| Pulse diagnosis is one of the four diagnoses in tradifional chinese medicine.for thousands of years,pulse tracings have been recognized and distinguished by doctors'understanding of the concept of pulse diagnosis and feeling from their fingers. Because of general concept,vague standard as well as some subjective facters from doctors'judging experience,it's difficult teach pulse tracings and impossible to communicate experience of pulse diagnesis. so that it becomes the bottleneck of developing the techniques and theory of pulse diagnosis.The research purpose of this subject is to set up 13 kinds of teaching models of pulse tracings to guide experimental teaching in diagnosis of traditional chinese medicine.We chose mini-pigs and people as study objects and used NX-8 multifunctional sphygmograph to obtain pressure pulse graph and its parts by feeling pulse such as axillary and femoral arteries of mini-pigs,brachial and femoral arteries of days and human left Guan pulse. The optimizational extraction method is used to copy pulse graphs and get the average number from 5 pulse waves. The index is measured according to the method used by Department of physiotogy, Beijing University of Traditional Chinese Medicine. The parameters chosen are HB, SAB,SBC,HE/HB,HFF'and TW. The standard feeling pulse is based on the two experienced Chinese medicine practioners with the same result of pulse diagnosis by double-blind , After setting up normal pulse, we began to make models which were not complete until pulse and pulse graph are stable.1. The stippery pulse modelMini-pigs were intravenously injected low-molecular-weight dextran and 10% glucose injection for 60 drops per minute. Five minutes later, slippery pulse feature appeared through feeling pulse and pulse graph. Pulse could be felt in three parts under fingers in a short time, which was smooth like pearls and its rate is stable, fast and regular. Ten minutes after stopping medicine, pulse graph was steep. B wave was high and narrow. D wave was small and not obvious. E valley had relatively low heiyht . F wave was clear.2. The unsmooth pulse modelMini-pigs were injected propranolol(5mg) and quickly injected 10% high-molecular-weight dextran(7ml/kg) within 3 minutes. Five minutes later, the pulse was weak and unsmooth. The pulse graph showed the amplitude of B wave decreased and its rising and falling rates were slow with pause and transition. B wave and D wave were mixed together. The relative position of E valley was high. F ware was not obvious.3. The wiry pulse modelMini-pigs were injected noradrenaline (1mg/100ml) for 10 drops per minute. About 2 minutes later, the pulse tension increased. The pulse felt straight like touching a string, which existed during injection, and became normal five minutes after stopping injection. The pulse graph was steep. B wave was high and wide. D wave was quite obvious. The relative height of E valley wse high and about half of B wave.4. The full pulse model25ug endotoxin was made into 100ml of solution by using aseptic physiological saline. 0.25ug/kg of the solution was injected slowly through ear vein to cause fever. Two hours after injection, the pulse felt rough, coming strongly but going weaky. The pulse rate was a little fast. The amplitude of B wave increased clearly. and its rising and falling speed were fast.5. The hollow pulse modelWe did phlebotomy on mini-pigs intermittently for many times.Each time phlebotomy amount was 5ml/kg, which was completed in 15-30 seconds. Phlebotomy interval was 5 minutes. When phlebotony amount came to average 15ml/kg, we felt hollow pulse floating and soft. In pulse graph, B wave height decreased. The rising and falling speed was fast. D wave was absent. E valley position was low, nearing the basic line or under it. The subjects blew into an airtight container testing pressure to cause pressure to result in hollow pulse model. The pulse rate of mini-pigs was faster than people's.5. The micro pulse modelThe tube was inserted into femoral artery to cause phlebotomy intermittently. when the blood amounted to average 20ml/kg or so. The pulse was clear, but pulse tracings were thin and weak. B wave decreased, but its width increadsed. The amplitude of D ware was low or unclear.6. The deep pulse modelThe ice bag was put on axillary artery and femoral artery for about 10 minutes. The pulse position was sinking. The pulse shape was thin. You couldn't feel pulse unless you put your fingers heavily on it, which showed obvious deep pulse tracings.7. The long pulse modelMini-pigs were intravenously injected adrenaline (1mg/100ml) for 10 drops per minute.3 minutes later, the pulse felt straight at the beginning and the end, which was longer than the width of three fingers. The pulse rate became fast, which indicated long pulse tracings with strong pulse.9. The abrupt pulse modelMini-pigs were slowly injected 0.4% barium chloride (1ml/kg). About 15 minutes after injection, the pulse rate became faster . with irregular interrals,which showed abrupt pulse tracings. 10. The sthenic pulse model The subjects were asked to lower their left arms and lift their legs for 5-10 minutes. The pulse became strong, which showed sthenic pulse tracings.11. The asthenic pulse modelThe subjects were asked to lift their left arms and do the exercise called Valsalva for 5-10 minutes. The pulse became weak, which showed empty asthenic pulse traings.12. The frequent pulse modelThe subjects were asked to do"squating down and standing up"for 15 times per 30 seconds. When the heart rate fell by 10-20 times, which showed thin and fast frequent pulse tracings.13. The infrequent pulse modelThe carotid sinus of the subjects was constricted. When the heart rate fell by 10-20 times, which showed infrequent pulse ,coming and going slowty.Combining together foregoing research,We compared the features of physiology and pulse tracings among home rabbits, sheep, dogs and mini-pigs. Dogs and mini-pigs were thought of as ideal model animals. The dog's pulse was 70-120/min, blood pressure 95-142/35-85mmHg and respiration 10-30/min. Dogs were similar to human beings in physiology, anatomy and reaction to diseases. In addition, the dog's vessels were large with springy walls; its pulse feeling was obvious; and the tracings were clear and stable. The mini-pigs pulse was 70-130/min, blood pressure 140-160/100-120mmHg and respiration 12-18/min. Its vessels were large with spring walls; its pulse feeling was obvious and tracings were clear and stable with good repetition. Because of simple anesthesia in these animals. Students could do experiment easily. But there is a problem that the dog's and mini-pig's pulse was fast. The comparation between the pulse feeling and the pressure pulse graphs of dog's and mini-pig's axillary artery, brachial artery, radial artery and femoral artery found the pulse feeling of axillary artery and femoral artery was clear and the pulse could be felt on the three parts. The pulse graph could be easily obtained with high amplitude and strong stability. The pulse could be felt from brachial artery and radial artery (not from rabbits radial artery), but the pulse was weak and unclear with low amplitude of pulse graph. From the comparation of pressure pulse graph between axillary artery and femoral artery, we found the pulse graph of axillary artery was similar to that of human's radial artery, both of which had dicrotic front wave and dicrotic wave. But the pulse graph of femoral artery had no dicrotic front wave and so its position was low. Therefore, it is feasible to choose axillary artery and femoral artery to feel pulse and get pressure pulse graph . And axillary artery was the most ideal part to feel pulse on.The feeling of finger ,pressure sphygmograpy and time domain index of sphygmograpy were choosed to evaluate experimental teaching models of pulse diagnosis,The index is sensitiveness,stabilizationand reliability.It is most important evaluating standard that the feeling of finger is obtained exactly. |
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