冠心病和糖尿病痰湿证“异病同证”脉诊信息特征分析  

Analysis of pulse diagnosis information characteristics of coronary heart disease and diabetes mellitus with phlegm-dampness syndrome‘different diseases with same syndrome'

作　　者：莫国凤 宋诗博 樊西倩 冉清智 李阳 向灵希 刘佳[1,3] 汪南玥 MO Guofeng;SONG Shibo;FAN Xiqian;RAN Qingzhi;LI Yang;XIANG Lingxi;LIU Jia;WANG Nanyue(Experimental Research Center,China Academy of Chinese Medical Sciences,Beijing 100700,China;School of Basic Medicine,Shaanxi University of Chinese Medicine,Xianyang 712046,China;Beijing Key Laboratory of TCM Basic Research on Prevention and Treatment of Major Diseases,Beijing 100700,China)

机构地区：[1]中国中医科学院医学实验中心,北京100700 [2]陕西中医药大学基础医学院,陕西咸阳712046 [3]中医药防治重大疾病基础研究北京市重点实验室,北京100700

出　　处：《中华中医药杂志》2025年第3期1137-1142,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点研发计划项目(No.2018YFC1707605);中央级公益性科研院所基本科研业务费专项资金项目(No.JBGS2021008);中国中医科学院科技创新工程项目(No.CI2021A05207)。

摘　　要：目的:对冠心病、糖尿病痰湿证患者的脉诊信息进行比较与分析,探讨痰湿证“异病同证”脉诊信息的客观化异同。方法:应用三探头中医智能脉诊仪采集脉诊信息,通过信息预处理后建立12谐波拟合模型并提取193个特征参数,运用主成分分析(PCA)、最小二乘回归(LS)、套索回归(LasSo)等方法进行数据分析。结果:冠心病、糖尿病的痰湿证和非痰湿证患者脉诊信息具有显著差异,LS及Lasso分类判决准确率在62%~69%之间。痰湿证脉诊信息,时域参数h1、s、s1、s2参数值较非痰湿证显著升高;频域参数,总体上相位较非痰湿证升高、能量较非痰湿证降低,主要表现在右关。与非痰湿证相比较,冠心病痰湿证左寸h1、s、s1、s2显著升高(P<0.05),左寸w显著降低(P<0.05),左寸、右关的相位总体上升高,右寸、右关的能量总体上降低;糖尿病痰湿证左尺h1、s、s2和右寸h1、s显著升高(P<0.05),左寸、右关的相位总体上升高,右关的能量总体上降低。结论:痰湿证较非痰湿证血液充盈、脉道流利,脉象更偏向于滑脉,痰湿证病位表现在脾,与中医理论相符;冠心病脉诊信息主要表现在左寸,而糖尿病表现在左尺和右寸,与冠心病病位在心、糖尿病病位主要在肺、肾符合。Objective:To compare and analyze the pulse diagnosis information of patients with coronary heart disease(CAD)and diabetes mellitus(DM)phlegm-dampness syndrome,and to explore the objective similarities and differences of pulse diagnosis information of phlegm-dampness syndrome'different diseases with the same syndrome'.Methods:To collect pulse diagnosis information with the three-probe TCM intelligent pulse diagnosis instrument.After information preprocessing,a 12-harmonic fitting model was established and 193 characteristic parameters were extracted.Principal component analysis(PCA),least squares regression(LS),lasso regression(Lasso)and other methods were used for data analysis.Results:There were significant differences between phlegm-dampness syndrome and non-phlegm-dampness syndrome of CAD and DM,and the classification accuracy of LS and Lasso is between 62%and 69%.Phlegm-dampness syndrome pulse diagnosis information,compared with non-phlegm-dampness syndrome,time domain parameters hl,s,sl,s2 increased significantly;frequency domain parameters,in general,phase increases,energy decreases,and mainly in the right Guan.Compared with non-phlegm-dampness syndrome,the left Cun h1,s,s1,s2 of CAD increased significantly(P<0.05),the left Cun w decreased significantly(P<0.05),the phase of left Cun and right Guan increased generally,and the energy of right Cun and right Guan decreased generally;the left Chi hl,s,s2 and right Cun hl,s of DM increased significantly(P<0.05),the phase of left Cun and right Guan increased generally,and the energy of right Guan decreased generally.Conclusion:Phlegm-dampness syndrome is more inclined to slippery pulse than non-phlegm-dampness syndrome,with blood filling and smooth pulse.The location of phlegm-dampness syndrome is manifested in the spleen,which is consistent with the theory of TCM.The pulse diagnosis information of CAD is mainly manifested in the left Cun,while DM is manifested in the left Chi and right Cun,which is consistent with the location of CAD in the heart and the location

关 键 词：脉诊信息 特征参数 痰湿证 冠心病 糖尿病 

分 类 号：R241.1[医药卫生—中医诊断学]