pulse-taking.Integrating the tactile sensing model with the study of TCM pulse diagnosis opens a new chapter for visualizing and quantitatively interpreting pulse manifestations.This not only expands the scope of pulse diagnosis study effectively,but also provide a scientific basis for further technical upgrading and optimization of existing pulse di-agnosis equipment.