Research On Relationship Between Syndrome Differentiation Type Of TCM,Heart Function Index,LVEF And BNP In Patients With Chronic Heart Failure

Objective:To discussthe different TCM syndrome types in patients with chronic heart failure and cardiac function grading, LVEF and plasma BNP values between the change rules, for the pattern of chronic heart failure of TCM to provide objective basis.Methods:406 cases who caught chronic heart failure were selected in the first affiliated hospital of Henan university of TCM from July 2010 to June 2014. After collecting and establishment of a database cases with generally material、different pattern of syndromes 、NYHA classify of heart function、Doppler echocardiography and laboratory test results. All the cases were divided into seven groups, such as the data for statistical analysis.Results: 1The pattern of syndromes is correlated with age in patients with chronic heart failure.Age of patients of qi deficiency of both heart and Lung syndrome was significantly lower than fluid retention due to Yang Deficiency syndrome, phlegmatic fluid obstructing lung syndrome and depletion of yin causing yang collapse syndrome(P<0.05). Chronic heart failure syndromes in the frequency distribution of men and women does not exist significant differences(P>0.05). 2In the leading cause of chronic heart failure,the traditional Chinese medicine was not statistically different between the different syndromes. However, a cause of the card type frequency distribution differences.The causes of Qi deficiency and blood stasis type is coronary heart disease;The expansion of heart diseasecaused byfluid retention due to Yang-deficiency syndrome; The rheumatic heart disease caused by yang deficiency of both heart and kidney syndrome; The hypertensive heart disease caused byqi deficiency of both heart and Lung syndrome.Chronic heart failure in the distribution of TCM, deficiency of both qi and yin syndrome and qi deficiency and blood stasis syndrome accounted for the largest proportion, fluid retention due to Yang-deficiency syndrome and phlegmatic fluid obstructing lung syndrome accounted for the larger proportion, qi deficiency of both heart and Lung syndrome and yang deficiency of both heart and kidney syndrome relatively small proportion. 3The pattern of syndromes are correlated with the NYHA classify of heart function in patients with chronic heart failure.when the NYHA classify shows gradually raising trend, the pattern of syndromes were changed. X2=14.989,df=7,P=0.036、P<0.05. The data is the following: qi deficiency of both heart and Lung syndrome and deficiency of both qi and yin syndrome cardiac function II level for grading much, qi deficiency and blood stasis syndrome and phlegmatic fluid obstructing lung syndrome more thanⅢlevel for grading cardiac function; yang deficiency of both heart and kidney syndrome and fluid retention due to Yang-deficiency syndrome for moreⅣissuing cardiac classification level. 4The pattern of syndromes are correlated with the NYHA classify of heart function, LVEF value and BNP value in patients with chronic heart failure. Different syndromes in LVEF values are different, compared with fluid retention due to Yang-deficiency syndrome and phlegmatic fluid obstructing lung syndrome, qi deficiency of both heart and Lung syndrome has statistics signification(P<0.01); compared with fluid retention due to Yang-deficiency syndrome and phlegmatic fluid obstructing lung syndrome, deficiency of both qi and yin syndrome has statistics signification(P<0.01); compared with fluid retention due to Yang-deficiency syndrome and phlegmatic fluid obstructing lung syndrome, qi deficiency and blood stasis syndrome has statistics signification(P<0.01); At the yang deficiency of both heart and kidney syndrome and fluid retention due to Yang-deficiency syndrome, there are statistical differences(P<0.01).while there is no statistical difference withothers(P>0.05). Different syndromes in BNP values are different, compared with qi deficiency of both heart and Lung syndrome and deficiency of both qi and yin syndrome, fluid retention due to Yang-deficiency syndrome and depletion of yin causing yang collapse syndrome had statistics signification(P<0.01); compared with qi deficiency of both heart and Lung syndrome and deficiency of both qi and yin syndrome, qi deficiency and blood stasis syndrome and phlegmatic fluid obstructing lung syndrome had statistics signification(P<0.05).There is statistical difference between depletion of yin causing yang collapse syndrome and others(P>0.05). 5The NYHA classify of heart function are correlated with the LVEF value and BNP value in patients with chronic heart failure. Different the NYHA classify of heart function in the LVEF values are different, compared with NYHA gradeⅡand IV has statistics signification(P<0.01); compared with NYHA grade Ⅲ and Ⅳ has statistics signification(P<0.05); But the LVEF value is no statistical difference between NYHA gradeⅡandⅢ(P>0.05). Different the NYHA classify of heart function in the BNP values are different, compared with NYHA grade Ⅱ and IV has statistics signification(P<0.05); But the BNP value is no statistical difference between NYHA gradeⅡandⅢ, NYHA gradeⅢandⅣ(P>0.05). 6LVEF values are a negative correlation with BNP values, but the way of correlation is not strong(Pearson R is-0.247).Conclusion: 1The pattern of syndromes are correlated with age in patients with chronic heart failure.When the age of patients are changing, the pattern of syndromes are fluid retention due to Yang-deficiency syndrome, yang deficiency of both heart and kidney syndrome and depletion of yin causing yang collapse syndrome. The pattern of syndromes in the frequency distribution of men and women does not exist significant differences. 2In the TCM syndrome type of heart failure, with the aggravation of the NYHA grade, the pattern of syndromes is developing gradually. The condition of CHF gradually progress roughly follow qi deficiency of both heart and Lung syndrome, deficiency of both qi and yin syndrome, qi deficiency and blood stasis syndrome, phlegmatic fluid obstructing lung syndrome, yang deficiency of both heart and kidney syndrome, fluid retention due to Yang-deficiency syndrome and depletion of yin causing yang collapse syndrome. 3As the pattern of syndromes change from light to serious, NYHA grade and BNP values increase accordingly, while LVEF values correspondingly decline. With the aggravation of the NYHA grade, BNP values increase accordingly and LVEF values correspondingly decline. Between LVEF value and BNP value has the inverse correlation, with the aggravation of the LVEF value, the LVEF values correspondingly decline.