摘要
目的基于压力脉搏波探讨2型糖尿病气虚痰浊型脉象特征及与症状的相关性。方法选取2022年1—12月于宁波市中医院内分泌科诊治的2型糖尿病气虚痰浊型患者49例作为气虚痰浊组,2型糖尿病非气虚痰浊型患者47例作为非气虚痰浊组,另选取同期体检体质相对平和的健康人23例作为健康组。应用上海道生DS01-C脉象采集系统及合肥华科HK-2010/3三通道脉象采集仪获取3组受试者“寸关尺”部位的压力脉搏波参数[h1(主波波幅)、h2(主波峡波幅)、h3(重搏前波幅)、h4(降中峡幅度)、h5(重搏波幅度)、t(心动周期或脉动周期)、t1(左心室快速射血时限)、t2(主波峡出现的时限)、t3(重搏前波出现时限)、t4(左心室收缩时限)、t5(左心室舒张期时限)、w1(上1/3处的脉图宽度)、w2(上1/5处的脉图宽度)、h3/h1(血管顺应性和外周阻力)、h4/h1(阻力系数)、h5/h1(弹性系数)、w1/t和w2/t(弦度系数)、t1/t(左心室快速射血时限/心动周期)、t5/t4(左心室舒张时限/左心室收缩时限)、As(收缩期面积)、Ad(舒张期面积)、A(收缩期与舒张期脉图面积之和)],寻找特征性参数,分析特征性参数与气虚痰浊组患者临床症状的相关性。结果气虚痰浊组寸脉h3/h1显著低于非气虚痰浊组(P<0.05),寸脉h5/h1、h5均显著高于非气虚痰浊组(P均<0.05),但此3项参数与健康组比较差异均无统计学意义(P均>0.05)。3组关脉参数比较差异均无统计学意义(P均>0.05)。气虚痰浊组尺脉t1、h3/h1、t1/t、w2/t、w2均显著高于健康组(P均<0.05),尺脉h5/h1、h5均明显低于健康组(P均<0.05),其余参数3组比较差异均无统计学意义(P均>0.05)。气虚痰浊组男性寸脉h5/h1、h5均显著高于女性(P均<0.05)。气虚痰浊组20~40岁者寸脉h3/h1显著低于41~60岁和61~80岁者(P均<0.05)。气虚痰浊组寸脉h3/h1与脉细无力呈正相关(r=0.332,P<0.05),与脉滑、濡呈负相关(r=-0.416,P<0.05);寸脉h5/h1与形体肥胖呈正相关(r=0.363,P<0.05);寸脉h5与形体肥胖、大便黏滞均呈正相关(r=0.393,P<0.05;r=0.310,P<0.05);尺脉t1与神疲乏力呈负相关(r=-0.343,P<0.05);尺脉h5/h1与舌淡胖苔薄白齿痕呈正相关(r=0.289,P<0.05);尺脉h5与舌淡胖苔薄白齿痕呈正相关(r=0.391,P<0.05),与舌淡胖苔腻呈负相关(r=-0.288,P<0.05);尺脉t1/t与舌淡胖苔腻呈正相关(r=0.367,P<0.05);尺脉w2/t与舌淡胖苔薄白齿痕呈负相关(r=-0.297,P<0.05)。结论2型糖尿病气虚痰浊型患者脉象特征参数为寸脉h3/h1、h5/h1、h5和尺脉t1、h3/h1、t1/t、w2/t、w2、h5/h1、h5,其中寸脉h3/h1、h5/h1、h5和尺脉t1、t1/t、w2/t、h5/h1、h5与患者临床症状具有显著相关性,或可为2型糖尿病气虚痰浊型的客观化诊断提供参考依据。
Objective It is to explore the pulse characteristics of type 2 diabetes mellitus(T2DM)with Qi deficiency and phlegm turbidity syndrome and its correlation with symptoms based on pressure pulse wave.Methods Forty-nine T2DM patients with Qi deficiency and phlegm turbidity syndrome diagnosed and treated in the Department of Endocrinology of Ningbo Hospital of Traditional Chinese Medicine from January to December 2022 were selected as Qi deficiency and phlegm turbidity group,and 47 T2DM patients without Qi deficiency and phlegm turbidity syndrome as the non-Qi deficiency and phlegm turbidity group,and another 23 cases of healthy people with relatively normal constitution from physical examination in the same period were selected as the healthy group.The pressure pulse wave parameters[h1(main wave amplitude),h2(main wave gorge amplitude),h3(pre-rebroke amplitude),h4(descending middle gorge amplitude),h5(rebroke wave amplitude),t(cardiac cycle or pulsation cycle),t1(time frame for left ventricular rapid ejection),t2(time frame for occurrence of main wave gorges)t3(time frame for occurrence of pre-cardiac wave),t4(time frame for left ventricular contraction),t5(time frame for left ventricular diastole),w1(pulse width in the upper third),w2(pulse width in the upper fifth),h3/h1(vascular compliance and peripheral resistance),h4/h1(resistance coefficient),h5/h1(elasticity coefficient),w1/t and w2/t(chordality coefficients),t1/t(left ventricular rapid ejection time frame/cardiac cycle),t5/t4(left ventricular diastolic time frame/left ventricular systolic time frame),As(systolic area),Ad(diastolic area)、A(As+Ad)]at three regions Cun,Guan,Chi of subjects of the three groups were obtained by Shanghai Daosheng DS01-C pulse acquisition system and Hefei Huake HK-2010/3 three-channel pulse acquisition instrument,to