| Background: Traditional Chinese medicine (TCM) pulse diagnosis is used to assess the health status of patients in TCM consultation. However, the low inter-rater reliability of pulse diagnosis among TCM doctors does not fit well with evidence-based practice. Developing an objective and reliable standard for TCM pulse diagnosis has thus become a pressing issue.;Aim: The aim of this doctoral work was to develop an objective and reliable standard for TCM pulse diagnosis in hypertensive patients.;Method: A correlational study design was used and a dice model was formulated to integrate the concepts of pulse in TCM and modern medicine. A TCM doctor rated the eight elements (depth, rate, regularity, width, length, smoothness, stiffness, and strength) at the six locations (left and right cun, guan, and chi) on a visual analogue scale. A validated pulse acquisition device was used to acquire the arterial pressure waveforms at the six locations. Univariate analysis, regression analysis, and an artificial neural network (ANN) were used to analyze the data. A p-value of less than 0.05 denoted statistical significance.;Results: Group and location had a significant effect on both the eight elements and the physical parameters (p < 0.05). The nonlinear relationship among the eight elements and the physical parameters at the six locations was identified using an ANN. The r-squared of the models ranged from 0.60 to 0.80. The accuracy of the differentiation models for hypertension was around 80%.;Discussion: The nonlinear relationship among the eight elements and the physical parameters at the six locations indicates that this is a fruitful direction for future study. For the differentiation model of hypertension, the results substantiate the recent postulation in TCM on hypertension. It may help to simplify the complicated process of syndrome differentiation in hypertension.;Conclusion: It reports the first study to demonstrate the nonlinear relationship of the eight elements and the physical parameters at the six locations, and the first to differentiate hypertension using the eight elements at the six locations. With further verification, the findings could pave the way for the development of an objective, reliable, and TCM-specific pulse diagnosis standard. |
