以徑向共振理論探討動脈系統之末端：環狀結構與微循環

Abstract

中文摘要 循環系統是人體當中維持生命最重要的系統。西方醫學目前對於循環系統的想法，是將心臟視為一個幫浦，將血液打入血管中，然後以推動流量的想法，透過血管將血送進組織當中。目前雖然由此理論所衍生出來的相關醫藥產業，每年產值高達數千億美金，然而對於有關高血壓等目前盛行的循環系統疾病，仍無法提出其原因與解決之道。 王唯工教授與王林玉英教授所提出的徑向共振理論，認為循環系統是以壓力來傳遞能量，而非透過流量來傳遞。也因此這個系統如何處理壓力傳遞到末端之後的狀況，將會影響這個系統的穩定性，同時也是目前為止相關血液流體力學理論認為極需要解決的問題。 動脈系統的最末端，最主要是透過網狀的微循環連接到微靜脈，也因此研究微循環之結構與功能，長久以來都是極為重要的課題。而較靠近心臟端的動脈，大多以環狀方式連結（loop or arch），例如四肢的末端、器官內部，此種結構以傳統流量理論幾乎無法解釋。因此本論文主要探討的循環系統末端範圍有二：環狀結構與微循環。我們將試著從徑向共振理論出發，來探討此兩種結構在生理上所代表的意義以及可能的功能。 在微循環的部分，我們討論了徑向共振理論對微循環的看法，並且試圖驗證傳統流量理論將微循環視為強反射點的看法是否正確。此外，由於微循環是以脈動方式運作，因此我們提出一套新的訊號分析方式，用來分辨不同動物模型的腎臟皮質微循環。我們利用雷射都卜勒血流計，比較傳統觀察直流流量值和我們提出的脈動法，結果發現脈動法能清楚分辨差異。再次說明了徑向振動在生理中處處可見，並且有其應用的空間。 目前對環狀結構的研究，大多數報告為解剖學上型態的敘述。但我們認為此結構有其特殊的功能，如可以將反射減小；或者主頻位置不會因為環狀結構的破壞而改變等等。我們進行的水管實驗以及動物實驗均證明了上面所敘述的功能。 透過徑向共振理論對於循環系統各個部分的看法，我們不僅提出一更有力的訊號分析方法來分析微循環，同時也替動脈系統中的環狀結構，找到了其存在之必要性。未來也相信可以經由本理論，提供更多臨床上對病症之治療與評估的方法。

Abstract The circulatory system is the most important for maintaining life. Modern western medicine treats heart as a pump, and considers heart pumps blood into artery. However, it is hard to believe that heart can overcome the high resistance of the arterial system with only 1.7Watt output power. Besides, there is no efficient solution on nowadays prevailing cardiovascular disease. Since the potential energy on aorta in vivo is more than 90%, which is much more than the axial kinetic energy, radial resonance theory（RRT）, proposed by Dr. Wang and Dr. Lin, infers that circulatory system deliver energy by pressure, not flow. In one pressure-transmission system, the terminal condition of system will affect the stability of system. Here we will discuss two structures of arterial terminals: loop structure and microcirculation. We will discuss the meaning and function of these two structures based on RRT. The terminal of arterial system is formed by net-like microcirculatory bed, and microcirculatory function and anatomy has been studied for long time. Here we discuss the microcirculation function based on RRT, and try to verify if microcirculation as strong reflection site, which is proposed by reflection theory. Using the heartbeat as a trigger, we investigated whether the relation between pressure and flux can be used to discriminate different microcirculatory conditions. We propose the three pulsatile indices for evaluating the microcirculation condition from the normalized pressure and flux segment with a synchronized-averaging method. The abdominal aortic blood pressure and renal cortex flux (RCF) signals were measured in spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY). The mean value of the RCF did not differ between SHR and WKY. However, both PDT and FRT were longer in SHR than in WKY. We propose that a new dimension for comparing the LDF signals, which the results from the present study show, can be used to discriminate RCF signals that cannot be discriminated using traditional methods. Researches for loop structure nowadays are mostly anatomical description and treat loop as useless in hemodynamics. However, based on the availability on body, we think it must contain more specific function, such as reduction of reflection or maintain of main frequency. Tube experiments and animal experiments were conducted to prove the functions mentioned. It seems that the loop structure is the best design after long evolution. Through the vision of RRT, we not only proposed one new signal analysis method to analyze microcirculation, but also find the importance of loop structure in arterial system. In the future, we believe that with the help of this theory, we can provide more efficient treatment and evaluation method for clinical use.