北京生物医学工程

寸口脉脉位与疾病状态关联性的血流动力学建模分析

Hemodynamic modeling to study the association between pulse-taking depths and particular disease conditions in the pulse examination

作者：史宇兵杨晓航

单位：陕西中医药大学整合医学研究院（陕西咸阳712046），陕西中医药大学医学技术学院（陕西咸阳712046） <p>通信作者：史宇兵，教授。E-mail: yshi@sntcm.edu.cn</p> <p> </p>

关键词：脉位；桡动脉；血流动力学；数学模型；频率特性

分类号：R318.04

出版年·卷·期（页码）：2021·40·4（385-392）

摘要：

目的当前关于脉诊的血流动力学建模研究集中于分析各种生理病理变化对脉象的影响，而忽略了切脉对桡动脉血流的干预作用，所以无法从物理上解释寸口脉与所主病症的关系。本研究通过分析切脉对桡动脉血流动态的影响以探讨寸口脉浮中沉脉位和所表征病症的联系。方法本研究构建了简单的桡动脉血流动力学模型，推导了血流特征量（包括寸口处的血流摩擦损失、桡动脉血流动态响应的自然频率和阻尼比等）随切脉深度而变化的定量关系，以评估切脉对桡动脉血流动态的影响。结果研究发现桡动脉血流动态响应的自然频率随切脉深度的增加而增大但基本保持在之间。该变化范围和正常人脉搏波的主要频谱范围高度重合，因此通过切脉至不同深度产生桡动脉血流动态响应的频率特性变化，可以与脉搏波频谱中不同的频率分量合拍共振，从而在寸口处捕捉到脉搏波中对应于不同生理病理状态的频率成分。结论本研究从切脉引起桡动脉血流动态响应的自然频率变化的角度，为寸口脉浮中沉脉位与不同病症状态的联系提供了初步解释。

Objective Current Sphygmography studies based on hemodynamic modelling focused much on the analysis of how the different pathophysiological conditions influence the pulse manifestation, while neglected the effect of the pulse-taking procedure on the radial blood flow, thus could not give a clear physical explanation to the relation between the pulse manifestation and the diseases characterized. This research aims to study the association between the pulse-taking depths and the different disease conditions they reflected through explicitly modeling the effect of the pulse-taking procedure on the radial flow dynamics. Methods This study developed a simple hemodynamic model of the radial flow, and derived equations to quantify the changes of hemodynamic variables (including the frictional loss at cunkou, the natural frequency and the damping ratio of the radial flow dynamics) under different pulse-taking depths, to evaluate the influence of the pulse-taking procedure on the radial flow response. Results Results showed that the natural frequency of the radial flow response increased with the increment of the pulse-taking depths, but it was generally maintained in the range of 5-10Hz. This range was highly overlapped with the range of the major frequency spectrum in the radial pulse wave in normal human subjects. Thus through pulse-taking at different pulse depths, there would be resonance produced between the induced natural frequency of the radial flow response and selected frequency bands in the pulse wave, which facilitated the manifestation of specific frequency components at cunkou corresponding to the different pathophysiological conditions. Conclusions This study gives a preliminary explanation to the association between the pulse-taking depths and the particular disease conditions, from the aspect of the change of the natural frequency in the radial blood flow induced by pulse-taking.

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