潜阳育阴颗粒改善高血压病亚临床心肌损害的价值探讨

Clinical value of qianyangyuyin granules in improving subclinical myocardial damage in patients with hypertension

目的应用超声心动图二维分层应变技术评估潜阳育阴颗粒改善高血压病亚临床心肌损害的效果。方法将原发性高血压患者41例分为对照组17例和试验组24例。两组均予以常规西药基础降压治疗,试验组在此基础上口服潜阳育阴颗粒(3次/d,每次10 g),对照组未予口服中药制剂,两组均治疗6个月。应用经胸超声心动图获取两组治疗前后的常规超声心动图检查参数及左室心内膜层纵向应变(LSendo)、心中膜层纵向应变(LSmid)和心外膜层纵向应变(LSepi),并对其进行对比分析。结果治疗前后两组常规超声心动图检查参数比较差异均无统计学意义。试验组治疗前LSendo、LSmid、LSepi分别为(-20.76±1.84)%、(-17.94±1.60)%、(-15.64±1.40)%,治疗后分别为(-22.77±2.27)%、(-19.56±2.03)%、(-16.88±1.85)%,差异均有计学意义(均P<0.01);试验组与对照组LSendo、LSmid改善差值比较差异均有统计学意义(均P<0.05),而LSepi改善差值差异无统计学意义。结论潜阳育阴颗粒可以有效改善高血压病亚临床心肌损害;超声心动图二维分层应变技术在评估高血压病患者早期心肌损伤及药物干预效果方面均有重要价值。

Objective To evaluate the effect of qianyangyuyin(QYYY) granules in improving the subclinical myocardial damage in patients with hypertension by two-dimensional layer-specific strain echocardiology. Methods There were 41 patients with essential hypertension,including 17 cases in the control group and 24 cases in the experimental group. The patients in both groups were treated with conventional western medicine. Oral administration of QYYY granules was given 10 g tid in experiment group.QYYY granules wasn’t given in control group. Both groups were observed for 6 months and underwent transthoracic echocardiography before and after the intervention.The left ventricular endocardial longitudinal strain(LSendo),midmyocardial longitudinal strain(LSmid),epicardial longitudinal strain(LSepi)and the conventional echocardiographic parameters were obtained,then the results were compared.Results There were no significant difference in conventional echocardiographic parameters between two groups before and after treatment. In the experimental group,the LSendo,LSmidand LSepiwere(-20.76±1.84)%,(-17.94±1.60)%,(-15.64±1.40)% before the treatment,while(-22.77±2.27)%,(-19.56±2.03)%,(-16.88±1.85)% after the treatment,there were significant difference(all P<0.01).The improvement difference of LSendoand LSmidin the experimental group were higher than those in the control group(both P<0.05),while there was not statistically significant in the improvement difference of LSepi.Conclusion The subclinical myocardial damage in hypertensive patients can be effectively improved by QYYY granules. The two-dimensional layer-specific strain echocardiology has important application value in the evaluation of early myocardial injury and the effect of pharmacological intervention.