Investigation On TCM Syndromes Distribution And Related Factors In Central Heart Syndrome Of Heart Failure Patients

Background:Cardiorenal syndrome (CRS) is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. CRS has high morbidity and mortality rates, especially in older persons. Interactions between the heart and the kidneys are increasingly acknowledged among both cardiologists and nephrologists. Cardiovascular disease (CVD) is a major threat to patients with chronic kidney disease (CKD), while renal dysfunction is prevalent in patients with cardiac disease and is a significant predictor of prognosis in cardiac patients. CVD and CKD share many risk factors. Hypertension, diabetes mellitus, dyslipidemia, smoking are among the classical risk factors for CVD and are all associated with the development of CKD. Limited information exists regarding early markers for the development of CRS. The identification of predisposing trigger factors, particularly in the elderly, plays a key role in reducing morbidity and mortality. An early recognition can be useful to optimize therapy, encourage a multidisciplinary approach and prevent complications.The treatments of HF and CKD have accumulated rich experience in traditional Chinese medicine(TCM). But TCM syndrome of CRS was not been well described. So the study on the distribution of TCM syndrome and the related factors of CRS is necessary.Objective:To discuss the distribution of TCM syndrome and the related factors of CRS in HF patients and to prevent the occurrence of CRS.Methods:1.This research was included 106 patients hospitalized with HF from cardiology department of Dongfang Hospital from September 2014 through January 2015. A total of 106 HF hospitalizations included 69 males and 37 females, with an average age of 73.46±12.15 years.2.According to eGFR, all Patients which were included in this study were divided into two groups:non-CRS group (eGFR>90ml/min) and CRS group (eGFR<90ml/min). Clinical data were analyzed including general case, medical history, clinical manifestation, laboratory results, echocardiogram results, TCM symptoms.3.Finishing questionnaire data were collated.4.The data were entered into SPSS 20.0 statistical software for statistical analysis. The risk factors, cardiac function, and the distribution of TCM symptoms were compared among the 2 groups.Results:1.A total of 106 HF patients were enrolled in the present study, including 69 males (covered 65.1%) and 37 females(covered 34.9%), with an average age of 73.46±12.15 years. According to eGFR, there are 44 patients with normal renal function (covered 41.5%) and 62 patients with renal dysfunction were (covered 58.5%). Between the two groups, difference in age, hypertension, is statistically significant (P<0.05).2.Comparison of objective indicators:Difference between the two groups in NT-proBNP is statistically significant(P<0.05).3.It is showed by the frequency number analysis that in the no-CRS group, the mostly TCM syndromes is obstruction of Qi deficiency and blood stasis syndrome (covered 34.1%), deficiency of both qi and yin syndrome (covered 25.0%), the lung by phlegm and fluid syndrome (covered 25.0%). In the CRS group, however, the lung by phlegm and fluid syndrome is a mostly Chinese medicine syndrome (covered 29.0%), and next are Qi deficiency and blood stasis syndrome (covered 19.4%). By the analysis of statistics, it shows that the distribution of TCM syndromes was no significant difference in two group(P>0.05). Patients in two groups showed similar distribution of TCM syndromes. Conclusion:1.The mostly TCM syndrome type in the CRS patients is obstruction of the lung by phlegm and fluid syndrome and the distribution of TCM syndromes was no significant difference in two group.2.CRS is associated with higher age.3.The prevalence of hypertension was higher in CRS patients.4..The level of NT-proBNP was higher in CRS patients.