| BackgroundPulse Diagnosis refers to a traditional Chinese medicine diagnosis method of detecting the pulse condition through pulse-taking and the internal body changes in physiology and pathology. According to traditional Chinese medicine theory, the pulse condition is affected by human body’s physiological and pathological condition and then its change occurs. It is of great reference significance for pulse-taking and diagnosis if this change is studied.Pain syndrome is a common clinical syndrome, and there are many records of its pulse condition in traditional Chinese medicine documents. The causes and pathogenesis of pain syndrome in different body parts are different, and the pulse conditions reflected are also different. Besides, medical scientists throughout the ages held different views on it.What characteristics does the pulse condition change of pain syndrome have? What differences do pain syndromes in different body parts have? The clinical significance of pulse condition is discussed in Diagnostics of traditional Chinese Medicine, the teaching material of modern TCM (traditional Chinese medicine) colleges, in which the main pain syndromes are mentioned under the entries of wiry pulse, tense pulse and active pulse- is this statement accurate? Based on this, documental study and experimental study were adopted in this paper to explore the pain syndrome in terms of different body parts and their relevant pulse conditions; the patients of primary dysmenorrheal were selected as the subjects, and by means of the measuring tool, pulse detector, the relevance between the degrees of primary dysmenorrheal and the changes on pulse chart were observed to provide objective evidence for the study on the pulse condition of pain syndrome.ObjectiveFirst, the difference of the pain syndrome pulse conditions in different body parts recorded is arranged in this paper through organizing the representative pulse diagnosis and the records about pain syndrome pulse condition in comprehensive medical monographs;Second, by means of experimental study, the difference between pulse conditions and pulse chart before and after the attack of primary dysmenorrheal is observed to explore the relevance between dysmenorrheal and the changes of pulse conditions, pulse chart, so that people’s objective recognition of pain syndrome pulse condition can be improved.Methods1. Collect and arrange the ancient representative TCM pulse diagnosis and comprehensive medical monographs; search, interpret and analyze the records about pain syndrome pulse condition; generalize and summarize the pain syndrome pulse conditions in different body parts; and analyze the characteristics of the pain syndrome pulse conditions in different body parts.2. Pulsograph and pain level of PD patients were detected using electro-pulsograph and Visual-analogue Scale (VAS) respectively at four time points,7-10 days before menstruation (TO), maximal pain during menstruation (T1), immediately after acupuncture analgesia (T2) and 30mins after acupuncture analgesia (T3). Parameters (t, h, w) and normalized time parameters (t’) of pulsograph were analyzed.Results1. Results of the documentary study are as follows:(1) The characteristics of stomachache pulse condition:①it is only seen in the guan part; ②there are many hard pulse conditions and few weak pulse conditions; ③tense pulse in guan dominates stomachache;④deep pulse in guan dominates stomachache;⑤ the pulse condition of stomachache caused by food stasis is short and unsmooth; ⑥the pulse condition of stomachache caused by internal emotional injury is mainly wiry pulse; ⑦the pulse condition of stomachache caused by sputum resistance appears as slippery pulse;(2) Here are the characteristics of headache pulse condition:①the pulse condition in cun part is different from it in other parts; ②the pulse position often reflects as the floating pulse; ③the contour of the pulse is often highly intense; ④there is more rapid pulse than slow pulse; ⑤the short rough pulse in headache indicates poor diagnosis;(3) There are few records about the pulse conditions of neck pain, which are active pulse, tense rapid pulse and bounding pulse;(4) The characteristics of heart pain pulse condition are as follows:①the pulse condition is often reflected in cun part other than other body parts; ②deep pulse in cun part dominates the chest pain; ③wiry pulse in cun dominates the chest pain;④rough pulse in cun dominates chest pain; ⑤yinwei pulse dominates heartache; ⑥the pulse condition of chest pain is mainly concurrent pulse;(5) Here are the characteristics of hypochondriac pain pulse condition:①the pulse condition in guan part is different from other parts; ②the position is almost hidden pulse;③ left guan pulse dominates hypochondriac pain;④double wiry pulse dominates hypochondriac pain;(6) The characteristics of stomachache pulse condition:①it is only seen in the guan part; ②there are many hard pulse conditions and few weak pulse conditions;③tense pulse in guan dominates stomachache; ④deep pulse in guan dominates stomachache;⑤the pulse condition of stomachache caused by food stasis is short and unsmooth;⑥the pulse condition of stomachache caused by internal emotional injury is mainly wiry pulse;⑦the pulse condition of stomachache caused by sputum resistance appears as slippery pulse;(7) Here are the characteristics of hypochondriac pain pulse condition:①abdominal pain pulse condition in guan and chi part differs from other parts;②abdominal pain may reflect as floating pulse;③abdominal pain almost reflect as deep pulse;④floating pulse in chi dominates abdominal pain; ⑤tense pulse in chi dominates abdominal pain;⑥wiry pulse dominates abdominal pain;⑦there