藏醫尿診法初探

Urinalysis of the Tibetan Medicine

尿診是藏醫診斷中重要的一環，其方法是用自色容器盛取患者晨起第一次尿液，於尿仍熱時，立即觀察尿的顏色、蒸氣、氣味、泡沫；待尿溫降低，氣味不明顯時，則觀察沉澱物及浮皮；尿冷時，則觀察尿的轉變時間、轉變情形及轉變後的顏色。根據各項觀察，分析人體的寒熱虛實等特性，以供診療之參考。本研究針對 80 例大學生之尿液檢體進行藏醫尿診觀察及西醫尿液常規檢查，利用 Fish- er's exact test、t-test及Pearsoncorrelation coefficients 等方法加以分析，探討尿檢前的飲食種類，睡眠狀況等因素與各項尿診指標之間的相關性；並分析受檢者口苦症狀與各項尿診觀察的相關性。自願受檢學生平均年齡 24.5 歲，男性 58 人，女性 22 人，95%檢體非晨起第一泡尿，回溯至受檢前晚，曾喝茶者佔 8.8%，酒 8.8%，大量水 15%，奶製品 22.5%，藥 11.3%，素食13.8%，油炸物或肉類 63.8%。各變項間相關分析之結果如下：一、受檢學生之尿液檢體，以尿色淡黃，知味濃淡中等，未兼夾其他氣味，無泡沫，沉渣量少，均勻分佈，形似棉絮狀，無浮皮者為最常見。二、尿色方面，清淡佔 16.3%，淡黃佔 38.8%，淺黃佔 12.6%，明黃佔 23.8%，鮮黃佔 1.3%，橙黃佔 7.5%。尿色與是否晨起第一泡尿及尿液比重有顯著之相關。三、尿味方面，濃佔 30%，淡佔 10%，中等佔 60%；焦肉味佔 16.3%，脂肪味佔 5%。尿味是否兼夾其它氣味，與吃油炸物或肉類與否有顯著相關。四、泡沫方面，無泡沫佔56.3%，泡沫小(10 ≦ 10mm)且易消失佔 16.3%，泡沫小但不易消失佔 26.3%，泡沫大小不一且不易消失佔 1.3%。泡沫之產生與否，與各項飲食起居因素均無顯著相關。五、沉渣方面，量多佔 13.8%，量少佔 48.8%；均勻分佈佔 86.3%，棉絮狀佔 52.5%，灰點狀佔21.3%。尿沉渣的量與尿液比重、酸鹼度及吃油炸物或肉類與否有顯著相關。六、浮皮方面，無浮皮產生者佔60%，2 小時內浮皮即產生者佔18.8%，2 小時後浮皮才在生者佔21.3%。浮皮的產生與素食、吃油炸物或肉類與否及酸鹼度有顯著相關。七、受檢者中有口苦症狀者佔11.3%，並與尿氣味之濃淡程度及比重有顯著相關。

Urinalysis is a diagnostic method in Tibetan medicine. Doctor observes the color, vapor, odor, and types of bubbles of urine to understand the patient's disorder. This study was designed to examine the associations between the variables from urinalysis and life style variables. The study sample consisted of 80 students from China Medical College. Information of urine observation such as color, odor, bub- bles, suspension, and oily chyle was collected. Fisher's exact test, t-test and Pearson correlation coeffi- cients were used to examine the relationship between the factors oflife style and the urine observations when appropriate. Of the 80 students, 58 students were male and 22 students were female. The mean age of the stu- dents was years Old. The percentage of the first urine in the morning was 5%. Thepercentages of individuals who draok tea, alcohol, a large amount of water, milk were 8.8%, 8.8%, 15%, and 22.5%, respectively. About 11 % of them were taking medication. The percentage of subjects who usually had vegetarian diet was 13.8%, while the percentage of subjects who ate fried food or meat was 63.8%. The percentages of urine color for less pale, pale yellow, light yellow, bright yellow, vivid yellow, and orange yellow were 16.3%, 38.8%, 12.6%, 23.8%, 1.3%, and 7.5%, respectively. The first urine in the morning and specific gravity are significantly associated with the urine color. The percentages of urine with moderate, foul, and faint smell were 60%, 30%, and 10% respec- tively, whereas the percentages of urine with singed, greasy, and other odor were 16.3%, 5%, and 8.8%, respectively. The urine with smell other than ammonia is significantly associated with eating fried food ormeaL The percentages of urine with no bubble, small (≦ 10 mm) and quickly disappearing, small but per- sist longer, and various size and persist longer were 16.3%, 26.3%, and 1.3%, respectively. There was no relationship between bubble production and the factors in this study. The percentages of urine suspension with large amount, little amount, evenly distributed, cotton- like, anddust-likewere 13.8%, 48.8%, 86.3%, 52.5%, and21.3%, respectively. The amount of suspen- sion was associated with specific gravity, and eating fried food or meat. The percentages of no chyle, and with chyle within 2 hours and after 2 hours were 60%, 18.8%, and 21.3%. The oily chyle was associated with vegetable diet, pH., and eating fried food or meat Among these study subjects, 11.3% of them had bitter taste in the mouth and the bitter taste in the mouth was related to the strength of odor and specific gravity.