慢性心力衰竭患者中医证候与左室质量指数和左室射血分数的关系

Relationship of TCM Syndromes in Chronic Heart Failure with Left Ventricular Mass Index and Left Ventricular Ejection Fraction

【目的】观察慢性心力衰竭患者中医证候与左室质量指数(LVMI)和左室射血分数(LVEF)的关系。【方法】将296例慢性心力衰竭患者按中医辨证分为气虚证(21例)、气虚血瘀证(98例)、气虚血瘀水停证(72例)、气虚阳虚血瘀证(56例)和气虚阳虚血瘀水停证(49例)5种类型,比较各型的LVEF和LVMI。【结果】按气虚证、气虚血瘀证、气虚血瘀水停证、气虚阳虚血瘀证、气虚阳虚血瘀水停证的顺序,LVMI呈递增趋势,而LVEF呈递减趋势。统计结果显示,气虚证、气虚血瘀证、气虚血瘀水停证3组间LVMI和LVEF差异均有显著性意义(P<0.05);气虚阳虚血瘀证、气虚阳虚血瘀水停证2组间LVMI和LVEF均无显著性差异(P>0.05),但与其他3组比较,LVMI和LVEF差异均有显著性意义(P<0.01)。【结论】左室质量指数和左室射血分数可作为慢性心力衰竭中医辨证的量化指标,这可能为该病的中医证候规范化研究提供了一条新途径。

Objective To explore the relationship of TCM syndromes in chronic heart failure （CHF） with left ventricular mass index （LVMI） and left ventricular ejection fraction （LVEF）. Methods Two hundred and ninety-six CHF patients were classified into the syndromes of Qi deficiency （21 patients）, Qi deficiency and blood stasis （98）, fluid retention due to Qi deficiency and blood stasis （72）, blood stasis due to the deficiency of Qi and yang （56）, and blood stasis and fluid retention due to the deficiency of Qi and yang （49）. LVMI and LVEF in different syndromes were campared. Results LVMI presented an increasing sequence and LVEF presented a decreasing sequence in the syndromes of Qi deficiency, Qi deficiency and blood stasis, fluid retention due to Qi deficiency and blood stasis, blood stasis due to the deficiency of Qi and yang, and blood stasis and fluid retention due to the deficiency of Qi and yang. Between the syndromes of Qi deficiency, Qi deficiency and blood stasis, and fluid retention due to Qi deficiency and blood stasis, there were significant differences of LVMI and LVEF （P 〈 0. 05 ） ; no significant differences of LVMI and LVEF were found between the syndromes of blood stasis due to the deficiency of Qi and yang, and blood stasis and fluid retention due to the deficiency of Qi and yang （ P 〉0. 05 ）, but LVMI and LVEF in these two syndromes differed from those in the former three syndromes （ P 〈 0. 01 ）. Conclusion LVMI and LVEF can be used as the parameters of TCM syndrome standardization.