北京中医药大学 北京 100029
杨莹莹,女,在读博士生
#通信作者:赵丽红,博士,助理研究员,主要研究方向:中医诊法与辨证的客观化、规范化,E-mail:lihongzhaolhz@163.com
收稿:2020-05-25,
纸质出版:2021-04-30
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杨莹莹, 王天芳, 赵丽红, 等. 多时点动态观测原发性痛经寒凝血瘀证患者的脉图参数变化[J]. 北京中医药大学学报, 2021,44(4):350-357.
Yingying Yang, Tianfang Wang, Lihong Zhao, et al. Variation of pulse parameters in patients of primary dysmenorrhea with the pattern of cold congelation and blood stasis based on multi-temporal dynamic observation[J]. Journal of Beijing University of traditional Chinese Medicine, 2021, 44(4): 350-357.
杨莹莹, 王天芳, 赵丽红, 等. 多时点动态观测原发性痛经寒凝血瘀证患者的脉图参数变化[J]. 北京中医药大学学报, 2021,44(4):350-357. DOI: 10.3969/j.issn.1006-2157.2021.04.010.
Yingying Yang, Tianfang Wang, Lihong Zhao, et al. Variation of pulse parameters in patients of primary dysmenorrhea with the pattern of cold congelation and blood stasis based on multi-temporal dynamic observation[J]. Journal of Beijing University of traditional Chinese Medicine, 2021, 44(4): 350-357. DOI: 10.3969/j.issn.1006-2157.2021.04.010.
目的
2
分析原发性痛经寒凝血瘀证患者脉图参数的动态变化及其与疼痛程度的相关性。
方法
2
以原发性痛经寒凝血瘀证患者为原发性痛经组,健康者为对照组。在痛经典型发作时予以电针治疗,形成4个观测时点(T
0
:经前7~10 d,T
1
:经期痛经典型发作时,T
2
:针刺镇痛治疗30 min结束即刻,T
3
:针刺镇痛治疗结束后30 min)。运用道生DS01-C型脉象仪采集脉图参数,包括幅度(
h
)、时值(
t
)、宽度(
w
)、幅度比、时值比、宽度与时值比、心率(HR)等,并用视觉模拟评分(VAS)评定疼痛程度。统计方法采用重复测量的方差分析、Pearson积差相关系数、Spearman相关系数及均值、标准差等描述性分析的方法。
结果
2
原发性痛经组纳入35例,对照组纳入32例。在疼痛程度的变化上,痛经发作前后,即4个时点的VAS比较结果,T
1
、T
2
、T
3
与T
0
比较均显著升高(
P
<
0.05),T
2
、T
3
与T
1
比较均显著降低(
P
<
0.05)。在脉图参数的变化上,痛经发作前后,即4个时点的脉图参数变化为:T
1
与T
0
比较,
h
2
、
h
4
、
t
1
均显著升高(
P
<
0.05);T
2
与T
1
比较,
t
5
显著升高(
P
<
0.05),
h
3
/
h
1
、
w
1
/
t
、
t
1
/
t
、
t
1
、HR均显著降低(
P
<
0.05);T
3
与T
2
比较,
h
3
/
h
1
、
w
1
/
t
、
t
1
/
t
、
t
1
均显著升高(
P
<
0.05)。同一时点与对照组比较:T
0
时点,原发性痛经组
h
2
、
h
4
均显著低于对照组(
P
<
0.05);T
1
时点,
h
3
/
h
1
、
w
1
/
t
、
t
1
、
t
1
/
t
均显著高于对照组(
P
<
0.05);T
3
时点,
t
1
、
t
1
/
t
均显著高于对照组(
P
<
0.05)。在脉图参数与疼痛程度的相关性上,与VAS呈显著正相关的脉图参数是:
h
2
、
h
3
、
h
4
、
h
3
/
h
1
、
h
4
/
h
1
、
w
1
(
P
<
0.05);与VAS呈显著负相关的脉图参数是:
h
5
、
h
5
/
h
1
(
P
<
0.05)。
结论
2
原发性痛经寒凝血瘀证患者的脉图参数在痛经发作时较痛经发作前、缓解后及健康人群有一定程度改变,且其脉图参数的变化与疼痛程度有一定的相关性。
Objective
2
To analyze the dynamic changes of pulse parameters and their correlation with pain degree in patients of primary dysmenorrhea (PD) with the pattern of cold congelation and blood stasis.
Methods
2
PD patients with the pattern of cold coagulation and blood stasis were the PD group and healthy subjects were the control group. Electroacupuncture treatment was administered at the typical onset of dysmenorrhea. Four observation points (T
0
-7~10 days before menstruation
T
1
-menstrual dysmenorrhea typical attack
T
2
-after the acupuncture analgesia treatment for 30 min immediately
T
3
-30 min after acupuncture analgesia treatment) were made. Pulse parameters were collected by using DS01-C pulse imager
including amplitude(
h
)
time(
t
)
width(
w
)
amplitude ratio
time-figure ratio
width-to-time-fiure ratio
heart rate(HR)and so on
and the Visual Analogue Score (VAS) was evaluated to assess pain severih. Repeated measurement variance analysis
Pearson correlation coefficient
Spearman correlation coefficient and the descriptive statistics including mean and standard deviation were used in statistical analysis.
Results
2
A total of 35 PD patients and 32 healthy controls were included. In terms of pain severity
VAS at T
1
T
2
and T
3
were all significantly higher than T
0
(
P
<
0.05) while the scores at T
2
and T
3
were all significantly lower than T
1
(
P
<
0.05). As for pulse parameters
compared with T
0
h
2
h
4
t
1
of T
1
all increased significantly (
P
<
0.05); compared with T
1
t
5
of T
2
increased significantly (
P
<
0.05) and
h
3
/
h
1
w
1
w
1
/
t
t
1
/
t
t
1
HR all decreased significantly (
P
<
0.05); compared with T
2
h
3
/
h
1
w
1
/
t
t
1
/
t
t
1
of T
3
all increased significantly (
P
<
0.05). Compared with healthy controls at the same time: the
h
2
h
4 of the syndrome of cold congelation and blood stasis were all significantly lower than those in the healthy control (
P
<
0.05)
the
h
3
/
h
1
w
1
/
t
、
t
1
t
1
/
t
were all significantly higher (
P
<
0.05) at the T
1
(
P
<
0.05); the
t
1
t
1
/
t
were all significantly higher (
P
<
0.05) at the T
3
(
P
<
0.05). In the correlation between pulse chart parameters and pain degree
the pulse chart parameters that were positively correlated with the VAS were:
h
2
h
3
h
4
h
3
/
h
1
h
4
/
h
1
w
1
(
P
<
0.05); negatively correlated:
h
5
h
5
/
h
1
(
P
<
0.05).
Conclusion
2
Pulse parameters in patients of PD with the pattern of cold congelation and blood stasis seem to change after the onset of pain and compared to the healthy population. The changes of the pulse parameters correlated with the severity of pain.
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