| Chronic heart failure is due to the changes of cardiac structure and function leads to impaired ventricular filling and ejection ability of a clinical syndrome, which is the ultimate destination of most cardiovascular disease and is the leading cause of death, serious harm to human health. The high incidence, high mortality rate and frequent hospitalization rate reduce the life quality of patients, bring a heavy burden to the family and community. Chronic heart failure has become a major public health problem, thus the prevention and treatment of this disease is particularly urgent.In recent years, with development of the study of Traditional Chinese medicine(TCM), TCM in the prevention and treatment of chronic heart failure made significant progress, especially in alleviating the clinical symptoms, controling the course of development, improving the life quality, have achieved outstanding advantages. Syndrome differentiation and treatment is the fundamental concept of TCM, and it can be effective to treat diseases by using syndrome differentiation. Therefore, to provide objective quantitative indicators for TCM has gradually become a hot spot in the research of heart failure.Ballistocardiogram(BCG) is a new type of cardiovascular function monitoring method in medical physics. It is mainly used to measure the mechanical changes of aorta and large blood vessel. Reported in the latest literature, BCG-ECG obtained RJ interval and pre-ejection period (PEP) linear correlation indirectly indicates the RJ interval and cardiac systolic function in relevant, which displays that RJ interval is expected to replace the PEP, becoming a safe and non-invasive, reliable and practical evaluative method of cardiac systolic function.The research method of modern medicine is combined with TCM syndrome, which can improve the accuracy of syndrome differentiation and play an important role in the prevention and treatment of this disease. Based on this viewpoint,the writer tries to explore the correlation of heart failure TCM syndrome types, BCG and cardiac function changes. Providing a beneficial reference for objectification and standardization of TCM syndrome differentiation typing.Objective:1. The heart failure(HF) group and non heart failure group in BCG main index (HI, IJ, JK, RJ interval) and cardiac function change (LVEF, BNP) differences, to investigate the feasibility of left ventricular systolic function of BCG assessment.2.Evaluating the correlation between different TCM syndrome types of HF group (HI, IJ, JK, RJ interval) and cardiac function (LVEF, BNP).Methods:From January 2015 to January 2016,130 cases were suspecting diagnosed as chronic heart failure patients as the research object in the Oriental Hospital of Beijing University of TCM cardiovascular ward.This study was divided into HF group and non HF group.Chronic heart failure diagnostic criteria of modern medicine basis Frmainghma standard and ESC guidelines,as well as TCM Syndrome Differentiation Typing According to the National Drug Administration in 2002 the new drugs of traditional Chinese medicine clinical research guiding principle points Qi Yin deficiency, Qi deficiency and blood stasis, heart and kidney yang deficiency, Yang deficiency and water flowing four syndromes. By professional staff in the Department of 130 cases diagnosing according to the Framingham criteria and ESC guidelines,CHF patients were included in the HF group, excluding the diagnosis of CHF patients with the inclusion of non HF group. The HF group and non HF group patients were collected for determination of plasma BNP concentration, ultrasonic echocardiography determination of LVEF, combined with BCG-ECG, determination of BCG HI,IJ,JK,RJ interval. Recording the above observation indicators, all the data using SPSS 19.0 for statistical analysis. Measurement data using t-test and ANOVA or non parametric test, count data by chi square test, ranked data by rank sum test, correlation analysis using Spearman correlation analysis, inclusion and exclusion value for the system default P< 0.05.Result:1.HF group BNP, RJ interval was significantly higher than that of non HF group, HF group LVEF was significantly lower than that of non HF group, the difference was statistically significant (P< 0.05). Non HF group and HF group HI, IJ, JK intervals had no significant difference (P> 0.05).2.HF group TCM syndrome types and BNP, LVEF, RJ interval values were correlated (P < 0.05), which was the strongest correlation with BNP (r=0.647, P< 0.01). With the change ofTCM syndrome types of chronic heart failure Qi and yin deficiency, Qi deficiency and blood stasis, heart and kidney yang deficiency, Yang deficiency and water flowing, BNP, RJ interval value increased gradually and LVEF values showed a gradual decrease trend (P< 0.05).3.There were significant differences in the BNP value between different TCM Syndrome Types in HF group (P<0.05), and the difference was statistically significant in each TCM Syndrome Types of BNP value. (P< 0.05)4. There were significant differences. (P< 0.05)HF group of different TCM syndrome types of LVEF, Qi and yin deficiency and yang deficiency of heart and kidney, yang deficiency and water flowing of BNP compared with Qi deficiency and blood stasis, yang deficiency of heart and kidney, yang deficiency and water flowing of BNP values compared the differences were statistically significant (P< 0.05) Values as compared to that of heart and kidney yang deficiency and yang deficiency and water flowing of BNP. Compared with the BNP value of Qi Yin deficiency syndrome and Qi deficiency and blood stasis syndrome, the difference was not statistically significant (P> 0.05).5. There was significant difference in RJ interval between different TCM Syndrome Types in heart failure group (P< 0.05), and the difference was statistically significant in each TCM Syndrome Types of RJ interval. (P< 0.05)6.HF group classification of cardiac function between LVEF had significant difference (P < 0.05) and NYHA Ⅱ and NYHA Ⅲ, Ⅳ LVEF compared to NYHA Ⅲ and NYHA Ⅰ, Ⅳ LVEF compared the differences were statistically significant (P< 0.05). The difference was not statistically significant (P> 0.05) compared with the LVEF of NYHA II and I.7.HF group classification of cardiac function between BNP values had significant difference (P< 0.05) and NYHA Ⅱ, Ⅲ and Ⅳ BNP compared to NYHA Ⅲ、Ⅰ, NYHA IV BNP compared the differences were statistically significant (P< 0.05). The difference was not statistically significant (P> 0.05) compared with the BNP value of NYHA Ⅱ and Ⅰ.8.There were significant differences (P< 0.05). Heart failure group classification of cardiac function between RJ interval value and NYHA Ⅱ,Ⅲ and Ⅳ RJ interval value compared to the NYHA Ⅲ, Ⅰ,NYHA Ⅳ RJ interval compared the differences were statistically significant (P< 0.05). There was no significant difference between NYHA 11,1 in the RJ interval (P> 0.05).Conclusion:1.There was a significant difference between BNP, LVEF and RJ interval between HF group and non HF group. Compared with other BCG indexes, the applying of RJ interval to evaluate the changes of cardiac systolic function is feasible.2.BNP, LVEF and RJ interval were all able to indirectly reflect the severity and prognosis of CHF.3.There is a correlation between BNP, LVEF, RJ interval and chronic heart failure TCM syndrome types, which can provide a useful objective quantitative basis for TCM differentiating types. |
PDF Full Text Request