exists uncertainty of pulse in abdominal pain;⑧ abdominal pain of ascariasis often reflects as solid pulse;⑨abdominal pain pulse should be hidden and thick instead of floating and long.2. Results of the clinical study are as follows:(1) Pulse condition:From the time point TO to T1, the chance of appearing wiry pulse increases; from T1 to T2, the chance of appearing wiry pulse decreases, and that of slow pulse increases;(2) VAS pain scores decreased from 6.40±1.13 at T1 to 0.70±0.75 at T2 to 0.11±0.32 at T3 (P<0.001 and 0.001). At T1, compared with those at T0, w1, h3 and h4 significantly increased (P<0.01), and t2, t2’, t3’and h(d) significantly decreased (P<0.01,0.001,0.05 and 0.001). At T2, compared with those at T1,t1, w1, w2, h2, h3, t1 ’and t4’ significantly decreased (P<0.05,0.01,0.01,0.001,0.01,0.001 and 0.05), and h(d) significantly increased (P<0.001). There was no difference between T2 and T3.Conclusion1. Based on the results of the documentary study we may conclude that:(1) The clinical significance of pulse condition is discussed in Diagnostics of traditional Chinese Medicine, the teaching material of modern TCM (traditional Chinese medicine) colleges, in which the main pain syndromes are mentioned under the entries of wiry pulse, tense pulse and active pulse. This statement is not proper enough yet. TCM diagnosis describes the clinical meaning of pulse condition in the form of "dominated by......", which is not beneficial to learners’comprehensive and correct understanding. Thus, it is suggested to be changed as "commonly seen in......".(2) There are various pulse conditions of pain syndrome, but different pain syndromes exist in some body parts when some pulse conditions appear. For example, pain syndrome often appears when one of the pulse conditions among hidden pulse, wiry pulse, floating pulse, active pulse and slow pulse occurs, or when some of them occur simultaneously. Wiry pulse in cun part appears in headache, rough pulse in left cun part appears in chest pain and tense pulse in chi appears in abdominal pain.(3) According to the Theory of 3-Part and 9-State, there are some relevant symptoms in the corresponding parts when pain syndrome occurs in different body parts. For example, headache is often only seen in the cun part, stomachache in the guan part, hypochondriac pain in the chi part, and the waist, leg and foot pain in the chi part.(4) The pain syndrome pulse conditions differ in the causes and pathogenesis of the disease. For instance, the pain syndrome pulse condition caused by exopatic cold is floating tense pulse, and pain attacks because of intense yang and heat stagnation or intense yin and breath stagnation, so there appears uncertainty in pulse, like irregular pulse; while hidden pulse is usually seen in the pain syndrome caused by breath close.(5) Owing to the physiological features, different body parts have different response to varied diseases, which often reflects in the difference among the pulse conditions of pain syndrome, such as floating pulse in headache, hidden pulse in abdominal pain and rough pulse in chest pain.(6) Since causes and pathogenesis of pain syndrome are relatively complicated, the pulse conditions of pain syndrome may appear in the form of concurrent pulse.2. Based on the results of the experimental study we may conclude that when pain attacks and pain alleviates, there are certain changes in the parameter of the pulse condition and pulse chart of primary dysmenorrheal, and there also appears basically opposite variation tendency in these two conditions. The changes in the parameter of the pulse condition and pulse chart show that when primary dysmenorrheal attacks, the intensity of the pulse increases; and the change in the parameter of the pulse chart also indicates that parameter of the pulse chart can be taken, to some extent, as the index of objectively reflecting the pain and its level.Innovation of the Study1. The pulse condition of pain syndrome has been systematically arranged, and the pulse condition of different parts of body have been collected and generalized.2. The pulse conditions of essential pain syndrome have been raised, such as wiry pulse, hidden pulse, active pulse, knotted pulse, slow pulse, quick pulse and so on, since there are various pulse conditions of pain syndrome.3. Clinical trials have been taken as the research method, and human bodies have been adopted as the experimental subject. Purposeful and instant observation is able to guarantee the reliability and practicability of the research.Shortage of the Studyl.The shortage in literature research:Although the literatures referred in his research were carefully selected, the number is still small, and the content is relatively limited.2. Limitation of the experimental research:Firstly, the number of sample is small, and the experimental results were not repeatedly tested; secondly, it did not set the pulse condition of healthy females as control, so it is hoped that in the further study, the pulse graph of healthy females’ menstrual period can be set as control, so as to better identify the influence of the pain in primary dysmenorrheal on pulse graph; next, it did not observe the primary dysmenorrheal patients in the syndrome differentiation type, thus cannot explain the pulse changes of different types of pain syndrome; finally, since the pain locations and patients of primary dysmenorrheal are special, it cannot represent all the other pains. Therefore, in the future study, we should comprehensively observe the changes in pulse graph resulted from different pains so as to have in-depth study on the influence of pain on pulse graph.
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