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上海中医药大学附属市中医医院(上海 200071)
周霖,男,硕士研究生,主要从事中医药防治恶性肿瘤的临床与研究工作
任建琳,主任医师,硕士研究生导师; E-mail:renjianlin666@126.com
收稿日期:2024-01-10,
纸质出版日期:2025-05-10
移动端阅览
周霖,赵勇,储金砚,等.结直肠癌术后患者脉象特征参数与中医证型分布研究[J].上海中医药杂志,2025,59(5):15-19.
ZHOU Lin,ZHAO Yong,CHU Jinyan,et al.Study on pulse characteristic parameters and distribution of traditional Chinese medicine syndromes in postoperative colorectal cancer patients[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(5):15-19.
周霖,赵勇,储金砚,等.结直肠癌术后患者脉象特征参数与中医证型分布研究[J].上海中医药杂志,2025,59(5):15-19. DOI: 10.16305/j.1007-1334.2025.2401072.
ZHOU Lin,ZHAO Yong,CHU Jinyan,et al.Study on pulse characteristic parameters and distribution of traditional Chinese medicine syndromes in postoperative colorectal cancer patients[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(5):15-19. DOI: 10.16305/j.1007-1334.2025.2401072.
目的
2
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
2
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
2
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
2
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
2
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
2
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.
Results
2
①Among the 83 postoperative CRC patients, there were 22 cases of spleen-kidney yang deficiency syndrome, 12 case
s 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. ② In 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 deficiency syndrome (
P
<
0.05). Patients with damp-heat accumulation syndrome had lower right pulse T1 than those with spleen-kidney yang deficiency syndrome and qi and blood deficiency syndrome (
P
<
0.05), and lower T than patients with the other four TCM syndromes (
P
<
0.05). Patients with qi and blood deficiency syndrome had higher right pulse T5 than those with damp-heat accumulation syndrome (
P
<
0.05), and lower right pulse T1/T than those with damp-heat accumulation syndrome and stasis-toxin internal accumulation syndrome (
P
<
0.05). Patients with spleen-kidney yang deficiency syndrome had higher left pulse T1 than those with liver-kidney yin deficiency syndrome, damp-heat accumulation syndrome, and stasis-toxin
internal accumulation syndrome (
P
<
0.05).
Conclusions
2
Pulse parameters in postoperative CRC patients showed characteristic changes and could provide a reference for intelligent diagnosis and syndrome differentiation for postoperative CRC patients. H1 assisted in diagnosing spleen-kidney yang deficiency syndrome and qi and blood deficiency syndrome, T assisted in diagnosing damp-heat accumulation syndrome, and W/T along with H3/H1 assisted in diagnosing stasis-toxin internal accumulation syndrome.
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