Theoretical Research Of Wiry Pulse In Traditional Chinese Medicine And Its Application In The Tumor Diseases

Wiry pulse is one of the most common pulses in clinical practice, which is closely related to major modern diseases. As an ancient Chinese saying goes, "wiry pulse is the pulse which is the most difficult to diagnose". The theory of wiry pulse is very rich, including yin and yang properties, shape property of wiry pulse, the diseses related to wiry pulse, and syndrome type of wiry pulse. Therefore, we can instruct the clinical application of wiry pulse and develop its scientific research, by systematically sorting and further uncovering the literature related with wiry pulse, exploring the source of wiry pulse, analyzing the meaning of wiry pulse, and combining the theory and clinical practice.In the article, four aspects of the wiry pulse theory are systematically studied: reserch history, basic theory, clinical application and the application in tumor diseases.First of all, by reviewing the history of wiry pulse theory, we illustrate several important issues. (1) The relationship between wiry pulse and inernal injuries caused by seven emotions. Internal injuries can lead to the dysfunction of five internal organs and cause the changes in pulse. Excessive anger and thought are often associated with wiry pulse. Anger induces the formation of wiry pulse by causing qi adverseness, stagnation of qi and blood, stress of meridian vessel. Thought induces the formation of wiry pulse by causing spleen injure, qi coagulation of earth, liver (wood) overwhelming spleen (earth). (2) The relationship between wiry pulse and six exogenous pathogenic factors. Wiry floating pulse is caused by wind because it is often found in the unhealthy body injured by wind. Wiry pulse is related to liver and wind. The gallbladder meridian of foot shaoyang, liver channel of foot jueyin, orifice of the uterine cervix, thoroughfare and conception vessels are damaged by wind, which result in wiry pulse. Summer heat also leads to wiry thready pulse, wiry rapid pulse and wiry slippery pulse, because summer heat is one of yang pathogens, consumes qi and injures yin, causes insufficiency of vital energy and blood, and is often accompanyed by dampness-pathogen. Exogenous damp and warm induce wiry thready soft pulse, by obstruction of qi, impairment of yang, and stagnation of vessel system. Wiry thready pulse is often found in the later stage of exogenous damp and warm disease. Cold pathogen lead to strong wiry pulse beacause of blockade and tense of blood vessel, just as a saying, wiry pulse must be found in the body injured by cold pathogen. (3) The relationship between wiry pulse and five internal organs. Wiry pulse is often found in liver disease or other disease caused by liver disease. (4) The nature of yin and yang of wiry pulse. Wiry pulse is yin within yang,later is mainly character.Secondly, in this article pulse manifestation is combined with disease and pulse reason. We systematically and comprehensively discuss the theory including disease, syndrome features, and treatment characteristics related with wiry pulse. Moreover we propose the characteristics of disease related with wiry pulse:cold or heat, deficiency or excess, exterior or interior, qi disease or phlegm disease. Symptoms related with wiry pulse include:pain, worry and fever. Wiry pulse suggests convergence and stagnation of qi, which induce the pain. Stagnation of qi induces heat, and later induces worry. The inside and outside, the exterior and interior are full of Heat and worry, which is the reason of fever. The pain related with wiry pulse includes:bloat pain, swelling pain, and shoot pain. Drugs related with wiry pulse include:(1) Carminative, which is used for soothing the liver and dispeling melancholy, dispersing the stagnated heat, inducing diaphoresis to dispel wind, and regulating activities of qi. (2) Sour and sweet drug, which is used for purging the liver of pathogenic fire, invigorating the splee, astringing yin, softening the liver, benefiting qi and nourishing blood. (3) Acrid and warming drug, which is used for warming yang, activating yang, dispeling cold and relieving pain. (4) Bitter and cold drug, which is used for removing heat from the liver and purging the pathogenic fire. This article also points out that pathological mechanism and drugs on clinical differentiation of syndromes are slightly different, because of the physiological basis difference in surgery, gynecology and pediatrics. The mechanism of wiry pulse in internal medicine is complex and diverse, including cold, heat, deficiency, excess, exterior and interior. The mechanism of wiry pulse in gynecology is liver disease, so the treatment is mainly regulation of liver function. The mechanism of wiry pulse in pediatrics is heat syndrome and wind syndrome, so the treatment includes clearing away stagnant heat and calming liver wind. The mechanism of wiry pulse in surgery is liver and gall heat, liver depression and spleen dampness, so the drugs are used to dispel the wind, clear heat and dampness, reduce phlegm, soften hard masses and dissipate stagnation.The recent research of Wiry focuses on cardiovascular disease, cerebrovascular disease and liver disease. There are few reports on the relationship of wiry and cancer disease. In this study, we found that wiry pulse and cancer disease are closely related. A book named mai jing has been saying:the pulse related with mass accumulation is wiry and tense pulse, wiry and hidden pulse indicates the mass in abdomen and fatal illness. From the traditional Chinese medical science point of view, the wiry formation mechanism of tumor disease is mainly related to the attack body inside of pathogenic factors, which include blood stasis, phlegm coagulation, poisoning accumulate, and lead to blockage of vessel, strain of meridian qi. From the perspective of modern medicine, the wiry formation mechanism of tumor disease mainly related to cancer pain, cancer invasion, cancer metastasis, tumor angiogenesis, and psychological factors including fear and worry.These factors can lead to the formation of wiry pulse by increasing myocardial contractility, cardiac output, vasoconstriction, peripheral vascular resistance and blood pressure. The drug characteristics of cancer disease related with wiry pulse are as follows:the drugs are focused on reducing phlegm, softening hard masses, regulating qi to alleviate mental depression, and soothing the liver to dispel melancholy. Furthermore, by analysising the pulse database collected from 481 cases of clinical malignant disease, we study the percentage of wiry pulse, the mechanism of wiry or/and other pulse, the distribution of traditional Chinese medical science syndromes. Then we illustrate the clinical significance of wiry pulse in neoplastic diseases, and provide the treatment reference for clinical practitioners.