基于移动平均线法改进的冠心病合并心衰患者脉图参数特征研究  

Study on Pulse Graph Parameters of Patients with Coronary Heart Disease Combined with Heart Failure Improved with Moving Average Line Method

作　　者：黄文悦 吕仪 丁晓东 王忆勤[2,3] Huang Wenyue;Lyu Yi;Ding Xiaodong;Wang Yiqin(School of Acupuncture-Moxibustion&Tuina,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;School of Basic Science of Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Key Laboratory of Health Identification and Assessment,Shanghai 201203,China)

机构地区：[1]上海中医药大学针灸推拿学院,上海201203 [2]上海中医药大学基础医学院,上海201203 [3]上海市健康辨识与评估重点实验室,上海201203

出　　处：《世界科学技术-中医药现代化》2023年第6期2209-2216,共8页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会面上项目(81673880):基于中医四诊大数据的冠心病风险评估与预测模型研究,负责人:王忆勤。上海市科学技术委员会科研计划项目(21DZ2271000):上海市健康辨识与评估重点实验室,负责人:王忆勤。上海市教育委员会大学生创新创业训练计划项目(S202110268055):冠心病合并心衰或肾衰患者中医脉诊客观化研究,负责人:黄文悦。

摘　　要：目的通过分析基于移动平均线法改进的冠心病合并心衰患者脉图时域参数特征,为冠心病合并心衰的诊断及预后提供更多客观依据。方法随机纳入2018年9月—2020年12月上海中医药大学附属曙光医院东院、上海市中医医院、上海中医药大学附属岳阳中西医结合医院心内科的单纯冠心病住院患者78例、冠心病合并心衰住院患者73例,上海中医药大学附属岳阳中西医结合医院、上海中医药大学附属曙光医院东院体检中心健康人78例。采用Smart TCM-I型脉象数字化采集分析仪采集脉象样本,并运用χ^(2)检验、LSD检验、Dunnett’s T3检验及Kruskal Wallis检验等方法比较分析冠心病合并心衰患者与健康人、单纯冠心病患者基于移动平均线法改进的脉图时域参数特征差异。结果①时值参数分析结果:与健康对照组相比,单纯冠心病组t_(5)显著减小(P<0.01),冠心病合并心衰组t、t_(3)、t_(5)均显著增大(P<0.01);与单纯冠心病组相比,冠心病合并心衰组t5显著增大(P<0.01),t_(3)增大(P<0.05)。②时值比值参数分析结果:与健康对照组相比,单纯冠心病组t_(1)/t、w/t、t_(f/4)/t、t_(f/3)/t_(4)、t_(f/4)/t_(4)、t_(f/5)/t_(4)、t_(f/3)/t_(max)、t_(f/4)/t_(max)、t_(f/5)/t_(max)、t_(f/6)/t_(max)显著减小(P<0.01),t_(max)/t、w/t_(4)、t_(f/3)/t、t_(f/5)/t、t_(f/6)/t、t_(f/6)/t_(4)减小(P<0.05),t_(0.8)/t_(max)增大(P<0.05),冠心病合并心衰组w/t、t_(0.9)/t、t_(0.8)/t、t_(f/3)/t、t_(f/4)/t、t_(f/5)/t、t_(f/6)/t、t_(f/3)/t_(4)、t_(f/4)/t_(4)、t_(f/3)/t_(max)、t_(f/4)/t_(max)、t_(f/5)/t_(max)、t_(f/6)/t_(max)均显著减小(P<0.01),t_(1)/t、t_(max)/t、w/t_(4)、t_(0.9)/t_(4)减小(P<0.05),t_(3)/t_(4)显著增大(P<0.01);与单纯冠心病组相比,冠心病合并心衰组t_(0.9)/t_(max)显著减小(P<0.01),t_(0.9)/t、t_(0.8)/t_(max)均减小(P<0.05),t_(3)/t_(4)显著增大(P<0.01)。③幅值参数分析结果:单纯冠心病患者h_(4)低于健康人(P<0.05);冠Objective To provide more objective reference in diagnosis and prognosis of coronary heart disease(CHD)combined with heart failure(HF)by analyzing features of pulse graph parameters improved with moving average line method of patients with CHD combined with HF.Methods From September 2018 to December 2020,a random sampling method was used to collect 78 inpatients with CHD and 73 inpatients with CHD combined with HF in department of cardiology of Shu Guang Hospital Attached to Shanghai TCM University,Shanghai Municipal Hospital of Traditional Chinese Medicine and Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine as well as 78 healthy people from physical examination center of Shu Guang Hospital Attached to Shanghai TCM University and Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine.Smart TCM-I type pulse digital acquisition analyzer was used to collect pulse samples.χ^(2) test,LSD test,Dunnett's T3 test and Kruskal Wallis test were used to analyze the differences of pulse graph parameters among the groups improved with moving average line method.Results①Results of pulse graph parameters about chronaxy:Compared with those in healthy people,t_(5) of patients with CHD decreased significantly(P<0.01),t,t_(3),t_(5) of patients with CHD combined with HF increased significantly(P<0.01).Compared with those in patients with CHD,t_(5) of patients with CHD combined with HF increased significantly(P<0.01),t_(3) increased(P<0.05).②Results of pulse graph parameters about ratio of chronaxy:Compared with those in healthy people,t_(1)/t,w/t,t_(f/4)/t,t_(f/3)/t_(4),t_(f/4)/t_(4),t_(f/5)/t_(4),t_(f/3)/t_(max),t_(f/4)/t_(max),t_(f/5)/t_(max),t_(f/6)/t_(max) of patients with CHD decreased significantly(P<0.01),t_(max)/t,w/t_(4),t_(f/3)/t,t_(f/5)/t,t_(f/6)/t,t_(f/6)/t_(4) decreased(P<0.05),t_(0.8)/t_(max) increased(P<0.05),w/t,t_(0.9)/t,t_(0.8)/t,t_(f/3)/t,t_(f/4)/t,t_(f/5)/t,t_(f/6)/t

关 键 词：移动平均线 时域参数 脉图 冠心病 慢性心衰 

分 类 号：R541.4[医药卫生—心血管疾病]