find the characteristic parameters,and to analyze the correlation between the characteristic parameters and clinical symptoms of patients with syndrome of Qi deficiency and phlegm turbidity.Results The h3/h1 at Cun region in the Qi deficiency and phlegm turbidity group was significantly lower,while h5/h1 and h5 were significantly higher than those in the non-Qi deficiency and phlegm turbidity group(all P<0.05),but the differences in these three parameters were not significant compared with the healthy group(all P>0.05).There was no significant difference in the parameters at Guan region among the three groups(all P>0.05).The t1,h3/h1,t1/t,w2/t and w2 at Guan region in the Qi deficiency and phlegm turbidity group were significantly higher,while h5/h1 and h5 were significantly lower than those in the healthy group(all P<0.05),and there was no significant difference in other parameters among the three groups(all P>0.05).The h5/h1 and h5 at Cun region in male patients were significantly higher than those in female patients in the Qi deficiency and phlegm turbidity group(all P<0.05).The h3/h1 at Cun region in the patients of 20-40 years old was significantly lower than that in the patients of 41-60 years old and 61-80 years old in the Qi deficiency and phlegm turbidity group(all P<0.05).In the Qi deficiency and phlegm turbidity group,h3/h1 at Cun region was positively correlated with thready and weak pulse(r=0.332,P<0.05),and negatively correlated with slippery and moist pulse(r=-0.416,P<0.05);h5/h1 was positively correlated with obesity(r=0.363,P<0.05);h5 at Cun region was positively correlated with obesity and sticky stool(r=0.393,P<0.05;r=0.310,P<0.05);t1 at Chi region was negatively correlated with fatigue(r=-0.343,P<0.05);h5/h1 and h5 at Chi region were positively correlated with pale enlarged tongue with thin white coating and teeth imprints(r=0.289,P<0.05,r=0.391,P<0.05)respectively,and negatively correlated with pale enlarged tongue with sticky coating(r=-0.288,P<0.05);t1/t at Chi region was positively correlated with pale enlarged tongue with sticky coating(r=0.367,P<0.05);w2/t at Chi region was negatively correlated with pale enlarged tongue with thin white coating and teeth imprints(r=-0.297,P<0.05).Conclusion The pulse characteristic parameters of T2DM patients with Qi deficiency and phlegm turbidity syndrome are h3/h1,h5/h1,h5 at Cun region and t1,h3/h1,t1/t,w2,h5/h1,h5 at Chi region,and h3/h1,h5/h1,h5 at Cun region and t1,t1/t,w2/t,h5/h1,h5 at Chi region are significantly correlated with the clinical symptoms,and can provide references for the objective diagnosis of T2DM with Qi deficiency and phlegm turbidity syndrome.
作者
贾梦娜
龚文波
JIA Mengna;GONG Wenbo(Ningbo Beilun District Hospital of Traditional Chinese Medicine,Ningbo 315800,Zhjiang,China;Ningbo Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University,Ningbo 315010,Zhejiang,China)
出处
《现代中西医结合杂志》
2025年第1期24-31,共8页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
浙江省中医药科技计划项目(2022ZB317)。
关键词
2型糖尿病
压力脉搏波
气虚痰浊型
脉象特征
症状
type 2 diabetes
pressure pulse wave
syndrome of Qi deficiency and phlegm turbidity
pulse characteristics
symptom
