盛　丽，郑　烈甘肃省中医院超声医学影像科，甘肃兰州730050；上海中医药大学附属龙华医院



基于血流动力学变化特点探讨多普勒频谱对中医脉象客观化评价分析

盛丽1，郑烈2
1甘肃省中医院超声医学影像科，甘肃兰州730050；2上海中医药大学附属龙华医院

［摘要］目的：从血流动力学变化探讨彩色多普勒频谱对中医脉象客观性的研究。方法：由2名高年资超声主任医师采用彩色多普勒超声血流成像仪进行检查，检查时将线阵探头置于对弦脉组、滑脉组、平脉组患者（每组各50例）右手桡动脉处，纵切清晰地显示出桡动脉，将多普勒取样容积置于该血管中心部位，校正角度小于60度，取3个连续频谱，采用QLAB自动包络线，可以显示各检测数据并计算分析。结果：3组研究对象的收缩期峰值血流速度(Vs)、平均峰值血流速度(Vm)、舒张末峰值血流速度(Vd)、阻力指数(R1)、血管横截面积(area)及血流量(Q)比较，差异均有统计学意义(P＜0.05)。结论：通过彩色多普勒频谱，从桡动脉的血流动力学变化为中医脉象提供了一种无创、直观、定量的新方法，进而可为中医脉诊的标准化、客观化提供重要依据。

［关键词］脉象；血流动力学；彩色多普勒频谱

Exploration on the Objectivity of Pulse Manifestations Evaluated by Doppler Spectrum Based on the Features of Hemodynamics

SHENG Li1,ZHENG Lie2
1 Ultrasonography Department of Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China;2 Longhua Hospital Shanghai University of TCM

Abstract Objective:To explore the objectivity of pulse manifestation evaluated by color Doppler spectrum on the foundation of hemodynamics.Methods:Color Doppler blood flow imaging instrument was used to examine by two veteran chief physicians,linear probes were placed on radial artery of right hand (50 cases each group) in the groups of taut pulse,slippery pulse and normal pulse,radial pulse was clearly presented from longitudinal section,dopple sampling volume was placed to central part of the artery,right angle was less than 60 degrees,three continuos spectrums were got and QLAB autonomous enveloping line was adopted,the detection data could be fully displayed,calculated and analyzed.Results:The difference showed statistical meaning (P＜0.05) in the comparisons of peak systolic blood flow velocity (Vs),mean peak blood flow velocity (Vm),peak end-diastolic blood flow velocity (Vd),resistance index(R1),vascular cross-sectional area(area) and blood flow quantity(Q) among three groups.Conclusion:Hemodynamics of radial artery could provide a noninvasive,direct and quantitative method for pulse manifestations by color Doppler,therefore,to provide important reference for normalized and objective pulse diagnosis.

Keywords pulse manifestations;hemodynamics;color Doppler spectrum

中医脉诊有着悠久的历史，是辨证论治的精华体现，是医生用手指触按患者桡动脉诊察脉象、了解病情变化的一种诊病方式。脉诊因医者水平不同可能有不同结果。如果没有客观的评价指标，会给学习和传承带来很大困难。如何使中医脉诊指标客观化，一直是人们关注的问题，也是需要通过现代科学技术解决的重要问题。……