| Purpose:To evaluate the clinical value of Qianyangyuyin(QYYY)granules in improving earlyleft cardiac damage in patients with hypertension on the foundation of attained depressurization based on the quantitative parameters provided by two-dimensional speckle tracking imaging(2D-STI),with an aim to provide new thinking and foundation for disease prevention in clinic.Methods:According to the inclusion criteria,32 cases were included into experiment group,while 25 cases were included into control group.Both groups were administered angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB)as the western medicine basic treatment;calcium channel blocker(CCB)was added when necessary,so that the blood pressure could be controlled up to standard(BP<140/90mmHg).Experiment group was given oral administration of QYYY granules(constituted by compatibility of bidens pilosa,scrophularia ningpoensis,cornus officinalis,prepared fleece flower root,alisma plantago-aquatica and achyranthes bidentata)on this basis,and both groups were observed for 6 months.25 of 32 cases in experiment group were completely followed up in the 6 months,while 14 of 25 cases in control group were completely followed up.Overall and local left ventricular longitudinal systolic functions of all patients were evaluated by means of 2D-STI before and after treatment;the precise parameters included left ventricular GLS of average(GLS-Avg),GLS of long axis(GLS-LAX),GLS of apical 2 chambers(GLS-A2C)and GLS of apical 4 chambers(GLS-A4C)as well as longitudinal strain of 17 myocardial segments.In addition,left ventricular structure and overall systolic and diastolic functions of patients were evaluated using conventional echocardiography;blood pressure,heart rate and TCM syndromes of patients were evaluated.Statistical processing was carried out upon the end of treatment,so as to analyze the improvements of QYYY granules on left ventricular function and clinical symptoms in hypertension patients with early cardiac damage.Results:Firstly,overall and local left ventricular longitudinal systolic function was detected by 2D-STI,the results of which indicated that GLS-Avg,GLS-LAX,GLS-A2C and GLS-A4C were notably improved in experiment group after treatment,with differences being of statistical significance(P<0.01);differences in the above four parameters in control group before andafter treatment were not statistically significant(P>0.05).Analyzing from the point of view of left ventricular GLS,the improving effects in experiment group were superior to those in control group(P<0.01);the improving effects of GLS-LAX in experiment group were better than those in control group(P<0.05),but differences in those of GLS-A2C and GLS-A4C between two groups were not statistically significant(P>0.05).7 out of the 17 myocardial segments had remarkably increased longitudinal strain in experiment group after treatment,with the difference before and after treatment being of extreme statistical significance(P<0.01);1 myocardial segment had distinctly increased longitudinal strain in control group after treatment,with the difference being of statistical significance(P<0.05);6 myocardial segments had better improving effects on longitudinal strain in experiment group than in control group,with the differences being of statistical significance(P<0.05 or P<0.01);and the difference in efficacy in experiment group showed an increasing trend on the longitudinal(P<0.0167),while the differences on the short axis were not statistically significant(P>0.05).Secondly,left ventricular structure and function indexes were detected by conventional echocardiography,which included LVEF,E/A,average E/e’,LVIDd.LVMI,IVSd and LVPWd.Intra-group comparisons in both groups before and after treatment showed no statistically significant differences(P>0.05).Differences in improvements of all conventional echocardiography indexes between two groups were not significant(P>0.05).Thirdly,systolic pressure,diastolic pressure and heart rate in experiment group reduced after treatment,with all differences being of extremely significant(P<0.01);systolic pressure and diastolic pressure reduced in control group after treatment,and differences were statistically significant(P<0.05).Differences in improvements of systolic pressure,diastolic pressure and heart rate between two groups were not significant(P>0.05).Fourthly,the total scores of TCM syndromes in experiment group had outstandingly reduced after treatment,and differences before and after treatment were extremely significant(P<0.01);those in control group showed an decreasing trend,and difference before and after treatment was not significant(P>0.05);experiment group had superior symptom improvements to control group,and difference was of statistical significance(P<0.05);total response rate in TCM syndrome improvement in experiment group was higher than that in control group,and difference was significant(P<0.05).Conclusion:QYYY granules can further improve left ventricular longitudinal systolic function on the basis of attained depressurization,which achieves the goal of preventing and treating hypertension-induced cardiac damage. |
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