Pulse Spectrum Analysis in 205 Patients with Abnormal Liver Function Test

205位肝功能異常病患脈波頻譜之分析

10.6200/TCMJ.2006.3.3.06

呂萬安(Wan-An Lu)

脈診 ； 頻譜 ； 傅立葉轉換 ； 諧波 ； pulse diagnosis ； spectrum ； fourier tran-sform ； harmonic

北市醫學雜誌

3卷3期（2006 / 03 / 01）

240 - 247

英文

目的：把脈是傳統中國醫學臨床上非常流行且非侵入性的方法，本研究之目的正是探討將把脈作為診斷的可行性。方法：選取223位疑似肝病病患進行研究，以6個脈波頻譜指標作為肝異常的脈診指標，分析這六項脈診指標與現代醫學各項肝功能檢查（各項肝功能指數包括T-Bil，D-Bil，SGOT，SGPT，ZTT，Alp，r-GT，Cho，AlB，AlB/Glo）以及超音波掃描的相關性，這六項脈診指標分別為(1)第一諧波強度大於等於3且第一諧波與第四諧波強度之和大於等於4，或第一諧波與第六諧波強度之和大於等於4；(2)第一諧波強度小於等於－3；(3)第六諧波強度大於等於3且第一諧波與第六諧波強度之和大於等於4；(4)第六諧波強度小於等於－2且第六諧波相位小於等於－2；(5)第一諧波強度大於等於2且第三諧波強度小於等於－2，或第三諧波相位小於等於－2；(6)第三諧波強度小於等於－2且第三諧波相位小於等於－2。第一諧波（肝）之強度每高於正常值的5%則定量為一個 ”+”，反之每低於正常值的5%則定量為一個”-”；第三諧波（脾）、第四諧波（肺）、第六諧波（膽）之強度每高於正常值的10%則分別定量為一個”+”，反之每低於正常值的10%則分別定量為一個”-”；至於相位部分，所有諧波之壓力波傳送速度每低於正常值的10%則分別定量為一個”-”。結果：當不考慮”+”、”-”的變化量而僅考量”+”、”N”及”-”三種情況，那麼11個諧波總共可產生311（強度）×311（相位）＝177，147×177，147個脈波頻譜，本研究僅選用6個脈波頻譜作為肝異常之指標，卻得到非常高之相關性，p值小於0.001，Kappa值等於0.68。結論：這個結果顯示脈診學說具有生理與病理上的重要性，將來值得進一步去深入研究。

Background and Purpose: Pulse analysis is non-invasive and very popular in traditional Chinese medicine clinics. The aim of this study was to evaluate the possibility of pulse diagnosis. Methods: We carried out pulse spectrum analysis on 205 patients with possible liver diseases. Correlation between liver tests, which included T-Bil, D-Bil, SGOT, SGPT, ZTT, Alp, γ-GT, Cho, AIB and AIB/Glo, and ultrasound scanning were analyzed. We used six criteria for pulse diagnosis of liver abnormality to test for correlation. These were (1) C1≧3 and C1+C4≧4 or C1+C6≧4 (in intensity), (2) C1≦-3 (in intensity), (3) C6≧3 and C1+C6≧4 (in intensity. (4) C6≦-2 (in intensity) and C6≦-2 (in phase), (5) C1≧2 and C3≦-2 (in intensity) or C3≦-2 (in phase), and (6) C3≦-2 (in intensity) and C3≦-2 (in phase). For the intensity, C1 (liver) every 5% above normal was given one ”+”, every 5% below normal was given one ”-”. For C3 (spleen), C4 (lung), C6 (gallbladder), every 10% above normal was given one ”+”, every 10% below normal was given one ”-”. For the phase, every 10% delay in the traveling speed of the pressure wave was given one ”-”. Results: Only the ”+”, ”N” (N=normal) and ”-” states were considered, while quantities of ”+” ”-” were neglected. In pulse analysis, there are 311 (from intensity)×311 (from phase)=177, 147×177, 147 possible states (3 qualitative states and 11 harmonics). We considered only six criteria for liver abnormality and the correlation was very high, p＜0.001, Kappa=0.68. Conclusion: The results strongly suggest that pulse diagnosis theory has physiological and pathological importance, and is worthy of further study in the future.