橈骨動脈脈搏波的頻譜分析(II)
郭正典
台北榮民總醫院
脈診學是長久以來應用於中醫臨床診斷的一項診察方法，歷代文獻及理論經驗的資料都非常豐富。傳統中醫脈學多屬主觀與經驗的描述，欠缺較客觀明確的定量及定性分析，尤其對於疾病與脈搏波型的相關性，並無客觀及明確的敘述，使得中醫脈診在現代醫學裡中難以被廣泛接受，在臨床研究上亦難以探究發展。雖然目前有多種脈搏波型的擷取儀器被研發出來，以取代傳統手指觸摸橈動脈的診脈方法，不同證型患者的脈搏波型也被客觀描繪出來，但是對於脈搏波形的研究、臨床意義的探討，和對於不同疾病是否具有臨床指標性的定性和定量分析，一直仍未有顯著的發展。因此，發展不同疾病患者脈搏波的客觀化、標準化波形分析法對於提升中醫脈診的實用客觀性是非常重要的。本研究擬以頻譜分析法(power spectral analysis)分析冠狀動脈疾病(Coronary artery disease, CAD)患者及正常對照組撓骨動脈的脈搏波訊號。藉由比對正常對照組及CAD病人撓骨動脈脈搏波的頻譜分析結果，希望能得到各種撓骨動脈脈搏波訊號在時域與頻域上的參數，及這些參數與CAD疾病嚴重度的相關性，以探討不同嚴重度CAD如何影響其脈搏波的情形。這些參數若能證明確與CAD的嚴重度有關，則可作為CAD的脈診診斷標準，提升脈診的診斷價值。
關鍵字：撓骨動脈；脈搏波；頻譜分析；冠狀動脈疾病
Power spectral analysis of radial artery pulse waveform (II)
Kuo, Cheng-Deng
Taipei Veterans General Hospital
The diagnostic method of pulse palpation has been used in traditional Chinese medicine for thousands of years. There are plenty of archives concerning the description of experience in this diagnostic method and the subjective description about the objective assessment of pulse palpation. There are many manipulations and equipments now to get the waveform of artery pulse instead of the way of traditional palpation on radial artery pulsation. However, The description and calculation of pulse waveform parameters and the unstanding of their clinical meanings need more improvements. The development of standardized pulse waveform analysis is necessary for the improvement of the diagnostic power of pulse palpation in traditional Chinese medicine. This study intends to access the signals of radial artery pulse wave taken from coronary artery disease patients and control subjects through the plethysmographic monitor and computer programme written with Mathcad software. We will measure and analyze the parameters from the radial artery pulse wave through power-spectral analysis to find the relationship between the parameters defined and the status of the diseases. By means of biostatistics we may be able to find the difference in pulse wave parameters between coronary artery disease patients and control subjects in different status.
關鍵字：Radial Artery；Pulse waveform；Spectrum Analysis；cardiovascular disease
