Study On Traditional Chinese Medicine Constitution Of Heart Failure With Preserved Ejection Fraction

Objective:At present,the specific mechanism of heart failure with preserved ejection fraction(HFpEF)in western medicine is not yet clear.This study explored the correlation between HFpEF and TCM constitution,as well as clinical indicators in different physique states,through the collection of clinical case information and physique questionnaire survey.In order to provide some reference for the clinical medical practice of Chinese medicine to prevent and treat HFpEF.Methods:This study adopts a cross-sectional study to collect 120 patients with HFpEF who were in the cardiology department of the Second People’s Hospital of Fujian University from January2020 to January 2021 and met the criteria for inclusion and discharge.According to the "Classification and Judgment of Traditional Chinese Medicine Constitution" "Table" to determine the physical fitness of patients in traditional Chinese medicine,and collect patients’ general data,blood biochemical and cardiac color Doppler ultrasound and other indicators,using SPSS20.0 statistical software for analysis.Results:1.120 cases of HFpEF basic diseases are as follows:27 cases of hypertension with atrial fibrillation(22.5%),20 cases of hypertension(16.7%),19 cases of hypertension with diabetes(15.8%),15 cases of hypertension with coronary heart disease(12.5%),12 cases of atrial fibrillation(10%),9 cases of coronary heart disease(7.5%),9 cases of hypertrophic cardiomyopathy(7.5%),5 cases of hypertensive coronary heart disease and atrial fibrillation(4.2%),4 cases of hypertension diabetic coronary heart disease(3.3%).2.The medication status of 120 HFpEF patients is as follows:91 RAS blockers(75.8%),87 beta-blockers(72.5%),92 diuretics(76.7%),75 spironolactone(62.5%),31 cases of antiplatelet drugs(25.8%),35 cases of anticoagulants(29.2%),50 cases of statins lipid lowering drugs(41.7%),31 cases of calcium channel antagonists(25.8%),22 cases of hypoglycemic drugs(18.3%),17 cases of digoxin(14.2%).3.HFpEF TCM constitution types are as follows:Qi-deficiency constitution in 30 cases(25%)> Blood-stasis constitution in 25 cases(20.8%)> Yang-deficiency constitution in 21cases(17.5%)> Yin-deficiency constitution in 16 cases(13.3%)> Phlegm-dampness constitution 15 cases(12.5%)>13 cases(10.8%)with Damp-heat constitution.4.Qi-deficiency and Yang-deficiency constitution are older than Damp-heat constitution(P<0.05);Qi-deficiency,Blood-stasis,Damp-heat constitution are higher than Yin-deficiency constitution(P<0.05);Phlegm-dampness constitution have W and BMI greater than Qi-deficiency,Yang-deficiency,Blood-stasis and Yin-deficiency constitution(P<0.05);Blood-stasis and Damp-heat constitution have BMI greater than Yang-deficiency constitution(P<0.05);Blood-stasis and Damp-heat constitution have W greater than Yin-deficiency constitution(P<0.05);Yin-deficiency,Blood-stasis,Damp-heat and Phlegm-dampness constitution has a longer 6MWT distance than Yang-deficiency constitution(P<0.05);Yin-deficiency and Damp-heat constitution has a longer 6MWT distance than Qi-deficiency constitution(P<0.05);Yang-deficiency constitution has a higher NT-pro BNP value than Phlegm-dampness,Damp-heat,Yin-deficiency constitution(P<0.05);GLU values of Yin-deficiency constitution are greater than Qi-deficiency,Yang-deficiency,Blood-stasis and Damp-heat constitution(P<0.05);UA values of Damp-heat constitution are all greater than Qi-deficiency,Blood-stasis and Yin-deficiency constitution(P<0.05);UA values of Yang-deficiency,Blood-stasis constitution are greater than Qi-deficiency constitution(P<0.05);The LVEF values of Yin-deficiency constitution are greater than Qi-deficiency,Yang-deficiency,Blood-stasis,Damp-heat constitution(P<0.05).5.BMI,6MWT,LVEF and Yang-deficiency constitution were negatively correlated(P<0.05),the ratio were 0.807,0.993,0.859;NT-pro BNP and Yang-deficiency constitution were positively correlated(P<0.05)),the ratio was 1.001;age and damp-heat quality were negatively correlated(P<0.05),the ratio was 0.905;UA and Damp-heat constitution were positively correlated(P<0.05),the ratio was 1.009;BMI and Phlegm-dampness constitution were positively correlated(P<0.05),the ratio was 1.857;W,BMI,NT-pro BNP and Yin-deficiency constitution were negatively correlated(P<0.05),the ratios were 0.811,0.626,0.999,respectively;6MWT,GLU,LVEF and Yin-deficiency constitution were positive Correlation(P<0.05),the ratios were 1.008,2.677,1.248.Conclusion:1.The common physique types of HFpEF patients are:Qi-deficiency constitution,Blood-stasis constitution,Yang-deficiency constitution,Yin-deficiency constitution,Phlegm-dampness constitution,Damp-heat constitution,all of which are biased constitutions.2.HFpEF patients are mainly elderly,and the number of women is greater than that of men;men’s H,W,Cr,LAD,IVST,LVPWT,LVEDD,and LVMI are larger than women;people with yang deficiency are the oldest,has the worst New York cardiac function,6MWT distance is the shortest,and LVEF is the lowest,NT-pro BNP has the highest value;the W and BMI of the Phlegm-dampness constitution are the largest,People with Yin-deficiency constitution have the highest GLU,the longest 6MWT distance,the smallest W and BMI,and the highest LVEF;the Damp-heat constitution has the largest UA value and the youngest age.3.BMI,6MWT,LVEF are negatively correlated with Yang-deficiency constitution,NT-pro BNP is positively correlated with Yang-deficiency constitution;age is negatively correlated with Damp-heat constitution,UA is positively correlated with Damp-heat constitution;BMI is positively correlated with Phlegm-dampness constitution;W,BMI,NT-pro BNP is negatively correlated with Yin-deficiency constitution,and 6MWT,GLU,LVEF and Yin-deficiency constitution are positively correlated.