基于径向脉搏波分析探讨冠心病合并高血压的中医病机

Exploring the Pathogenesis of Coronary Heart Disease Combined with Hypertension in Chinese Medicine Based on Radial Pulse Wave Analysis

目的通过比较冠心病患者径向脉搏波谐波指标的差异,阐释冠心病合并高血压的中医病机。方法采集2022年12月至2023年6月于北京中医药大学第三附属医院心血管科住院且已明确诊断冠心病的183例患者资料,根据是否合并高血压,将研究对象分为高血压组(113例)、非高血压组(70例)。运用脉诊仪采集研究对象径向脉搏波数据,通过傅立叶变换计算径向谐波指标,研究脉搏波谐波指标和冠心病合并高血压情况的相关性,从而分析冠心病合并高血压的中医病机。结果高血压组和非高血压组患者C0(心)、C1(肝)、C2(肾)、C3(脾)、C4(肺)、C5(胃)和C7(膀胱)比较差异均无统计学意义(P均>0.05)。但高血压组C6(胆)高于非高血压组(P<0.05)。Logistic回归分析结果显示,C6是冠心病高血压发病的危险因素(OR=1.011,P<0.05)。结论径向脉搏波C6对应的胆经状态越实,冠心病合并高血压的风险越高,考虑冠心病合并高血压背后的中医病机是胆气郁结,相火偏盛。

Objective To elucidate the traditional Chinese medicine pathogenesis of coronary heart disease combined with hypertension by comparing the differences in harmonic indicators of radial pulse waves in patients with coronary heart disease.Methods A total of 183 patients diagnosed with coronary heart disease who were hospitalized in the Department of Cardiovascular of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine from December 2022 to June 2023 were collected.Based on whether they had hypertension,the study subjects were divided into a hypertension group(113 cases)and non hypertension group(70 cases).A pulse diagnosis device was used to collect radial pulse wave data of the research object,the radial harmonic index was calculated through Fourier transform,the correlation between pulse wave harmonic index and coronary heart disease combined with hypertension was studied,and the traditional Chinese medicine pathogenesis of coronary heart disease combined with hypertension was analyzed.Results There was no statistically difference in C0(heart),C1(liver),C2(kidney),C3(spleen),C4(lung),C5(stomach)and C7(bladder)between the hypertension group and the non hypertension group(P all>0.05).But the C6(gallbladder)in the hypertensive group was higher than that in the non hypertension group(P<0.05).The results of Logistic regression analysis showed that C6(gallbladder)was positively correlated with the occurrence of coronary heart disease and hypertension(OR=1.011,P<0.05).Conclusion The more solid the gallbladder meridian state corresponding to the radial pulse wave C6,the higher the risk of coronary heart disease combined with hypertension.It is considered that the underlying TCM pathogenesis of coronary heart disease combined with hypertension is cholestasis and excessive phase fire.