B型肝炎濕熱證患者三部脈波圖之比較研究

A study of Radial Sphygmogram on Damp-heat Pattern in Patients with Hepatitis B

濕熱為B型肝炎初期患者常見之證，其主症狀有口苦、脅肋腹脹、心煩易怒、小便短赤、舌苔黃膩…等。本項研究是借助脈波儀對B型肝炎濕熱型患者進行臨床測量，就其脈波圖之各項參數進行分析。 本研究在中國醫藥大學附設醫院肝炎特別門診和消化內科病房篩選B型肝炎濕熱型患者34名，以脈波儀測量兩手寸、關、尺之最佳脈圖，並以自身寸口六部脈互相比較，期望能從其中找到臟腑分部主病的證據。 研究結果顯示：以六部脈圖互相比較，單因子重複測量變異數分析結果顯示脈波上1/3寬度與週期的比值（W/T）在兩關顯著大於其他部位（P<0.05），脈波面積（APW）、h1/t1及右手之h5則有浮、中、沉漸漸變小的變化（P<0.05），其餘參數則均無顯著差異。其次以皮爾森相關係數分析法對上述脈波參數與肝功能（SGOT、SGPT），進行檢定分析，結果顯示︰右關之W/T與SGOT呈顯著正相關（P=0.023、ｒ=0.389），與SGPT亦呈接近正相關（P=0.118、ｒ=0.274），左關之APW與SGOT呈接近顯著正相關（P=0.125、ｒ=0.268），與SGPT呈顯著正相關（P=0.026、ｒ=0.382），其餘的脈波參數與肝功能則均沒有顯著相關性。 因此，以本研究的結果而論，B型肝炎濕熱證患者脈波圖兩手關部的W/T與其它部位相比有顯著差異，顯示臟腑分部主病學說有其臨床價值。

“Damp-heat” is the most frequent pattern in patients with the initial stage of hepatitis B in traditional Chinese medicine (TCM). The main symptoms are bitter mouth, flank and abdomen fullness, annoyed and angry, red-short urine, yellow-greasy tongue spur…etc. In this study, radial sphygmogram is employed for pulse analysis in hepatitis B with damp-heat. A total of 34 subjects were collected from the hepatitis special clinic in Chinese medical university hospital. Bilateral radial pulse analysis was conducted with sphygmography, and divided into three parts of each radial artery, cun, guan, and chi. The purpose of this study is to find out the evidence of the TCM theory which states that different pulse positions correspond to different body organs. One-way repeated measures ANOVA shows the ratio of upper-third width of pulse wave and pulse wave period (W/T) on both guan are greater than other pulse positions (p<0.05). The Pearson correlation coefficient between W/T and liver function are as following: The correlation coefficient of right guan W/T between SGOT is 0.389. The correlation coefficient of right guan W/T between SGPT is 0.274. The correlation coefficient between left guan APW and SGOT is 0.268. The correlation coefficient between left guan APW and SGPT is 0.382. The other pulse parameters are not significant different. The result show that both sphygmograms of guan are significant associated with liver function in hepatitis B patients with damp-heat. Therefore, the TCM theory that different pulse positions correspond to different body organs is useful in clinic.