结直肠癌术后患者脉象特征参数与中医证型分布研究  

Study on pulse characteristic parameters and distribution of traditional Chinese medicine syndromes in postoperative colorectal cancer patients

作　　者：周霖 赵勇 储金砚 严玉婷 袁晨越 黄思维 靖琳 焦文 任建琳[1] ZHOU Lin;ZHAO Yong;CHU Jinyan;YAN Yuting;YUAN Chenyue;HUANG Siwei;JING Lin;JIAO Wen;REN Jianlin(Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071

出　　处：《上海中医药杂志》2025年第5期15-19,32,共6页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82174452,820042551,81873279);上海市科委科研计划项目(19401935200);上海申康医院发展中心临床三年行动计划疑难攻关项目(HDC2020CR2047B);上海医学创新发展基金会中医药传承项目(WLJH2021ZY-MZY026);上海市科委科技创新行动计划生物医药科技支撑专项(22S21901000)。

摘　　要：目的分析结直肠癌(CRC)术后患者的脉象特征参数及中医证型分布情况,探讨脉象特征参数与不同中医证型的关系,为CRC术后智能诊断辨证提供参考。方法选取83例CRC术后患者(病例组)及20例健康体检者(正常组),对病例组患者进行中医辨证分型,采用SmartMX-I型脉象仪采集所有研究对象的脉象信息,借助脉象分析系统分析CRC术后患者的脉象特征参数,比较CRC术后不同中医证型患者脉象参数的差异。结果①83例CRC术后患者中,脾肾阳虚证22例、肝肾阴虚证12例、气血两虚证6例、湿热蕴结证24例、瘀毒内结证19例。②与正常组相比,病例组右脉主波高度(H1)、舒张期时间(T5)、脉动周期(T)下降(P<0.05),快速射血期时间(T1)、重搏前波高(H3)/H1、T1/T、主波1/3宽度(W)/T升高(P<0.05);左脉H1、T下降(P<0.05),降中峡高度(H4)、T1、H3/H1、T1/T、W/T升高(P<0.05)。③脾肾阳虚证、气血两虚证患者双手H1低于其余3种中医证型(P<0.05),右脉W/T低于其余3种中医证型(P<0.05);瘀毒内结证患者右脉H3、W高于其余4种中医证型(P<0.05),左脉H4、W、H3/H1高于其余4种中医证型(P<0.05),左脉W/T高于脾肾阳虚证、气血两虚证(P<0.05);湿热蕴结证患者右脉T1低于脾肾阳虚证、气血两虚证(P<0.05),T低于其余4种中医证型(P<0.05);气血两虚证患者右脉T5高于湿热蕴结证(P<0.05),右脉T1/T低于湿热蕴结证、瘀毒内结证(P<0.05);脾肾阳虚证患者左脉T1高于肝肾阴虚证、湿热蕴结证、瘀毒内结证(P<0.05)。结论CRC术后患者脉象参数具有特征性变化,脉象参数可以为CRC术后智能诊断辨证提供参考,H1可协助诊断脾肾阳虚证、气血两虚证,T可协助诊断湿热蕴结证,W/T、H3/H1可协助诊断瘀毒内结证。Objective To analyze the pulse characteristic parameters and the distribution of traditional Chinese medicine(TCM)syndromes in patients after colorectal cancer(CRC)surgery,and to explore the relationship between pulse characteristic parameters and different TCM syndromes,providing a reference for intelligent diagnosis and syndrome differentiation of postoperative CRC patients.Methods Eighty-three postoperative CRC patients(case group)and twenty healthy individuals(normal group)were selected.Patients in the case group were differentiated according to TCM syndromes.Pulse information of all participants was collected using a SmartMX-I type pulse analyzer,and pulse characteristic parameters of postoperative CRC patients were analyzed with the help of a pulse analysis system.Differences in pulse parameters among postoperative CRC patients with different TCM syndromes were compared.Results①Among the 83 postoperative CRC patients,there were 22 cases of spleen-kidney yang deficiency syndrome,12 cases of liver-kidney yin deficiency syndrome,6 cases of qi and blood deficiency syndrome,24 cases of damp-heat accumulation syndrome,and 19 cases of stasis-toxin internal accumulation syndrome.②In the case group,right pulse H1,T5,and T were lower than those in the normal group(P<0.05),while T1,H3/H1,T1/T,and W/T were higher than those in the normal group(P<0.05).On the left pulse,H1 and T were also lower than those in the normal group(P<0.05),with H4,T1,H3/H1,T1/T,and W/T being higher than those in the normal group(P<0.05).③Patients with spleen-kidney yang deficiency syndrome and qi and blood deficiency syndrome showed lower H1 in both hands(P<0.05)and lower right pulse W/T(P<0.05)than patients with the other three TCM syndromes.Patients with stasis-toxin internal accumulation syndrome had higher right pulse H3 and W(P<0.05),higher left pulse H4,W,and H3/H1(P<0.05)than patients with the other four TCM syndromes,and higher left pulse W/T than patients with spleen-kidney yang deficiency syndrome and those with qi and blood de

关 键 词：结直肠癌 术后 中医证候 脉诊 客观化 

分 类 号：R273[医药卫生—中西医结合]