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[针刺对高血压患者左心室形态及心功能的影响]

[Effect of acupuncture on left ventricular configuration and cardiac function in patients with hypertension].

作者信息

Zhang Li-Li, Fan Xiao-Nong, Wang Shu

机构信息

First Teaching Hospital of Tianjin University of TCM, Tianjin 300193, China; National Clinical Research Center for TCM, Tianjin 300193.

First Teaching Hospital of Tianjin University of TCM, Tianjin 300193, China; National Clinical Research Center for TCM, Tianjin 300193; Tianjin Acupuncture and Moxibustion Institute, Tianjin 300193; Tianjin Key Laboratory of Acupuncture and Moxibustion, Tianjin 300193.

出版信息

Zhongguo Zhen Jiu. 2019 Aug 12;39(8):809-13. doi: 10.13703/j.0255-2930.2019.08.003.

Abstract

OBJECTIVE

To observe the related factors of left ventricular configuration in patients with mild to moderate hypertension, and to evaluate the influence of acupuncture on left ventricular configuration and cardiac function.

METHODS

acupuncture regime formulated by academician - was applied to 200 patients with mild to moderate hypertension. The treatment was given once a day, 5 times a week for 3 months. Blood pressure and blood lipid levels were measured before treatment. Before treatment and 3 months after treatment, the echocardiography was used to measured end-diastolic left ventricular diameter (LVIDd), end-diastolic left ventricular posterior wall thickness (LVPWTd), and end-diastolic interventricular septum thickness (IVSTd), ejection fraction (EF), left ventricular mass index (LVMI), etc.; the relevant influencing factors of different left ventricular configurations were analyzed.

RESULTS

The patients with mild to moderate hypertension had left ventricular dysplasia (left ventricular remodeling, concentric hypertrophy, eccentric hypertrophy) reached 60%, and compared with the normal configuration group and the left ventricular remodeling group, there were significant differences in nighttime mean pulse pressure, total cholesterol, BMI and waist circumference in the eccentric hypertrophy group (<0.05). LVMI was associated with nighttime pulse pressure, waist circumference, total cholesterol and BMI (<0.05). Left ventricular relative wall thickness was associated with total cholesterol, BMI and waist circumference (<0.05). The diastolic function from normal configuration to left ventricular remodeling, concentric hypertrophy and eccentric hypertrophy gradually decreased, but there were no significant difference (>0.05). The systolic function in the concentric hypertrophy group and the eccentric hypertrophy group was significantly lower than that in the normal configuration group and the left ventricular remodeling group (<0.05). There was no significant difference in left ventricular systolic function and diastolic function before and after acupuncture (>0.05).

CONCLUSION

Sixty percents of patients with mild to moderate hypertension have abnormal left ventricular configuration and are associated with total cholesterol, BMI, waist circumference and nighttime mean pulse pressure. Studies have not found that acupuncture can significantly improve the left ventricular configuration and left cardiac function.

摘要

目的

观察轻中度高血压患者左心室构型的相关因素,并评估针刺对左心室构型及心功能的影响。

方法

将院士制定的针刺方案应用于200例轻中度高血压患者。每日治疗1次,每周5次,共3个月。治疗前测量血压和血脂水平。治疗前及治疗3个月后,采用超声心动图测量左心室舒张末期内径(LVIDd)、左心室后壁舒张末期厚度(LVPWTd)、室间隔舒张末期厚度(IVSTd)、射血分数(EF)、左心室质量指数(LVMI)等;分析不同左心室构型的相关影响因素。

结果

轻中度高血压患者左心室发育异常(左心室重构、向心性肥厚、离心性肥厚)达60%,与正常构型组和左心室重构组相比,离心性肥厚组夜间平均脉压、总胆固醇、BMI和腰围差异有统计学意义(<0.05)。LVMI与夜间脉压、腰围、总胆固醇和BMI相关(<0.05)。左心室相对壁厚度与总胆固醇、BMI和腰围相关(<0.05)。从正常构型到左心室重构、向心性肥厚和离心性肥厚的舒张功能逐渐降低,但差异无统计学意义(>0.05)。向心性肥厚组和离心性肥厚组的收缩功能明显低于正常构型组和左心室重构组(<0.05)。针刺前后左心室收缩功能和舒张功能差异无统计学意义(>0.05)。

结论

60%的轻中度高血压患者左心室构型异常,且与总胆固醇、BMI、腰围和夜间平均脉压有关。研究未发现针刺能显著改善左心室构型和左心功能。

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