Quantifying fasting-related changes in pulse patterns at Cun, Guan, and Chi using a modern Traditional Chinese Medicine pulse-diagnostic platform

doi:10.19852/j.cnki.jtcm.2026.02.019

Abstract

Abstract:

OBJECTIVE: To quantify pulse waveform features in healthy adults under different fasting states and to explore the relationship between gastrointestinal “deficiency” and “excess” states [in the Traditional Chinese Medicine (TCM) sense] and corresponding pulse patterns at key pulse positions.

METHODS: Fifty-one healthy participants were enrolled and underwent standardized pulse recording at three time points: pre-fasting (Day 0), during-fasting (Day 4), and post-fasting (Day 7). Pulse signals were collected at the Left Cun, Right Cun, and Right Guan positions, which are classically associated with the heart, lungs, and spleen, respectively. Quantitative pulse parameters were extracted and compared across the three stages using statistical analyses to detect within-subject changes.

RESULTS: Significant differences in pulse patterns were observed across the three fasting stages, with the most pronounced changes occurring between pre-fasting and post-fasting. Overall pulse strength and related quantitative indices decreased from pre-fasting to post-fasting, and these changes were correlated with the relative fullness or emptiness of the gastrointestinal system. The Left Cun, Right Cun, and Right Guan positions contributed most strongly to discriminating between fasting stages.

CONCLUSIONS: This study provides quantitative evidence that gastrointestinal loading status is reflected in measurable changes in pulse characteristics at specific TCM pulse positions, supporting classical TCM theories regarding the roles of the stomach and spleen in Qiand blood regulation. These findings offer a preliminary bridge between traditional pulse diagnosis and modern quantitative assessment, and lay the groundwork for future studies integrating TCM concepts with contemporary biomedical methods.

Key words: pulse-taking positions, Cun, Guan, Chi, gastrointestinal function, Qi and blood regulation, fasting stages

WANG Meng, XU Shijie, LU Yu, ZHAO Kaiwei, WU Qiong, WANG Chao. Quantifying fasting-related changes in pulse patterns at Cun, Guan, and Chi using a modern Traditional Chinese Medicine pulse-diagnostic platform[J]. Journal of Traditional Chinese Medicine, 2026, 46(2): 470-479.

Figures/Tables 8

Table 1 Comparison of mean feature parameters of pulse diagnosis collected pre-fasting and during-fasting ($ \bar{x} \pm s$)

Group	n	Pulse rate	Left Cun phase 3	Left Cun phase 5	Left Chi energy 2	Left Cun energy 12	Left Guan phase 3
Pre-fasting	50	72.560±9.050	0.160±0.020	0.110±0.100	19.200±8.870	0.040±0.050	0.160±0.020
During-fasting	50	81.700±11.150	0.150±0.010	0.100±0.010	15.250±3.610	0.020±0.022	0.150±0.010
P value	-	<0.01	<0.01	<0.01	<0.01	<0.01	0.01
Effect size (Cohen’s dae; pre-during)	-	-0.90	0.67	0.18	0.63	0.56	0.67

Table 2 List of the most frequent indicators in the 20 classification decision combinations for pulse diagnosis information collected pre-fasting and during-fasting

Indicator name	Pulse Rate	Left Guan Phase 12	Right Guan Phase 6	Right Guan Phase 8
Usage frequency	20	20	20	20
Importance index	1.2849	1.1158	1.2937	1.2028
Average coefficient	-1.4433	-536.8184	1612.6092	-1174.86
Coefficient standard deviation	0.096303	41.9271	84.4039	40.7192

Table 3 Comparison of mean feature parameters of pulse diagnosis information collected pre-fasting and post-fasting ($ \bar{x} \pm s$)

Group	n	Pulse rate	Left Cun Phase 3	Left Chi	Left Chi Phase 1	Left Chi Energy 2	Right Guan Energy 6
Pre-fasting	50	72.560±9.050	0.160±0.010	0.470±0.110	0.330±0.030	15.250±3.610	1.040±0.660
Post-fasting	50	82.990±11.830	0.150±0.010	0.380±0.130	0.300±0.060	18.260±6.720	0.750±0.310
P value		<0.01	<0.01	<0.01	<0.01	0.01	0.01
Effect size (Cohen’s dav; pre-post)		-1.00	1.00	0.75	0.67	-0.58	0.60

Figure 1 Distribution of representative EFBLS discriminant indices for pulse diagnosis information collected pre-fasting and post-fasting A: representative discriminant-index distribution, panel 1; B: representative discriminant-index distribution, panel 2; C: representative discriminant-index distribution, panel 3; D: representative discriminant-index distribution, panel 4; E: representative discriminant-index distribution, panel 5; F: representative discriminant-index distribution, panel 6.Blue indicates the pre-fasting group (Day 0), and green indicates the post-fasting group (Day 7). Histograms show the distribution of discriminant-index values, and the overlaid curves represent fitted density distributions. This figure is intended to qualitatively illustrate the separation between pulse diagnosis information collected pre-fasting and post-fasting. Two-sided tests were used, and P < 0.05 was considered statistically significant. For this comparison, n = 50 session-records per group. Histograms show the distribution of discriminant-index values, and the overlaid curves represent fitted density distributions for the two comparison groups across the six representative panels. EFBLS: extended forward-backward least squares.

Table 4 List of the most frequent indicators in the 20 classification decision combinations for pulse diagnosis information collected pre-fasting and post-fasting

Indicator name	Left Cun Phase 3	Left Cun Energy 9	Left Cun Energy 12	Left Chi Phase 10
Usage frequency	20	16	15	11
Importance index	1.6033	1.3025	1.1799	1.1114
Average coefficient	-2024.8211	-176.5151	277.1496	724.5547
Coefficient standard deviation	124.9573	38.0768	21.378	49.1199

Figure 2 RSS profiles in relation to lambda and discriminant index A: RSS profile across different lambda values. Multiple curves are shown for comparison, and the red curve indicates the trajectory highlighted in the present analysis; B: RSS profile across the discriminant index range. Step curves of different colors are shown for comparative display. RSS: residual sum of squares.

Table 5 Comparison of mean feature parameters of pulse diagnosis information collected during-fasting and post-fasting ($ \bar{x} \pm s$)

Group	n	Right Cun S1		Right Cun Phase 12	Right Cun Phase 11	Right Cun Pulse Position	Right Guan S1	Right Guan Pulse Position
During-fasting	50	20.13±11.79		0.05±0.02	0.06±0.02	2.48±1.16	12.44±12.84	3.33±0.90
Post-fasting	50	14.60±7.66		0.06±0.01	0.06±0.01	3.00±1.14	8.00±5.10	3.72±0.85
P value	-	<0.01	0.01		0.02	0.03	0.03	0.03

Table 6 List of the most frequent indicators in the 20 classification decision combinations for pulse diagnosis information collected during-fasting and post-fasting

Indicator name	Right Cun Pulse Position	Right Cun H1	Right Cun Phase 11
Usage frequency	20	20	14
Importance index	1.1998	1.1517	1.1161
Average coefficient	-59.4072	-49.4155	-606.037
Coefficient standard deviation	7.7774	7.5019	48.1782

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