Analysis Of The Distribution Of TCM Syndromes And Correlation Of Influencing Factors In Chronic Heart Failure Combined With Renal Insufficienc

Objective : To explore the influencing factors and distribution characteristics of TCM syndromes in patients with chronic heart failure complicated with renal insufficiency,and to try to analyze the correlation between general data,concomitant diseases,cardiac function and TCM syndromes,so as to provide a basis for TCM syndrome differentiation and individualized diagnosis and treatment of patients with TCM characteristics.Material and method : In this study,patients with chronic heart failure and cardiac function grade III ~ IV were selected from April 2021 to October 2022 in the First Department of Cardiology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.According to the estimated glomerular filtration rate(e GFR),the patients were divided into normal renal function group(e GFR ≥ 90 ml / min / 1.72m2)and abnormal renal function group(e GFR ≤ 90 ml / min / 1.72m2).The general data of the patients were collected,including age,gender,smoking history,drinking history,concomitant diseases,cardiac ultrasound indexes and laboratory indexes such as hemoglobin,serum creatinine,serum uric acid,glomerular filtration rate,cholesterol and triglyceride.The four diagnostic information of the patients was collected,and the data were collated and analyzed by SPSS25.0 software.Results :1.Chronic heart failure with renal insufficiency related factors :(1)A total of 226 patients were included in this study,including 90 patients(39.8 %)with normal renal function and 136 patients(60.2 %)with abnormal renal function.There were124 males(54.9 %)and 102 females(45.1 %).The age of the abnormal renal function group was 75(67,82)higher than that of the normal group 70.5(64,76.25),and the difference was statistically significant(P < 0.05).(2)The proportion of renal insufficiency in CHF patients with hypertension,anemia and diabetes was higher,and the difference of CHF with renal insufficiency in hypertension,anemia and diabetes was statistically significant(P < 0.05).There were 127 patients(66.1 %)with grade IV cardiac function in the abnormal renal function group,and 25 patients(73.5 %)with grade III cardiac function in the normal renal function group.There were significant differences in cardiac function classification and LVDD between CHF patients with or without renal insufficiency(P < 0.05).(3)There were significant differences in serum creatinine,blood urea nitrogen,blood uric acid and hemoglobin levels between CHF patients with and without renal insufficiency(OR>1.00,P < 0.05).4.Distribution of TCM syndromes of chronic heart failure with renal insufficiency :(1)The distribution of TCM syndromes in patients with CHF and renal insufficiency was from high to low,including 35 cases(25.7 %)of heart and kidney yang deficiency syndrome,32 cases(23.5 %)of yang deficiency and water flooding syndrome,31 cases(22.8 %)of qi deficiency and blood stasis syndrome,16 cases(11.8 %)of heart and lung qi deficiency syndrome,12 cases(8.8 %)of qi and yin deficiency syndrome,and 10 cases(7.4 %)of phlegm retention obstructing lung syndrome.The distribution of TCM syndromes in CHF patients without renal insufficiency was 28 cases(31.1 %)of heart and kidney yang deficiency syndrome,19 cases(21.1 %)of qi deficiency and blood stasis syndrome,17 cases(18.9 %)of heart and lung qi deficiency syndrome,12 cases(13.3 %)of yang deficiency and water flooding syndrome,12 cases(13.3 %)of qi and yin deficiency syndrome,and 2cases(2.2 %)of phlegm obstructing lung syndrome.There was no significant difference in the distribution of TCM syndromes between CHF and CHF with renal dysfunction(P >0.05).3.Correlation between TCM syndromes and clinical indicators of chronic heart failure with renal insufficiency :(1)In patients with CHF and abnormal renal function,cardiac function grade III was more common in phlegm-fluid obstructing lung syndrome,and cardiac function grade IV was more common in heart-kidney yang deficiency syndrome.Conclusion :1.This study showed that age,hypertension,cardiac function grade,serum creatinine and blood urea nitrogen were independent risk factors for CHF with renal insufficiency(OR >1.00,P < 0.05).2.The distribution of TCM syndromes of CHF combined with renal insufficiency from high to low is heart and kidney yang deficiency syndrome,yang deficiency water pan syndrome,qi deficiency and blood stasis syndrome,heart and lung qi deficiency syndrome,qi and yin deficiency syndrome,phlegm and fluid obstructing lung syndrome.3.The distribution of TCM syndromes in CHF patients with renal insufficiency is correlated with cardiac function grading and anemia.Patients with cardiac function grade III are more common in phlegm-fluid obstructing lung syndrome,and patients with cardiac function grade IV are more common in heart-kidney yang deficiency syndrome;anemia patients are more common in qi deficiency and blood stasis syndrome;with the decrease of GFR level,the TCM syndrome type gradually changed from cardiopulmonary qi deficiency syndrome to heart and kidney yang deficiency syndrome.