The Exploration On Meridian Thermal Perceptive Measuring Method In Use Of Identification And Therapeutic Evaluation Of Yang-deficiency Construction

Background:Meridian thermal perceptive measuring method was introduced into China from Japan since 1950, it has gone through 60 years, but the measuring system and the interpretation method had not yet been improved, resulting many of the obstacles encountered in the clinical application, and gradually was restricted to laboratory studies. After improved by Professor Yu Yun,the measuring method can service for clinical again, and is used of severity evaluation and treatment guidance for acupuncture treatment of cancer, endocrine diseases, ENT diseases, ect. But the method has rarely been reported in the fields of the guidance of traditional Chinese medicine prescription, Clinical therapeutic evaluation, the research of the inherent characteristics of some difficult diseases. Furthermore, TCM has been committed to exploring the road of quantitative research, but always depend on modern means to explan the concepts of TCM and herbs. Improved meridian thermal perceptive measuring method is able to shake off the shackles of modern instruments, by using the meridian thermal sensitivity which is belongs to TCM meridian characteristics to explain the phenomenon of life, and provide a new idea for TCM quantitative research. This study use Yang-deficiency constitution as a carrier, initially explore the measuring method in use of constitution identification and therapeutic evaluation, in order to provide some data support for clinical research.Objectives:Through observing the meridian thermal sensitivity characteristics of Yang-deficiency constitution people and non-yang-deficiency constitution people, initially explore the function of the meridian thermal perceptive measuring method in the field of the constitution identification; through observing meridian thermal sensitivity measuring index of yang-deficiency constitution people who are treated by Chinese herbs, initially explore the function of this method in the field of therapeutic evaluation.Methods:The study on stability of the meridian thermal perceptive measuring method and usage of this method in the field of constitution identification, select cross-sectional survey research methods. Use Kruskal-Wallis rank sum test in the former subject for the measurements of acupoints of 7 placidness constitution cases between 10 days, and use Wilcoxon rank sum test for measurements of acupoints between morning and afternoon; observe and compare the median, maximum, variance, measurement of acupoints, imbalance index of acupoints, Gaohuang measurements, occurrence of lower thermal sensitivity acupoints, occurrence of imbalance acupoints and so on of 87 cases including yang-deficiency constitution, phlegm-dampness constitution, yang-deficiency mixed phlegm-dampness constitution and placidness constitution, then analyze them by Rank sum test or Chi-square test. Set transformed score of yang-deficiency and ratio of transformed score of yang-deficiency constitution to transformed score of placidness constitution as clinical evaluation standard, make paired comparison of specific thermal sensitivity measuring index of yang-deficiency constitution among 29 yang-deficiency constitution cases who were acceptted by Chinese herbs intervention, and initially explore whether this ratio can be index of clinical evaluation of yang-deficiency constitution.Results:1,Compare the acupoints'measurements of 7 cases with placidness constitution between 10 days or acupoints'measurements between morning and afternoon, all the results suggest that there is no significant difference (P>0.05), which initially suggest that the measuring method is stable and repeatability.2,The use of the meridian thermal perceptive measuring method in the field of constitution identification initially suggest that:when analyze the median, maximum, variance, measurement of acupoints, imbalance index of acupoints, Gaohuang measurements, occurrence of lower thermal sensitivity acupoints, occurrence of imbalance acupoints, ect, results suggest the above measuring index can be distinguished between placidness constitution and other constitution. Total median, total maximum, occurrence of lower thermal sensitivity points (Shenshu BL23, Pangguangshu BL28, Danshu BL19, Zhonglvshu BL29), measurement of Specific acupoints(DachangShu BL25 and so on), occurrence of imbalance acupoints(Shenshu BL23), and imbalance index of Specific acupoints(Shenshu BL23, Taixi KI3),they can be distinguished between yang-deficiency constitution and phlegm-dampness constitution; occurrence of lower thermal sensitivity