不同中医证型房颤患者心脏超声的相关性研究

目的：探讨心房纤颤（简称房颤）不同中医证型与心脏超声指标的相关性，结合病因分析，使中医辨证分型更加客观化、科学化，从而提高房颤中医辨证论治水平。方法：选取2013年8-12月期间在本院住院、经多导联心动图检查诊断为心房纤颤患者48例，经中医辨证分型，其中心血瘀阻23例，心脾两虚11例，心阳不振8例，水饮凌心6例，对其进行多普勒超声心动图检查。结果：水饮凌心及心脾两虚证的左房增大、二尖瓣返流面积增多，高于其他证型（P〈0.05），多见于风湿性心瓣膜病（简称风心病）；心阳不振证的左室射血分数、短轴缩短率、二尖瓣舒张早期流速峰值E峰、二尖瓣舒张晚期流速峰值A峰及E/A比值均低于其他证型（P〈0.05），多见于肺心病；心血瘀阻证的左房、左室增大，室间隔、左室后壁增厚（P〈0.05），多见于高血压及冠心病。48例患者中有9例并发左房附壁血栓。结论：心脏超声能够分析房颤患者不同中医证型与病因的相关性，提高房颤中医辨证论治水平。

The Correlation of Different TCM Syndrome in Patients with Atrial Fibrillation Echocardiographic Studies

Objective：To study atrial fibrillation different TCM syndrome types and the correlation of echocardiographic indexes,the cause analysis,and make traditional Chinese medicine more objective,scientific,and improve the level of atrial fibrillation treatment based on syndrome differentiation of traditional Chinese medicine.Method：Choose between August 2013 and November 2013 hospitalized in the hospital during the period,after much lead cardiogram examination diagnosis of 48 patients with atrial fibrillation. After TCM differentiation of symptoms and signs for classification of syndrome,there were 23 cases of stagnation of the heart-blood,11 cases of heart-spleen deficiency,and 8 cases of heart-Yang deficiency and 6 cases of fluid retention attacking heart.The examination of Doppler echocardiography was conducted on the patients.Result：For patients with fluid retention attacking heart and heart-spleen deficiency,left atrial enlargement and increased area of mitral regurgitation were higher than the remaining syndromes（P〈0.05）and mostly seen in rheumatic valvular heart disease（called RHD for short）. For patients with heart-Yang deficiency,left ventricular ejection fraction, shortening fraction,diastolic mitral early peak flow velocity value E peak,diastolic mitral late peak flow velocity value A peak and E/A ratio were lower than the remaining syndromes（P〈0.05）and mostly seen in pulmonary heart disease;For patients with stagnation of the heart-blood,the left atrial and left ventricular enlargement as well as the thickening of interventricular septum and posterior left ventricular wall were mostly seen in hypertension and coronary heart disease. Nine of 48 patients had the comitant left atrial mural thrombus.Conclusion：Heart ultrasound can analyze the relevancy between different TCM patterns of syndrome and the causes of disease for patients with atrial fibrillation,and can improve the level of TCM determination of treatment based on pathogenesis obtained through differentiation of symptoms and signs for patients with atrial fibrillation.