【摘要】：目的：以朝醫(yī)四象醫(yī)學(xué)為理論依據(jù),通過(guò)電刺激正中神經(jīng)測(cè)量體感誘發(fā)電位(SEP)和上肢的感覺神經(jīng)動(dòng)作電位(SNAP),結(jié)合辨象結(jié)果,觀察分析太少陰陽(yáng)各象體質(zhì)的神經(jīng)傳導(dǎo)特點(diǎn)與意義。根據(jù)辨象結(jié)果,分象整理其神經(jīng)傳導(dǎo)Parameters,比較分析：①四象人的中樞神經(jīng)傳導(dǎo)時(shí)間；②四象人的上肢感覺神經(jīng)傳導(dǎo)特點(diǎn)；③SEP與SNAP的相關(guān)規(guī)律；④左右側(cè)間的神經(jīng)傳導(dǎo)差異、潛在性損傷率。進(jìn)而全面地掌握電刺激正中神經(jīng)所誘發(fā)的SNAP-SEP與四象體質(zhì)間的關(guān)聯(lián),可以提高朝醫(yī)臨床中進(jìn)行四象人辨象的正確性,進(jìn)一步指導(dǎo)臨床治療。方法：對(duì)檢測(cè)實(shí)驗(yàn)環(huán)境的要求與控制：室溫維持在26℃左右,室內(nèi)環(huán)境的濕度適中,保持安靜。①收集1317位延邊大學(xué)內(nèi)的在校大學(xué)生作為本次的受試對(duì)象,受試對(duì)象均為健康人群且沒有神經(jīng)系統(tǒng)的相關(guān)疾病,如感覺障礙以及麻木等,而且無(wú)相關(guān)家族病史。所有受試對(duì)象按照隨機(jī)原則進(jìn)行分組。甲組：319位學(xué)生由157位男生和162位女生組成；學(xué)生年齡分布在18歲到35歲之間,平均(19.2±2.3)歲。乙組：998位學(xué)生由431位男生和567位女生組成；學(xué)生年齡分布在17歲到36歲之間,平均(18.5±2.8)歲。分別檢測(cè)甲組和乙組同學(xué)上肢的體感誘發(fā)電位(SEP)和感覺神經(jīng)動(dòng)作電位(SNAP)。②所有受試對(duì)象根據(jù)自身實(shí)際特點(diǎn)完成辨象調(diào)查表的填寫。辨象小組專家根據(jù)辨象表及對(duì)受試者頭面部,正、側(cè)和后面的拍照,以及結(jié)合臨床工作經(jīng)驗(yàn)對(duì)受試對(duì)象進(jìn)行辨象診斷,對(duì)于體質(zhì)診斷較為困難或診斷結(jié)果存在爭(zhēng)議的可進(jìn)一步選擇其他方式協(xié)助判斷,以確保四象人判斷的準(zhǔn)確。③進(jìn)行檢測(cè)前,受試對(duì)象在安靜的環(huán)境中休息5min,保證身體處于放松狀態(tài),待受試對(duì)象身體恢復(fù)平穩(wěn)后采取平臥位開始進(jìn)行檢測(cè)。④對(duì)正中神經(jīng)的SEP進(jìn)行檢測(cè),記錄從刺激開始到各誘發(fā)成分之間的傳導(dǎo)時(shí)間及其波形和波幅等。⑤檢測(cè)上肢感覺神經(jīng)傳導(dǎo)動(dòng)作電位,記錄其潛伏期、波幅、神經(jīng)傳導(dǎo)速度。⑥將四象人同組內(nèi)及不同組間中樞-上肢末梢感覺神經(jīng)傳導(dǎo)的相關(guān)性及差異進(jìn)行比較。對(duì)收集的所有數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,探討四象各類型的不同臟局所致的內(nèi)在環(huán)境與末梢感覺神經(jīng)及中樞神經(jīng)傳導(dǎo)的關(guān)聯(lián)性。結(jié)果：甲組：①相比于少陰人,太陰人的體重偏重,差異有統(tǒng)計(jì)學(xué)意義(P0.05);四象人各組間在身高和年齡上沒有顯著性差異(P0.05)。②太陰人左體N13波和N20波潛伏期間期(N13 Onset-N20 Onset,以下簡(jiǎn)稱N13a-N20a)和波峰間期(N13 Peak-N20 Peak,以下簡(jiǎn)稱N13b-N20b)較右體縮短,其差異有統(tǒng)計(jì)學(xué)意義(P0.05)。乙組：相比于左側(cè),右側(cè)SNAP的DD (Distal Duration遠(yuǎn)端持續(xù)時(shí)間,以下簡(jiǎn)稱DD)延長(zhǎng)(P0.01); DA (Distal Amplitude遠(yuǎn)端波幅,以下簡(jiǎn)稱DA)降低(P0.001); W-E Dist (Wrist-Elbow Dist腕-肘間的距離,以下簡(jiǎn)稱W-E Dist)短(P0.001); F-W SCV (Finger-Wrist sensory nerve conduction velocity手指-腕間感覺神經(jīng)傳導(dǎo)速度,以下簡(jiǎn)稱F-W SCV)慢(P0.05);W-E SCV(Wrist-Elbow sensory nerve conduction velocity腕-肘間感覺神經(jīng)傳導(dǎo)速度,以下簡(jiǎn)稱W-ESCV)慢(P0.001)。結(jié)論：1.中樞神經(jīng)特點(diǎn)：太陰人的左右側(cè)之間的N13-N20潛伏間期差異,提示頸髓中段的后索、束核或?qū)?cè)內(nèi)側(cè)丘索、丘腦及大腦皮層的傳導(dǎo)左右側(cè)的傳導(dǎo)差異。2.末梢神經(jīng)特點(diǎn)：健康受試者左右側(cè)之間的SNAP波持續(xù)時(shí)間DD、波幅DA、腕肘距離W-E Dist、以及傳導(dǎo)速度SCV均有差異(P0.05),提示健康成年人的電刺激正中神經(jīng)所誘發(fā)的感覺神經(jīng)傳導(dǎo)左右側(cè)之間存在差異。3.中樞-末梢神經(jīng)的關(guān)系：四象體質(zhì)中,太陰人的中樞神經(jīng)傳導(dǎo)N13-N20存在左右側(cè)差異。正中感覺神經(jīng)存在左右側(cè)傳導(dǎo)差異,暗示占人口數(shù)50%左右的太陰人有關(guān)聯(lián)。中樞-末梢神經(jīng)均為左側(cè)快于右側(cè)。4.太陰人體質(zhì)特點(diǎn)：血濁氣澀,好靜不好動(dòng),導(dǎo)致了該體質(zhì)人神經(jīng)傳導(dǎo)左右體之間傳導(dǎo)差異。
[Abstract]:Objective: To observe and analyze the characteristics and significance of nerve conduction of Yin and Yang physique in Tai Shao Yin and Yang physique by Electrostimulating median nerve to measure somatosensory evoked potential (SEP) and sensory nerve action potential (SNAP) of upper extremity. Analysis: 1) Central nerve conduction time of Sixiang people; 2) Sensory nerve conduction characteristics of upper limb of Sixiang people; 3) Correlative regularity of SEP and SNAP; 4) Difference of nerve conduction between left and right sides, potential injury rate. Methods: The requirement and control of the test environment were: the room temperature was maintained at about 26 ~C, the humidity of the indoor environment was moderate, and the indoor environment was kept quiet. All subjects were randomly divided into two groups. Group A: 319 students were composed of 157 boys and 162 