Chronic Heart Failure Tcm Syndromes Characterized By Clinical Studies

Chronic heart failure is one of the most harmful disease of the 21st century. Individual difference and different basic diseases make the syndrome of HF differentiation and treatment is also complicated and diversified. Therefore, in-depth syndromes research of chronic heart failure helps regulate the TCM syndrome, and then improve the clinical level of TCM. This study attempts to explore syndromes distribution characteristics of chronic heart failure and regularity of syndromes combination so as to provide research basis of chronic heart failure.Methods:(1) The objects of research are 122 in-patients in department of cardiology from.Dongfang hospital, Dongzhimen hospital, China-Japanese Friendship Hospital who have been diagnosed with chronic heart failure from May 2009 to March 2010. (2) The research has been investigating the potential heart failure patients due to evaluate the 2007 China's chronic heart failure diagnosis and treatment guidelines. And the definite diagnosis patients will be preliminary involved heart failure group. It will classify the patients by New York Heart Association (NYHA) to exclude some patients according to the standards. Then doctors who have TCM certificate will give TCM diagnose and collect other clinical record. (3) Statistical method:Use the Statistical software of SPSS 13.0 for windows. Measurement data use t-test or variance analysis. The comparison of percentages between two groups use X2-test.Results:(1) Distribution of syndromes:The statistical analysis shows that the most common syndromes is the deficiency-syndrome of qi (89.3% of total). The second are the syndrome of blood stasis (61.5% of total) and water overflowing (27.9% of total), while only a few syndromes are the syndrome of sputum-turbid, the deficiency-syndrome of yin and the deficiency-syndrome of yang. The most common deficiency-syndrome of the viscera are the deficiency-syndrome of the heart(92.6% of total), then is the deficiency-syndrome of the kidney (82.0% of total) and the deficiency-syndrome of the lung(49.2% of total) and the deficiency-syndrome of the spleen (39.3% of total). The deficiency-syndrome of the liver has a little proportion (39.3% of total), while the deficiency-syndrome of the stomach has the lowest proportion. Through the statistical analysis the percentages of the deficiency-syndrome of qi, the syndrome of blood stasis, the syndrome of the water overflowing, the deficiency-syndrome of the heart, the deficiency-syndrome of the lung, the deficiency-syndrome of the kidney and the deficiency-syndrome of the spleen of the group of HF are higher than that of the group of NHF (P< 0.05). The deficiency-syndrome of yang, the syndrome of the water overflowing and the syndrome of sputum-turbid have a higher percent in NYHAⅣthan NYHAⅡandⅢ(P< 0.01). (2) Combination of syndromes:The statistical analysis shows that the most common combination of syndromes among the patients of HF is the combination of three-syndromes (50.8% of total). Besides, the combination of two-syndromes (32.0% of total) and four-syndromes (9.8% of total) are also relatively common combination, while only a few combination are the Combination of five-syndromes (4.1% of total) or single-syndrome (3.3 of total). The combination of the deficiency-syndrome of qi and the syndrome of blood stasis is the basis of the combination of syndrome. The most common combination of the deficiency-syndrome of the viscera is the combination of three-syndromes (43.4% of total). Besides, the combination of two-syndromes (29.5% of total) and four-syndromes (18.0% of total) are also relatively common combination, while only a few combination are the combination of five-syndromes (5.1% of total) and single-syndrome (4.1% of total). The deficiency-syndrome of the heart can be alone, but the deficiency-syndrome of the heart with other deficiency-syndrome of the viscera has more percents.Conclusion:(1) The basic features of pathogenesis of HF is primary deficiency and secondary excess. The syndrome of deficiency of qi and the blood stasis is the basic syndrome of HF. (2) The deficiency-syndrome of qi, the syndrome of blood stasis and water overflowing can be the characteristics syndrome of HF. (3) After HF has appeared, cardiac function will deteriorate after the appearance of the deficiency-syndrome of yang, the syndrome of the water overflowing and the syndrome of sputum-turbid, and these syndromes play an important role among the changes of the state of HF. (4) This thesis studied on common syndrome of HF by clinical observation, then we make a conclusion that the syndrome of deficiency of qi and the blood stasis is the basic syndrome of HF. From this basis the syndrome of deficiency of qi and deficiency of yang, the syndrome of exhaustion of yangqi, the syndrome of the water overflowing and the syndrome of sputum-turbid will appeare, which will be the basic of treatment based on syndrome differentiation in HF.