Clinical Study On Relationship Between TCM Syndrome Differentiation-Type Of Chronic Heart Failure And B-type Natriuretic Peptide And 6-Minute Walk Test And Tei Index

Objective:To study the relationship between B-type natriuretic peptide(BNP),6-minute walk test(6MWT),Tei index and TCM Syndrome Differentiation-type(TCM-SDT) of chronic heart failure(CHF),trying to find some peculiar indexes and leading them to the TCM differentiation of CHF.These indexes which make the differentiation more practical provide reliable basis for treatment,besides they can illuminate the distribution regularity of TCM-SDT of CHF.Methods:105 patients eases of CHF.Dividing the patients by differentiation standard and collecting their test results of BNP,6MWT and Tei index,and compared with those in 25 healthy subjects in control group.To analyze the distribution regularity of TCM-SDT of CHF and its relationship to the levels of these test results.Results:1.The levels of BNP,6MWT and Tei index in CHF patients are significantly different from those in control group(P＜0.01).2.Donstituent ratio of TCM-SDT of CHF:Syndrome of blood stasis due to deficient Qi＞Syndrome of deficiency of both Qi and Yin＞Syndrome of Yang deficiency of heart and kidney＞Syndrome of Qi deficiency of heart and lung,turbid phlegm obstruting lung＞Syndrome of water overflowing due to Yang deficiency＞Syndrome of depletion of Yin causing Yang collapse.3.The level of BNP TCM-SDT of CHF:Syndrome of turbid phlegm obstructing lung(1134.14±386.05pg/ml)＞Syndrome of water overflowing due to Yang deficiency(987.09±300.40pg/ml)＞Syndrome of Yang deficiency of heart and kidney(819.87±276.90pg/ml)＞Syndrome of deficiency of both Qi and Ylin(554.05±239.73pg/ml)＞Syndrome of blood stasis due to deficient Qi(517.29±177.10pg/ml)＞Syndrome of Qi deficiency of heart and lung(396.77±187.40 pg/ml).The levels of BNP in Syndrome of Qi deficiency of heart and lung,Syndrome of blood stasis due to deficient Qi and Syndrome of deficiency of both Qi and Yin are significantly different from those in Syndrome of Yang deficiency of heart and kidney, Syndrome of water overflowing due to Yang deficiency and Syndrome of turbid phlegm obstructing lung(P＜0,01).4.Evaluations of heart function involving NYHA heart function classification and 6MWT in different TCM-SDT of CHF have obvious difference.5.Tei index increasingly rises from Syndrome of Yang deficiency:of heart and kidney(0.63±0.09) to Syndrome of water overflowing due to Yang deficiency(0.60±0.10) to Syndrome of turbid phlegm obstructing lung(0.59±0.08) to Syndrome of blood stasis due to deficient Qi(0.47±0.09) to Syndrome of deficiency of both Qi and Yin(0.46±0.08) to Syndrome of Qi deficiency of heart and lung(0.46±0.09),while ejection,fraction(EF) reduces gradually.Conclusion:1.The levels of BNP,6MWT and Tel index in CHF patients are significantly different from those in health,which can act as diagnostic criteria of CHF.2.The relativity between TCM-SDT of CHF and Doppler Echocardiography and the levels of BNP,6MWT and Tei index is obvious.The difference between the different TCM-SDT of CHF can be confirmed by BNP,6MWT and Tei index,as well as symptom.3.The degeneration of different TCM-SDT of CHF is increasingly serious by turns:Syndrome of Qi deficiency of heart and lung→Syndrome of deficiency of both Qi and Yin,Syndrome of blood stasis due to deficient Qi→Syndrome of Yang deficiency of heart and kidney,Syndrome of water overflowing due to Yang deficiency,Syndrome of turbid phlegm obstructing lung→Syndrome of depletion of Yin causing Yang collapse.