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喻心傲,瞿昊宇,陈彦坤,谢梦洲.湖南地区超重人群高血压脉象频域特征研究[J].湖南中医药大学学报,2020,40(6):717-721[点击复制] |
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| 湖南地区超重人群高血压脉象频域特征研究 |
| 喻心傲,瞿昊宇,陈彦坤,谢梦洲 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药大学中医诊断重点实验室, 湖南 长沙 410208;湖南中医药大学, 湖南 长沙 410208;湖南中医药大学中医诊断重点实验室, 湖南 长沙 410208;湖南2011数字中医药协同创新中心, 湖南 长沙 410007;湖南省药食同源功能性食品工程技术研究中心, 湖南 长沙 410208) |
| 摘要: |
| 目的 探索超重伴发高血压人群脉象的频域特征。方法 从1 116例湖南中医药大学第一附属医院门诊资料中筛选超重或肥胖者253例（22.67%），分为青年组：正常血压组（A组）、高血压组（B组）；中老年组：正常血压组（C组）、高血压组（D组）。采集脉象并分解为C1、C2、C3、C4、C5、C6谐波，将青年组、中老年组组内对比显示差异有统计学意义的波次作为特征波次，再应用ROC曲线寻找特征波次上的特征点，评价特征点预测伴发高血压的价值。结果 超重人群青年伴发高血压者的C2（肾经）为特征谐波，其频率增大（P<0.05）；中老年伴发高血压者的C1（肝经）、C2（肾经）、C3（脾经）为特征谐波：C1（肝经）、C2（肾经）频率增大，C3（脾经）频率减小（P<0.05）。青年C2（肾经）、中老年C1（肝经）、C2（肾经）超重伴发血压的谐波频率占比切点值分别为0.238、0.499、0.182。青年组C2的AUC值为0.696，表示C2有一定的预测价值——超重青年C2大于0.238者伴发高血压风险较大；中老年组C1的AUC值为0.663，表示C1有一定的预测价值——超重中老年C1在0.499以上者伴发高血压风险较大；中老年组C2的AUC值为0.977，说明有极好的预测价值——超重中老年C2在0.182以上者伴发高血压的风险极大；中老年组C3的AUC值为0.000，说明C3对是否发生高血压没有预测价值。结论 超重人群伴发高血压的主要病机在青年是“肾阴亏虚”，在中老年是“肾阴亏虚”“肝火上炎”“脾气亏虚”；超重者高血压的发生由“肾阴亏虚”的病机主导；病证演变过程大致为初期病位在肾，久之肝、脾、肾同病；脉图谐波C2（肾经）、C1（肝经），尤其是C2能较准确而敏感地反映超重者的血压升高，但本研究得出的切点值的普适性，尚需要在更大的样本中得到验证。 |
| 关键词: 超重 高血压 脉诊 脉诊仪 频域分析 |
| DOI：10.3969/j.issn.1674-070X.2020.06.015 |
| 投稿时间：2020-02-15 |
| 基金项目:科技部科技基础专项资助项目（2013FY114400）；华中地区不同体质人群中医正常脉诊生理参数系统调查（2013FY114400-4）。 |
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| Study on Pulse Percentage Characteristics of Hypertension in Overweight Population in Hunan Province |
| YU Xin'ao,QU Haoyu,CHEN Yankun,XIE Mengzhou |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Key Laboratory of Traditional Chinese Medicine Diagnosis, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Key Laboratory of Traditional Chinese Medicine Diagnosis, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Hunan 2011 Digital Chinese Medicine Collaborative Innovation Center, Changsha, Hunan 410007, China;Hunan Provincial Research Center for Homology of Medicine and Food of Functional Food Engineering, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To explore the percentage-domain characteristics of pulse in overweight patients with hypertension. Methods A total of 253 overweight or obese patients (22.67%) were selected from 1116 cases of the Outpatient Department of The First Affiliated Hospital of Hunan University of Chinese Medicine. They were divided into youth group: normal blood pressure group (group A), hypertension group (group B); the middle aged and elderly group: normal blood pressure group (Group C), hypertension group (Group D). The pulse was collected and decomposed into C1, C2, C3, C4, C5, C6 harmonics. The harmonic waves of statistical difference between the young group and the middle aged and elderly group were taken as the characteristic harmonic waves. Then, ROC curve was used to find the characteristic points on the characteristic harmonic waves and evaluate the value of the characteristic points in predicting the concomitant hypertension. Results The C2 (kidney meridian) of the young people with hypertension in the overweight group was a characteristic harmonic, and its frequency increased (P<0.05); the C1 (liver meridian), C2 (kidney meridian), C3 (spleen meridian) of the middle-aged and elderly people with hypertension were characteristic harmonic, and the frequency of C1 (liver meridian), C2 (kidney meridian) increased, and the frequency of C3 (spleen meridian) decreased (P<0.05). The cut-point value of C2 (kidney channel) in youth group, C1(liver channel) and C2 (kidney channel) in the middle-aged and elderly group were 0.238, 0.499 and 0.182 respectively. The AUC value of C2 in the young group was 0.696, indicating that C2 had certain predictive value. The risk of hypertension in overweight youth with C2 greater than 0.238 was relatively high; the AUC value of C1 in the middle-aged and old group was 0.663, indicating that C1 had certain predictive value. The risk of hypertension in overweight youth with C2 greater than 0.499 was relatively high; The AUC value of C2 in the middle-aged and elderly group is 0.977, indicating that it had excellent predictive value. The risk of hypertension was rather high in the overweight middle-aged and elderly people with C2 above 0.182; the AUC value of C3 in the middle-aged and elderly group was 0.000, indicating that C3 had no predictive value for the occurrence of hypertension. Conclusion The main pathogenesis of hypertension in overweight people is "deficiency of kidney Yin" in young people, and "deficiency of kidney Yin", "liver fire flaring up" and "deficiency of spleen Qi" in the middle-aged and elderly group; the occurrence of hypertension in overweight people is dominated by the pathogenesis of "deficiency of kidney Yin"; the process of disease is roughly that the disease is located in the kidney at the initial stage and in the liver, spleen and kidney at the later stage; pulse harmonic C2 (kidney channel), C1 (liver channel), especially C2 can accurately and sensitively reflect the blood pressure rise of overweight people, but the universality of the cut-off point value obtained in this study needs to be verified in a larger sample. |
| Key words: overweight hypertension pulse diagnosis pulse apparatus percentage domain analysis |
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