acupoints (Shenshu BL23, Pangguangshu BL28, Danshu BL19), measurement of Specific acpoints(Chongyang ST42),they can be distinguished between phlegm-dampness constitution and yang-deficiency mixed phlegm-dampness constitution.The meridian thermal sensitivity characteristics of Yang-deficiency constitution are:the value of the total median, total maximum, total variance are larger than those of placidness constitution. Most of the acupoints'measuring time are longer than 20 seconds, the acupoints with longest measuring time are Pishu BL20 (200 seconds), Shenshu BL23 (133 seconds), Pangguangshu BL28 (92 seconds), Zulinqi GB41 (90 seconds), Taixi KI3 (90 seconds), Baihuanshu BL30(84 seconds); the specific lower thermal sensitivity points of Yang-deficiency constitution are:Dachangshu BL25, Hegu LI4, Dushu BL16, Geshu BL17, Xiaochangshu BL27, DanshuBL19, Panggguangshu BL28, Jinggu BL64, Daling PC7, Gongsun SP4, Shenmai BL62, Taixi KI3, Zulinqi GB41, totally of 13 acupoints; occurrence of lower thermal sensitivity acupoints involving Shenshu BL23 (68.97%), Pangguangshu BL28 (68.97%), Pishu BL20 (65.52%), Lieque LU7 (48.28%), Danshu BL19(37.93%),totally of 5 acupoints. Most of the index of imbalance acupoints are larger than 20, the acupoints with lagest value of imbalance index are:Pishu BL20(192), Tai Chong LR3 (103), Taixi KI3 (81). Imbalance acupoints of Yang-deficiency constitution are:Shenshu BL23, Taixi KI3; occurrence of imbalance acupoints of Yang-deficiency constitution are: Shenshu BL23(62.07%), Jinggu BL64(55.17%), Pishu BL20(51.72%),totally of 3 acupoints. Yang-deficiency constitution mainly related to the meridian of Du, Kidney, Bladder, Spleen. In addition, phlegm-dampness constitution mainly related to the meridian of Spleen, Stomach, Triple Energizer, Ren, yang-deficiency mixed phlegm-dampness constitution mainly related to the meridian of Du,Kidney, Stomach, Spleen.3,The use of the meridian thermal perceptive measuring method in the field of therapeutic evaluation initially suggest that:Set transformed score of yang-deficiency as clinical evaluation standard, improvements show at the effective group are the value of total median, total maximum, total variance, and specific acupoints measurements of Yang-deficiency constitution (Xiaochangshu BL27, Danshu BL19, Jinggu BL64, Shenmai BL62, Taixi KI3, Gongsun SP4, Zulinqi GB41), occurrence of specific lower thermal sensitivity acupoints of Yang-deficiency constrction, index acupoints of specific imbalanced acupoints index of Yang-deficiency constitution (Shenshu BL23, Taixi KI3), occurrence of specific imbalance acupoints of Yang-deficiency constitution, Jiuwei (RN15) and total measurement of Gaohuang; set ratio of transformed score of yang-deficiency constitution to transformed score of placidness constitution as clinical evaluation standard, the measuring index above are also improving at the Markedly effective group and the effective group. When transformed score of yang-deficiency is considered as clinical evaluation standard, improvements show at the invalid group are specific acupoints measurements of Yang-deficiency constitution (Dushu BL16, Gongsun SP4, Taixi KI3)(P<0.05), but the above acupoints'measurements no longer show significant differencethe in invalid group when ratio of transformed score of yang-deficiency constitution to transformed score of placidness constitution is considered as clinical evaluation standard (P> 0.05). In addition, both of the clinical evaluation standard, specific acupoints measurements of Yang-deficiency constitution (Dachangshu BL25, Hegu LI4, Geshu BL17, Daling PC7), measurement of Qihai(RN6)in each efficacy of group, it shows no significant difference (P>0.05). It can indicate the improvement of effect may be partly associated with the improvement of the meridian thermal measuring index. Moreover, according to the initial exploration results from the above view, it is likely that when ratio of transformed score of yang-deficiency constitution is considered as clinical evaluation standard is more objective than transformed score of yang-deficiency.Conclusion:Meridian thermal perceptive measuring method can effectively distinguish yang-deficiency constitution and non-yang-deficiency constitution in the view of meridian thermal sensitivity characteristics, and show a supplementary therapeutic evaluation after the intervention by Chinese herb of Yang-deficiency constitution. In addition, the improvemen of meridian thermal sensitivity measuring index is associated with the improvement of clinical effect, suggesting that the method can be used of constitution identification and therapeutic evaluation as a new supplementary method.