摘要
目的：探讨虚证原发性高血压患者左心室收缩功能变化的特异性。方法：９８例临床确诊高血压病患者按中医辨证标准分为阴虚阳亢证３０例，气阴两虚证３８例，阴阳两虚证３０例，应用二维超声心动图技术测量左心室收缩功能指标。结果：阴虚阳亢证组左心室收缩功能指标左室短轴缩短分数（ＦＳ）、射血分数（ＥＦ）、心肌收缩性显著高于正常对照组（Ｐ＜０．０５和Ｐ＜０．０１）；气阴两虚证组和阴阳两虚证组ＦＳ、ＥＦ、心肌收缩性、左室射血时间（ＬＶＥＴ）显著低于正常对照组（Ｐ均＜０．０１），射血前期时间（ＰＥＰ）、ＰＥＰ／ＬＶＥＴ显著高于正常对照组（Ｐ均＜０．０１）；虚证各组间比较：各项指标差异均显著，其中ＦＳ、ＥＦ、ＬＶＥＴ和心肌收缩性呈下降趋势（阴阳两虚证组＜气阴两虚证组＜阴虚阳亢证组）；ＰＥＰ、ＰＥＰ／ＬＶＥＴ呈升高趋势（阴阳两虚证组＞气阴两虚证组＞阴虚阳亢证组）。结论：阴虚阳亢证高血压病患者心肌收缩功能亢进，气阴两虚证患者心肌收缩功能储备减退。
Objective:To investigate the specialities of changes in left ventricular systolic function (LVSF) in patients with essential hypertension (EH) of deficiency syndrome (DS) in TCM.Methods:98 cases clinically diagnosed with hypertention were divided into Yin deficiency and Yang excess syndrome (YDYES, n =30),both Qi and Yin deficiency syndrome (BQYDS, n =38),and both Yin and Yang deficiency syndrome (BYYDS, n =30).The indices of LVSF were measured by 2dimentional echocardiography.Results:Among the indices of LVSF fractional shortening (FS),ejection fraction (EF),and myocardial contractility in YDYES group were significantly higher than those in normally control group ( P <0 05 and P <0 01).The FS,EF,myocardial contractility and left ventricular ejection time (LVET) in BQYDS and BYYDS group were significantly lower than those in normally control group (all P <0 01),meanwhile the preejections period(PEP) and PEP/LVET were significantly higher than those in normally control group.In comparison among all the deficiency syndrome groups all kinds of indices presented significant differences.The FS,EF,LVET and myocardial contractility showed depressing tendency,BYYDS group<BQYDS group<YDYES group;the PEP,PEP/LVET showed elevating tendency,BYYDS group>BQYDS group>YDYES group.Conclusions:In patients with hypertension of YDYES,the hyperfuctions of cardiac contractility is existed in patients with hypertension of BQYDS,the reserve of myocardial contractility is declined,and in patients with hypertension of BYYDS the myocardial contractility is obviously reduced.
关键词
高血压
虚证
收缩功能
左心室
hypertention of deficiency syndrome\ \ left ventricular systolic function\ \ 2dimentional echocardiography
