| PurposeTo investigate the clinical characteristics and risk factors of CHF combined with anemia,and to study the independent risk factors of each TCM evidence in CHF combined with anemia patients,in order to provide some reference basis for future clinical treatment.ResearchUsing retrospective analysis,460 patients with CHF who attended the cardiovascular ward of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from April2020 to October 2021 were selected for the study.Then,they were divided into 206 cases in the CHF combined with anemia group(group A)and 254 cases in the CHF non-anemia group(group B)according to whether anemia occurred.The patients’general conditions,relevant laboratory tests,clinical comorbidities,and symptoms and signs present at the time of admission were collected,and the weights of each evidence factor were calculated according to the evidence factor identification scale provided in Professor Zhu Wenfeng’s"Evidence factor identification",and the patient was judged to have the corresponding evidence factor when the total weight of the evidence factor was≥[14]70.An Excel database was created to enter the case information,and then SPSS 23.0 statistical software was applied to analyze the data statistically.Results1.Comparison of general conditions between group A and group B:Among 460 patients with CHF who met the inclusion criteria,206 patients(44.8%)in group A had an average age of 73.68 years,53%were female,the average heart rate was 77.34 beats/min,the average diastolic blood pressure was 78.88 mm Hg,and 36.4%were smokers;254 patients(55.2%)in group B had an average age of The mean age of 254 patients(55.2%)in group B was 70.76years,43%were female,the mean heart rate was 82.18 beats/min,the mean diastolic blood pressure was 83.80 mm Hg,and the number of smokers was 46.1%.group A patients showed the characteristics of advanced age,high proportion of female,low number of smokers,and low heart rate and diastolic blood pressure,and the difference was statistically significant(P<0.05).2.Comparison of relevant laboratory tests between group A and group B:In this study,compared with group B,group A showed higher levels of red blood cells(RBC),hemoglobin(HGB),red blood cell pressure(HCT),mean red blood cell volume(MCV),mean red blood cell hemoglobin content(MCH),mean red blood cell hemoglobin concentration(MCHC),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),uric acid(UA),estimated glomerular filtration rate(GFR),and alanine aminotransferase(ALT)levels were lower,and the differences were statistically significant(P<0.05).3.Comparison of combined diseases in group A and group B:The top three combined diseases in group A were hypertension in 162 cases(78.6%),coronary artery disease in 139cases(67.5%),and arrhythmia in 110 cases(53.4%),in that order.In this study,compared with group B,group A had higher prevalence of hypertension,pulmonary disease,renal disease,and pulmonary hypertension and lower prevalence of arrhythmia,and the difference was statistically significant(P<0.05).4.Comparison of evidence in group A and group B:In this study,the distribution of evidence in group A was as follows:heart 122 cases(59.2%)>lung 75 cases(36.4%)>spleen32 cases(15.5%)>kidney 14 cases(6.8%)>liver 12 cases(5.8%);disease evidence was as follows:qi deficiency 112 cases(54.4%)>phlegm 106 cases(51.5%)>yang deficiency 62cases(30.1%)>yin deficiency The pathological evidence elements in order were Qi deficiency112 cases(54.4%)>Phlegm drink 106 cases(51.5%)>Yang deficiency 62 cases(30.1%)>Yin deficiency 50 cases(24.3%)>Blood deficiency 49 cases(23.8%)>Qi stagnation 12 cases(5.8%)>Blood stasis 8 cases(3.9%);compared with group B,group A had more blood deficiency evidence elements,and the difference was statistically significant(P<0.05).5.Correlation analysis of TCM evidence elements and influencing factors in group A:the independent influencing factors of heart evidence elements were age,total bilirubin(TB),indirect bilirubin(IB),and prevalence of lung diseases,among which age,IB,and prevalence of lung diseases were negatively correlated with heart evidence elements,and TB was positively correlated with heart evidence elements,and the difference was statistically significant(P<0.05).The independent influencing factors of pulmonary evidence were age,B-type natriuretic peptide(BNP),platelet(PLT),and Cl~-concentration,among which Cl~-concentration was negatively correlated with pulmonary evidence,and age,BNP,and PLT were positively correlated with pulmonary evidence,and the difference was statistically significant(P<0.05).The independent influencing factors of spleen evidence were admission systolic blood pressure(SBP),hemoglobin(HGB),red blood cell pressure(HCT),and mean red blood cell hemoglobin concentration(MCHC),among which SBP and HGB were negatively correlated with spleen evidence,and HCT and MCHC were positively correlated with spleen evidence,with statistically significant differences(P<0.05).The independent influencing factors of sputum-drinking evidence factor were admission heart rate(HR),Na+concentration,and albumin(ALB),among which Na+concentration and ALB were negatively correlated with sputum-drinking evidence factor,and HR was positively correlated with sputum-drinking evidence factor,and the difference was statistically significant(P<0.05).The independent influencing factor of Yang deficiency evidence factor was mean red blood cell volume(MCV),and MCV was negatively correlated with Yang deficiency evidence factor,and the difference was statistically significant(P<0.05).Conclusion1.The prevalence of anemia in CHF combined with anemia was higher,and showed characteristics of higher age,higher proportion of women,less smoking,lower heart rate and diastolic blood pressure compared with the non-anemic group,and the anemia-related indexes,blood lipids and renal function indexes were more likely to decrease in patients with CHF combined with anemia.2.Among the pathological evidence of Qi deficiency,Yang deficiency,Yin deficiency,blood deficiency,Qi stagnation,sputum-drinking and blood stasis,the deficiency evidence of Qi deficiency and Yang deficiency was dominant,and the actual evidence of sputum-drinking was dominant.Compared with the non-anemic group,there were more blood deficiency evidence elements in the anemic group.It is suggested that the factors affecting anemia have certain similarities in both Western and Chinese medicine.3.CHF combined with anemia has more combined diseases,mainly hypertension,coronary heart disease and arrhythmia.The prevalence of hypertension was also higher in the anemic group compared with the non-anemic group,suggesting that patients with CHF combined with anemia are more likely to have combined hypertension.4.There were more independent influencing factors of heart,lung and spleen evidence elements and phlegm-drinking evidence elements in the CHF combined with anemia group.It is suggested that the heart,lung and spleen functions are more likely to be impaired in patients with CHF combined with anemia,and the lesions are more complex due to multiple factors;the pathological product of phlegm is more likely to be formed. |
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