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Traditional Chinese medicine wrist pulse-taking is associated with pulse waveform analysis and hemodynamics in hypertension

引用

Journal of Integrative Medicine 2016年第2期14卷 100-113页

作者： Nathalia Gomes Ribeiro de Moura ivan cordovil Arthur de Sa Ferreira Postgraduate Program of Rehabilitation Science Augusto Motta University Center21041-010Rio de JaneiroR JBrazil Division of Arterial Hypertension National Institute of Cardiology22240-002Rio de JaneiroR JBrazil Department of Physical Therapy Salgado de Oliveira University24030-060NiteroiR JBrazil

BACKGROUND： Pulse wave analysis（PWA） quantifies the phenomenon of pulse waveform propagation in patients with cardiovascular diseases, whereas pulse image analysis（PIA） is a subjective examination in traditional Chinese medicine. OBJECTIVE： This study evaluated the association of PIA with PWA and hemodynamics in patients with hypertension. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This observational, cross-sectional study enrolled 45 patients（26 men,（55.2± 10.3） years, systolic blood pressure（155± 28） mm Hg, diastolic blood pressure（93± 17） mm Hg） for assessment of clinical and laboratorial data. MAIN OUTCOME MEASURES： Primary outcomes comprised： pattern differentiation based on an automated method; PIA at the radial artery using the ‘simultaneous pressing＇ method for identification of factors such as strength（strong/weak）, depth（superficial/deep）, and speed（fast/moderate/slow）; and PWA at the same artery using a noninvasive system. RESULTS： Significant multivariate main effects were observed for depth（l=0.648, F_（5,29）=3.149, P=0.022, h^2 =0.352）, strength（l=0.608, F_（5,29） =3.736, P=0.010, h^2 =0.392）, and speed（l=0.535, F_（5,29） =5.302, P=0.002, h^2 =0.465）. General effects comprised high values of PWA and blood pressure for superficial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥ 62.5 mm Hg and systolic blood pressure ≥ 149.5 mm Hg, whereas a superficial pulse was found for heart rate ≥ 58.25 beats/min; a fast pulse was found for heart rate ≥ 69.6 beats/min and pulse wave velocity ≥ 9.185 m/s. CONCLUSION： Associations were explained by La Place＇s law, arterial remodeling in hypertension, alongside the traditional criterion for classifying speed in pulse images. PIA is associated with PWA and hemodynamics in patients with hypertension. Systolic and pulse pressures, heart rate, and pulse wave velocity are quantitative variables that have information to describe the qualitative pulse images such as strength, depth and speed.

关键词： medicine Chinese traditional hypertension syndrome differentiation rehabilitation

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