[1]宋姗姗,姜敏,黄博臻,等.基于五诊合参模型探讨双臂血压对肝脾不调证的诊断与疗效评估价值[J].西部中医药,2025,38(11):161-168.[doi:10.12174/j.issn.2096-9600.2025.11.30]
　SONG Shanshan,JIANG Min,HUANG Bozhen,et al.The Value of Inter-Arm Blood Pressure Measured Simultaneously in the Diagnosis and Clinical Evaluation of Spleen-liver Disharmony Pattern Based on the Model of Integrated Application of Five Diagnostic Methods[J].Western Journal of Traditional Chinese Medicine,2025,38(11):161-168.[doi:10.12174/j.issn.2096-9600.2025.11.30]
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基于五诊合参模型探讨双臂血压对肝脾不调证的诊断与疗效评估价值()

《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
38
期数:
2025年11期
页码:
161-168
栏目:
诊断剖析
出版日期:
2025-11-15

文章信息/Info

Title:
The Value of Inter-Arm Blood Pressure Measured Simultaneously in the Diagnosis and Clinical Evaluation of Spleen-liver Disharmony Pattern Based on the Model of Integrated Application of Five Diagnostic Methods
作者:
宋姗姗, 姜敏, 黄博臻, 刘馨心, 马思懿, 王国玉, 张良登, 王婉卿, 王路瑶, 王亮, 薄瑞晴
首都医科大学附属北京世纪坛医院，北京 100038
Author(s):
SONG Shanshan, JIANG Min, HUANG Bozhen, LIU Xinxin, MA Siyi, WANG Guoyu, ZHANG Liangdeng, WANG Wanqing, WANG Luyao, WANG Liang, BO Ruiqing
Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
关键词:
肝脾不调证; 双臂血压; 五诊合参; 诊断价值; 疗效评估
Keywords:
spleen-liver disharmony pattern; the inter-arm blood pressure measured simultaneously; integrated five diagnostic methods; diagnostic values; clinical evaluation
分类号:
R256.3
DOI:
10.12174/j.issn.2096-9600.2025.11.30
文献标志码:
B
摘要:
目的探讨双臂血压相关指标对肝脾不调证的诊断价值及疗效评估作用。 方法采用前瞻性横断面调查结合前瞻性观察性研究设计，采集111例以失眠和/或胃脘痛为主诉、中医辨证为肝脾不调证患者的双臂血压及辨证诊疗数据，同期纳入60例健康人群作为对照并采集其双臂血压数据。分析血压、脉压差、心率等指标与肝脾不调证的关联性，比较两组双臂血压相关指标的差异及潜在影响因素，初步构建基于双臂血压的脏腑辨证诊断模型。 结果健康组与肝脾不调组在年龄、婚姻状况、文化程度、左臂收缩压、心率、右臂收缩压、内外循环偏离度、左右平衡度（肝脾）、左右平衡度（肺肾）、左侧脉压差、右侧脉压差等指标上比较，差异均有统计学意义（P＜0.05）；逐步回归分析显示，已婚状态、左右平衡度（肝脾）异常增高、左右平衡度（肺肾）异常增高是肝脾不调证的重要危险因素，心健康偏离度降低与肝脾不调证发病风险增加相关。相关性分析提示，婚姻状况、左右平衡度（肝脾）、左右平衡度（肺肾）与肝脾不调证呈正相关（P＜0.05），心健康偏离度与肝脾不调证呈负相关（P＜0.05）。婚姻状况、左右平衡度及心健康偏离度构建的联合指标，预测肝脾不调证的曲线下面积最大。疗效评价显示，55例患者经4周中药治疗后，肾同比差、肺健康偏离度、肾健康偏离度、脾健康偏离度、肝健康偏离度、左右平衡度（肝脾）、左右平衡度（肺肾）等指标与治疗前比较，差异均有统计学意义（P＜0.05）。 结论双臂血压相关指标与肝脾不调证存在明确相关性，对该证候具有较高诊断预测价值，且可作为疗效评价指标量化评估脏腑平衡的恢复状况。
Abstract:
ObjectiveTo discuss the values of the indexes of inter-arm blood pressure measured simu-ltaneously in the diagnosis and clinical effects of spleen-liver disharmony pattern. MethodsUsing a prospective cross-sectional survey combined with prospective observational study design, we collected blood pressure in both arms and the data of syndrome differentiation and treatment from 111 patients with insomnia and/or epigastric pain, diagnosed with spleen-liver disharmony pattern, included 60 healthy people as the control concurrently, and gathered the data of blood pressure in both arms. To analyze the relationship between the indexes of blood pressure, pulse pressure difference, heart rate, and spleen-liver disharmony pattern, to compare the differences in the indexes of the inter-arm blood pressure measured simultaneously and potential influencing factors between the two groups, for preliminary construction of a diagnostic model of visceral differentiation based on the inter-arm blood pressure measured simultaneously. ResultsThe difference had statistical meaning in age, marital status, and degree of education, left arm systolic pressure, heart rate, and right arm systolic pressure, internal and external cycle deviation, left-right balance degree (liver-spleen), left-right balance degree (lung-kidney), left pulse pressure difference between healthy group and the group of spleen-liver disharmony pattern (P<0.05); stepwise regression analysis displayed that being married, abnormal increase of left-right balance degree (liver-spleen) and left-right balance degree (lung-kidney) were the important risk factors of spleen-liver disharmony pattern, mental health deviation decrease is related to the increased risk of disease. The correlation analysis suggested that marital status, left-right balance degree (liver-spleen), and left-right balance degree (lung-kidney) were positively related to spleen-liver disharmony pattern (P<0.05), mental health deviation is negatively related to spleen-liver disharmony pattern (P<0.05). A composite index combining marital status, left-right balance degree and mental health deviation revealed that the area under the curve for the prediction of liver and spleen disharmony syndrome was the largest. Clinical evaluation showed that the difference had statistical meaning in year-on-year change in renal parameters, lung health deviation, renal health deviation, spleen health deviation, liver health deviation, left-right balance degree (liver-spleen), and left-right balance degree (lung-kidney) when 55 patients after four weeks of TCM treatment were compared with before the treatment (P<0.05). ConclusionThere is a clear correlation between the indexes of the inter-arm blood pressure measured simultaneously and spleen-liver disharmony pattern, possessing high diagnostic predictive value for the syndrome, and they can be used as efficacy evaluation indicators to assess the adjustment degree of zang-fu organs deviation.

备注/Memo

备注/Memo:
国家中医药管理局基本中医药循证能力建设项目（2019XZZX-JB004）；首都卫生发展科研专项项目（2022-1-4301）。宋姗姗（1999—），女，在读硕士研究生。研究方向：肿瘤的中医药防治。
更新日期/Last Update: 2025-11-15