| Objective:To observe the associaticity between Heart Failure TCM syndrome and BNP(B-type natriuretic peptide),FIB(Fibrinogen,Fg),blood stasis scoring,explore the HF patient blood stasis exchange rule.improve clinical differentiation and treatment of CHF.Methods:Selecting 112 inpatients who caught CHF in Jiang su Province Hospital Of TCM.All cases classified TCM syndrome,heart function qulitate,blood stasis score.draws blood sample to laboratory inspection of BNP,FIB.To analyze the distribution regularity TCM syndrome and its relationship to the levels of these tests results.Results:Altogether completes observes 112 cases,62(55.36%) male and 50(44.64%) female, average 74.48(±11.38) years old.Cases of heart functionⅡ-Ⅳis 14,34,and 64 seperately,42%of the cases with CHD,and 43%with FIB increase. The qi-deficiency and blood-stasis syndrome is the most testimony syndrome of NYHA gradeⅡ-Ⅲ.As heart function failure get worse,phlegm retention and obstructive pulmonary syndrome and Yin and Yang exhausted simultaneously increase.There were Significant differences in BNP among NYHA grade(P=0.00,＜0.01),and increase with the later,but there is no difference between TCM syndromes (X~2=11.70,P=0.06,approaching 0.05);FIB in gradeⅡ,Ⅳis higher than in gradeⅢ(P＜0.05).There was no difference in blood stasis scoring.There were significant differences in blood stasis scoring between TCM syndromes (X~2=24.87,P=0.000,＜0.05),and among non-qi-deficiency-and-blood-stasis-syndrome, blood stasis scoring in Yin and Yang exhausted simultaneously syndrome is the highest(X~2=11.381,P=0.044,＜0.05).The highest level of FIB is in phlegm retention and obstructive pulmonary syndrome(P＜0.05),detailed in Table 2-10.By Pearman correlation analysis and non-linear regression analysis showed that, BNP and FIB rank correlation's coefficient was 0.162(P＞0.05),BNP levels and blood stasis scoring's correlation coefficient 0.102(P＞0.05),by Pearson correlation analysis, FIB with the blood stasis correlation coefficient 0.228,FIB and blood stasis syndrome was significantly associated(P=0.016 P＜0.05).Conclusion:Qi-defieiency and Blood-stasis is the most commonly of syndrome of CHF,is core of whole course.BNP have positive correlation with NYHA grade,which in gradeⅡIs about 156.5pg/ml,489.85pg/ml more or over in gradeⅢand about 1245pg/ml in gradeⅣ,and in patients with chronic heart failure was increased progressively in order of heart-lung deficiency syndrome,qi deficiency and blood stasis syndrome,qi-yin deficiency syndrome,syndrome of edema caused by deficiency of yang,heart and kidney yang-deficiency syndrome,phlegm retention and obstructive pulmonary syndrome,Yin and Yang exhausted simultaneously.Blood stasis scoring in patients with chronic congestive heart failure was increased progressively in order of heart and kidney yang-deficiency syndrome,heart-lung deficiency syndrome,qi-yin deficiency syndrome,phlegm retention and obstructive pulmonary syndrome,syndrome of edema caused by deficiency of yang,Yin and Yang exhausted simultaneously,qi deficiency and blood stasis syndrome,and the level of FIB increase in order of qi-yin deficiency syndrome,heart-lung deficiency syndrome,heart and kidney yang-deficiency syndrome,syndrome of edema caused by deficiency of yang, qi deficiency and blood stasis syndrome,Yin and Yang exhausted simultaneously,phlegm retention and obstructive pulmonary syndrome.Although the main syndrome of severe heart failure is phlegm retention and obstructive pulmonary syndrome and Yin and Yang exhausted simultaneously,but there is serious blood stasis at the same time.The level of BNP can't be used as reference index for blood-stasis of CHF in clinical differentiation... |
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