中醫脈波分析利用一次導函數與頻域互驗：應用在汪教授之弦脈上

TCM Pulse Contour Analysis Correlate First-Derivative to Frequency Domain: on Dr. Wang’s Stringy (xian) Pulse

四十年前，汪叔游教授還是一位心臟科醫師的時候，就決心投入中醫臨床脈診研究的工作，他將中醫脈象大致分為六類，曾發表在各類文獻中，今能獲得汪氏之第一手脈圖資料並已置入本文中乃筆者之無比榮幸。當筆者還是研究所學生之時，汪老師就有吩咐吾人將重點放在脈圖之電腦程式開發上。基於過去之經驗，本研究將進行一連串的脈圖數據運算，目的在找尋對應在脈圖上的諧波，條件是它只對Bisferiens（複脈）有反應，但不會對圖形的整體性產生劇變。結果，從數據中得證第五諧波的貢獻最大，複脈波形在傅立葉函數加減重組下，脈圖數據能提供弦脈IV 型的量化資料。過去我們曾經在脈波的一次導函數斜率曲線上，發現一｀W＇變化，此現象對P1,P2 波辨析很靈敏，而今運用在原波圖形及諧波折損圖的分析上仍然有。這項結果，無疑是提供了時域／頻域脈圖分析的線索，提昇了脈波圖形之自動化及量化判讀。本研究之初衷是用數據分析方法，協助汪教授的脈圖作分析，並盼能為未來的自動化運算作出貢獻。日後，若能在此自動分析方法基礎上，累積更多的臨床病例，將可與汪教授的中醫脈証學作比對，從統計中便可考驗各種假設，使真理成為證據。本研究將可為中醫脈診帶來預期的自動化之實證。

Dr. SY Wang being a cardiologist, who used to study TCM pulsology clinically forty years ago, had been summarized six important category of TCM pulse contours in his publications and it is my honor to have his latest pulses morphological map is released in this manuscript. I used to work on the computer programming for pulse contour analysis (PCA) under Dr. Wang’s tutorial and instructions. Applied our previous experiences to this study, a series of computer procedures was solved for mining a variety of harmonics which had strong impact on the bisferiens waveform only but not the whole curve. Finally, evidence showed the 5th harmonic be an important factor to probe on. Results from the first-derivative function, there is a ‘W’ shaped on the slope curves which appeared to be very sensitive to the P1, P2 waves. Through the slope derivative and 5th harmonic-reduced results which may help us to quantify the bisferiens waveform and categorize into IV types (strong bisferiens to dicrotic). Another important contribution of this study is being a clue for PCA automation and demonstrating the different levels of Xien pulse. Empirically, this study may give some efforts to Dr. Wang’s TCM pulsology interpretation with numerical analysis capability which may enrich PCA automation functions. In future, we want to accumulate more clinical cases for studying the PCA and verifying evidences which may raise new challenges on Dr .Wang’s hypothesis and let truth become evidence. This work probably can provide a prospective research on pulsological automation evidence.