摘要
慢性心力衰竭的典型外在症状与体征出现较晚,而传统四诊方法未能深入至微观层面,严重制约辨证的开展。借助现代检测技术获取的微观指标,可丰富直观的外象观测内容,弥补传统四诊方法的局限,已逐步成为慢性心力衰竭辨证的有益补充。本文归纳心功能分级及相关指标、心脏分泌的利钠肽、生物学标志物等微观指标在慢性心力衰竭辨证中的研究概况,分析不同微观指标与慢性心力衰竭证候演变规律的关联程度,探讨各微观指标的诊断价值及局限性。对现阶段存在的单一指标局限性、部分指标缺乏特异性等问题进行论述,据此提出引入权重量化概念、多指标联合运用、借助系统生物学等发展思路,以期为慢性心力衰竭辨证客观化提供新思路。
The typical external symptoms and signs of chronic heart failure appear relatively late,while the traditional four-diagnostic method failed to go deep into the micro level,which seriously restricts the development of syndrome differentiation.Micro-indexes obtained by modern detecting techniques can enrich the visual observation content of external images,and make up for the limitations of the traditional four-diagnostic method,thereby gradually becoming beneficial complements to the syndrome differentiation of chronic heart failure.This paper summarizes the research situation of micro-indexes such as cardiac function classification and related indicators,natriuretic peptides secreted by the heart,biological markers and other micro indexes in the syndrome differentiation of chronic heart failure,analyzes the correlation between different micro-indexes and the evolution of chronic heart failure syndromes,discusses the diagnostic value and limitations of each micro-indexes,and discussse the limitations of single index and the lack of specificity of some indexes at present,and puts forward some development ideas,such as introducing the concept of weight quantification,combined application of multiple indexes and the aid of system biology,in order to provide new ideas for the objectification of chronic heart failure syndrome differentiation.
作者
钟森杰
李静
李琳
胡思远
杨梦
张倩
熊霞军
胡志希
ZHONG Senjie;LI Jing;LI Lin;HU Siyuan;YANG Meng;ZHANG Qian;XIONG Xiajun;HU Zhixi(Diagnostic Institute of Chinese Medicine,Hunan University of Chinese Medicine,Hunan Province,Changsha,410208,China)
出处
《中国医药导报》
CAS
2021年第28期51-55,共5页
China Medical Herald
基金
国家自然科学基金资助项目(81774208)
湖南省自然科学基金项目(2020JJ4062、2020JJ5408、2019JJ50447)。
关键词
慢性心力衰竭
微观指标
生物标志物
辨证
Chronic heart failure
Micro-indexes
Biomarkers
Syndrome differentiation