girls; the age of the students ranged from 18 to 35 years old, with an average age of (19.2 (+ 2.3) years. Group B: 998 students were 431 boys. And 567 female students aged between 17 and 36, with an average age of 18.5 (+ 2.8) years. The somatosensory evoked potentials (SEP) and sensory nerve action potentials (SNAP) of upper limbs of students in group A and group B were detected respectively. All subjects completed the questionnaire according to their own actual characteristics. The subjects'head and face, front, side and back photographs, as well as the combination of clinical work experience on the subject of image diagnosis, for physical diagnosis is more difficult or controversial results can be further selected to assist in the judgment of other ways to ensure the accuracy of the four elephants. After resting for 5 minutes, the subjects were in relaxed state. The SEP of median nerve was detected in supine position. The conduction time, waveform and amplitude were recorded from the beginning of stimulation to each evoked component. _Sensory nerve conduction action potential of upper limb was detected and its latency was recorded. _Comparing the correlation and difference of central-upper limb peripheral sensory nerve conduction between the same group and different groups. Statistical analysis was made on all data collected to explore the relationship between the internal environment caused by different visceral organs and peripheral sensory nerve conduction and central nerve conduction. Results: Group A: Compared with Shaoyin people, the weight of Taiyin people was heavier, and the difference was statistically significant (P 0.05); There was no significant difference in height and age among the four elephants groups (P 0.05). The latency period of left body N13 wave and N20 wave in Taiyin people (N13 Onset-N20 Onset, hereinafter referred to as N13a-N20a) and N13 Peak-N20 Peak (hereinafter referred to as N13 Peak-N20 Peak). N13b-N20b was shorter than the right body, and the difference was statistically significant (P 0.05). Group B: Compared with the left side, the distal duration of the right SNAP (Distal Duration, hereinafter referred to as DD) was prolonged (P 0.01); the distal amplitude of the DA (Distal Amplitude, hereinafter referred to as DA) was decreased (P 0.001); and W-E Dist (Wrist-Elbow Dist wrist-elbow distance, hereinafter referred to as W-E Dist) Short (P 0.001); F-W SCV (Finger-Wrist sensory nerve conduction velocity between fingers and wrists, hereinafter referred to as F-W SCV) slow (P 0.05); W-E SCV (Wrist-Elbow sensory nerve conduction velocity between wrist and elbow, hereinafter referred to as W-ESCV) slow (P 0.001). Differences in N13-N20 latency between the left and right sides of the cervical spinal cord suggest differences in conduction between the posterior funiculus, fascicular nucleus or contralateral medial colliculus, thalamus and cerebral cortex. (P 0.05), suggesting that there is a difference between the left and right sensory nerve conduction induced by electrical stimulation of the median nerve in healthy adults. 3. The relationship between the central nerve and the peripheral nerve: In the four-figure constitution, there is a difference between the left and right sides of the central nerve conduction N13-N20 in Taiyin people. The central and peripheral nerves are faster on the left than on the right. 4. Physical characteristics of the Taiyin: blood turbidity and astringency, good static and inactive, resulting in the difference of nerve conduction between the left and right bodies.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R29

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