循環器疾患々者の特殊性 (各種疾患の温泉療法とリハビリテーテーション(シンポジウム-2-))
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Haemodynamic effects of warm bathing were studied on subjects with cardiovascular diseases, and the results were applied for setting up a reasonable standard of warm bathing for these patients.Subjects: 20 normal cases, 32 cases of essential hypertension with no ischemic changes in ECG, 9 cases of coronary sclerosis including 4 cases of old infarction and 9 cases of acquired valvuar diseases were selected for investigation.Methods: Fresh-water and a salt water (Atami Spa) bathing with different temperature (38°C to 42°C) and time 3min. to 8mim. were adopted. Heart rate, respiration rate, blood pressure, ECG, PDG and A-VCG (acceleration vibrocardiography) before and after bathing were compared.Results:1. No remarkable difference of haemodynamic effects was observed between fresh and salt water bathing.2. In hypertensive patients, blood pressure tended to decrease during bathing and increase after bathing. This tendency was exaggerated when room temperature being below 20°C. Passive bathing (Hubbard's tank) caused decrease of pressure during and after bathing irrespective of room and bathing temperature.3. No remarkable change was observed in ECG, except several cases showing a sporadic ventricular extrasystole, and a case of coronary sclerosis showing a moderate ST depression after bathing.4. In one of 4 patients with mitral stenosis, bathing caused an accentuation of the first and second heart sounds with increase of Q-I-II-OS, and a rise in left atrial pressure was suggested.5, In normal subjects, A/S and V/S ratios of A-VCG were decreased or remained unchanged after bathing. In cases with hypertension and coronary sclerosis, relatively hot (42°C) and long (over 5min.) bathing occasionally caused a increase of A/S and V/S. This was considered to indicate a temporary pressure rise in the left atrium, and suggest a manifestation of transient left heart failure.Summary and Conclusion:It was concluded from our results that warm bathing of 41°C within 5min. may be indicated without undesirable overloads to the patients with hypertension, coronary sclerosis and acquired valvular diseases. A-VCG was regarded as a most simple and reliable examination for assessment of transient haemodynamic change after bathing when combined with blood pressure measurment and recording of ECG.
- 一般社団法人 日本温泉気候物理医学会の論文
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