细脉客观化研究

Sdudy on objectiveness of the thready pulse

本文从心血管及血液动力学着手分析细脉产生的病生基础。通过超声多谱勒检测发现细脉与不细脉比,左心舒张期内径、心脏每搏量、平均动脉压较低(P<0.05),动脉壁张力较小(P<0.005),寸口桡动脉舒缩期内径明显减少(P<0.001),桡动脉血流量亦偏低。这说明中医指下细直而软的感觉是有其病生基础的。通过MX—5型脉象仪,观察比较桡动脉直径内从中间到两边七个等分点上压力随时间变化的波型,检测后发现细脉者从中间到两边的峰高下降快而且平均值较小。反映了细脉细小而软血少气虚的定义。设想用脉道图面积积分和七个波平均峰值的乘积作为鉴别脉道粗细的指标,与中医切脉符合率达80%左右。

According to the data obtained by doppler,We analysisedthe pathophysiologic bases of thready pulse.It was found that sub-jects with thready pulse had a smaller left ventricular diastolic intern-al diameter than that without thready pulse(P<0.05);SV was less(P<0.05)and mean arterial blood pressure was lower(P<0.05).Ten-sion of the radial artery wall was less(P<0.001).The radial arterialdiastolic and systolic internal diameter was less(P<0.001)and themean discharge of radial artery is lower.It was also found,in thesubjects with thready pulse,that the pressure value of pulse was lo-wer and the peak of that descented fast than that in the subjects with-out thready pulse.The accordance rate of thready pulse between takingpulse by 3 doctors of TCM andtesting it by the MX—5 sphymogrphis about 80%.So we think that the“thready”sensation felt by thedoctor during taking pulse in the traditional fashion has a certain pa-thophysiologic basis.