心气虚证左室舒张功能的临床及实验研究

作者	单位
程伟	湖北中医学院附属医院心内科
史载祥	中日友好医院
武泽民	中日友好医院
张铁中	中日友好医院
王兵	中日友好医院
周明	中日友好医院

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中文摘要:

采用微机检测心机械图,获取心功能参数。结果64例心气虚证与正常人比较,左室舒张和收缩功能均低下(P<0.01),而肺、脾胃、肾气虚证与正常人比较左室舒张功能参数无显著差别;心气虚证患者,左室舒张性能指标舒张时间振幅指数(DATI)较收缩性能指标左室射血前期/左室射血期(PEP/LVET)更为敏感,DATI和PEP/LVET异常率无显著差别,但两者正常、异常间有交叉,说明心气虚证有单纯心收缩或舒张功能异常。随机双盲法证实,益心补气的益心合剂能改善心气虚证异常的心收缩和舒张性能。实验选用狗急性心肌缺血动物模型,尝试性探讨缺血心肌的"心气"变化,短暂心肌缺血及复灌过程中"心气虚"表现,同临床结果一致。

英文摘要:

In order to assess the left ventricular diastolic function of Heart Qi Insufficiency Syndrome （HQIS）, apexcardiogram, ECG, electro-cardio-phonogram, impedance cardiogram were recorded and computerized simultaneously. A/D, PEP/LEVT, A/H were increased, while TRTI, DATI, HI, SV, CI reduced in 64 patients , 34 of them with coronary heart disease. The change was statistically significant. This study showed that DATI was more sensitive than PEP/LEVT in patients with HQIS, while there was no significant difference between abnormal ratio of them, overlapping of the two indices was showed. Replenishing Heart Mixture attained its therapeutic effect through improving abnormal left ventricular function. After treatment A/H, A/D, PEP/LEVTwere reduced and DATI, SV, CI increased （P<0.05 0.01）. In experiment, HQIS was produced by acute myocardial ischemia in open-chest anesthetized dogs by left anterior descending coronary artery occlusion. It has been shown that dp/dt_max and T were more sensitive than dp/dt_max. Result of the clinical and the experimental study were consistent.

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