上焦病症患者溢脉及炎症的关联研究  

The Relationship between Syndrome of Upper Energizer Diseases,Overflow Pulse and Inflammation

作　　者：张祉薇 李菲菲 张旭峰[2] 石晓兰[3] 邓皖利[1] 范忠泽[1] 谢曼丽 张晓晓[1] ZHANG Zhi-wei;LI Fei-fei;ZHANG Xu-feng;SHI Xiao-an;DENG Wan-li;FAN Zhong-ze;XIE Man-li;ZHANG Xiao-xiao(Department of Oncology,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062;Department of Thoracic Surgery,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062;Department of Education&Training,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062)

机构地区：[1]上海中医药大学附属普陀医院中医肿瘤科,上海200062 [2]上海中医药大学附属普陀医院胸外科,上海200062 [3]上海中医药大学附属普陀医院教育规培科,上海200062

出　　处：《世界中西医结合杂志》2024年第2期326-330,335,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：上海市普陀区卫生健康系统临床特色专科建设(2021tszk01);上海市卫生健康委员会中医药科研项目(2022QN052)。

摘　　要：目的 分析上焦病症患者发生溢脉及炎症反应的关联。方法 选取2019年3月15日—2022年7月31日期间在上海中医药大学附属普陀医院门诊就诊并确诊的上焦病症患者1151例作为病例组,选同期健康志愿者1000例作为对照组。比较两组受试者发生溢脉及炎症反应的关系。结果 与对照组比较,病例组的溢脉发生率、外周血细胞介素-1(Interleukin-1,IL-1)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子(Tumor necrosis factor),(TNF-α)均明显增高,差异有统计学意义(P<0.05)。与对照组溢脉比较,病例组溢脉外周血IL-1、IL-6和TNF-α均明显增高,差异有统计学意义(P<0.05),与对照组无溢脉比较,病例组无溢脉外周血IL-1、IL-6和TNF-α均明显增高,差异有统计学意义(P<0.05),与病例组无溢脉比较,病例组溢脉外周血IL-1、IL-6和TNF-α均明显增高,差异有统计学意义(P<0.05)。899例溢脉中单脉象797例(88.65%),复合脉象102例(11.35%),单脉象中涩脉539例(59.96%)、滑脉89例(9.90%)、实脉68例(7.56%)、弦脉56例(6.23%)、洪脉分别为45例(5.01%),复合脉象中滑实脉89例(9.90%)、洪弦脉13例(1.45%)。与单脉象比较,复合脉象的IL-1、IL-6和TNF-α明显升高,差异有统计学意义(P<0.05);单脉象中涩脉、滑脉、实脉的IL-1、IL-6和TNF-α明显升高,差异有统计学意义(P<0.05)。失眠、紧张焦虑症、口鼻咽疾病、甲乳疾病、高血压、反流性食管炎、颅内疾病等上焦病症发生溢脉比例较高,差异有统计学意义(P<0.05),且外周血IL-1、IL-6和TNF-α也较高,差异有统计学意义(P<0.05)。结论 溢脉不是一种生理性脉象,发生溢脉与上焦疾病相关性较大,且伴随明显的炎症反应,以失眠、焦虑相关最大,口鼻咽疾病次之,可能与呼吸系统的喘息无关。因此临床脉诊出溢脉,应引起重视。Objective Pulse diagnosis is a very distinctive diagnostic method in traditional Chinese medicine.Overflow pulse is s a relatively understudied aspect of pulse diagnosis in clinical research.Analyzing the relationship between overflow pulse and inflammatory reactions in patients with upper energizer diseases contributes to enriching the value of overflow pulse in clinical diagnosis and treatment.Methods A total of 1151 outpatients with upper energizer disease treated at Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from March 15,2019 to July 31,2022 were collected as the case group,and 1000 healthy volunteers at the same period were selected as the control group.The relationship between the occurrence of overflow pulse and inflammatory reaction was compared between the two groups.Results Compared with the control group,the incidence of overflow pulse in the case group was significantly higher,along with elevated levels of interleukin-1(IL-1),interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α),with statistically significant differences(P<0.05).Compared with the control group with overflow pulse,the peripheral blood IL-1,IL-6 and TNF-α in the case group with overflow pulse were significantly increased(P<0.05).Compared with the control group w ithout overflow pulse,the peripheral blood IL-1,IL-6 and TNF-α in the case group without o-verflow pulse were significantly elevated(P<0.05).Compared with the case group without overflow pulse,the peripheral blood IL-1,IL-6 and TNF-α in the case group with overflow pulse were significantly elevated(P<0.05).Among 899 cases of overflow pulse,797 cases exhibited single pulse(88.65%),and 102 cases exhibited complex pulse(11.35%).A-mong the single pulse cases,539 cases were unsmooth pulse(59.96%),89 cases were slippery pulse(9.90%),68 cases were replete pulse(7.56%),56 cases were wiry pulse(6.23%),and 45 cases were surging pulse(5.01%).Among the complex pulse cases,89 cases were slippery-replete pulse(9.90%),and 13 cases were surging-wir

关 键 词：溢脉 脉诊 上焦病症 炎症 细胞介素-1 白细胞介素-6 肿瘤坏死因子 

分 类 号：R241.11[医药卫生—中医诊断学]