超声心动图对高血压病心脏损害中医辨证相关性的研究

摘要

目的：探讨超声心动图与高血压病心脏损害的中医辨证相关性。方法：将100例高血压并心脏损害患者辨证分为肝火亢盛型30例、阴虚阳亢型20例、痰湿壅盛型20例、阴阳两虚型30例，采用超声心动图对患者左心长轴切面、左心短轴切面乳头肌、左心短轴切面二尖瓣水平、主动脉根部短轴切面、肺动脉长轴水平、心尖四腔室和五腔切面进行测定。结果：肝火亢盛型升主动脉扩张，左房、左室扩大程度较阴阳两虚型小，而阴阳两虚型升主动脉扩张，左房、左室扩大程度较显著(P＜0.05)；左室后壁及室间隔增厚情况4个证型间差异无统计学意义(P＞0.05)，阴阳两虚型左室收缩功能各项指标均低于肝火亢盛型、阴虚阳亢型、痰湿壅盛型，而阴虚阳亢型左室收缩各项指标均高于肝火亢盛型、阴虚阳亢型、痰湿壅盛型，差异均有统计学意义(P＜0.05)。结论：心脏结构超声心动图检查可以作为高血压病中医辨证分型的客观指标。%Objective:To discuss the associations of ultrasonic cardiogram (UCG) with TCM differentiation for the treatment of hypertension with cardiac involvement. Methods:Totally 100 cases of hypertension with cardiac involvement were classified into 30 cases of liver fire exuberance type, 20 cases of hyperactivity of Yang due to Yin deficiency, 20 cases of phlegm and dampness accumulation as well as 30 cases of Yin and Yang deficiency. The lon-gitudinal aspect of left heart, the transverse aspect with papillary muscle and horizontal mitral valve of left heart, the transverse aspect of aortic root, the longitudinal aspect of pulmonary artery, the fourth ventricular of apex as well as five aspects of chamber of the patients were determined by UCG. Results:In the cases of liver fire exuberance type the ascending aorta dilated and the enlargements of left atrium and ventricle were lighter than those cases of Yin and Yang deficiency, and the dilation of the ascending aorta and the enlargement of the left atrium and ventricle in the cases of Yin and Yang deficiency were significantly marked (P<0.05);the differences in comparing the thickness of left ventricular posterior wall and interventricular septum of the four types had no statistical meaning (P>0.05);the indexes of left ventricular systolic function in patients of Yin and Yang deficiency were all lower than those indexes of liver fire exuberance type, hyperactivity of Yang due to Yin deficiency as well as phlegm and dampness accumu-lation, while the indexes of left ventricular systolic function in patients of hyperactivity of Yang due to Yin deficien-cy were all higher than those indexes of fire exuberance type, Yin and Yang deficiency as well as phlegm and damp-ness accumulation, and these differences had statistical meaning (P<0.05). Conclusion:The UCG used to examine the structure of the heart can be the objective indexes for differentiating the TCM syndromes of hypertension.