Study On The Diagnostic Scale Of Integrated Traditional Chinese And Western Medicine For Chronic Heart Failure With Heart-Yang Deficiency Syndrome

Objective:To explore and establish a diagnostic scale with combination of the western medicine and traditional chinese medicine for chronic heart failure classified as heart-yang deficiency.Methods:1.The modern literature were collected and sorted out from many literature databases,the symptoms,signs and objective indicators related to the diagnosis of chronic heart failure classified as heart-yang deficiency were excavated,and the diagnostic items were standardized and sorted out to form the diagnostic item pool of chronic heart failure classified as heart-yang deficiency.2.Based on the results of literature research,a questionnaire was formulated and Delphi method was used to judge the importance of diagnostic items for the diagnosis of chronic heart failure classified as heart-yang deficiency.The diagnostic items were screened from the three indicators through two rounds of Delphi method expert consultation questionnaire,such as mean,full score ratio and coefficient of variation.3.Combined with medical records of ancient famous doctors,the data are analyzed statistically,Fisher’s weighted modeling method was used to weight the diagnostic items,and ROC curve was used to determine the diagnostic threshold.Finally,a draft involved in diagnostic scale with combination of the western medicine and traditional chinese medicine for diagnosis of chronic heart failure was drawn up.Results:1.Through literature research,51 items of symptoms and signs related to the diagnosis of chronic heart failure classified as heart-yang deficiency as well as 24 items of objective indicators were screened out.2.Through two rounds of Delphi expert consultation,a total of 12 items meeting the standard were finally selected,namely,8 symptoms including chest tightness,chest pain,palpitation,shortness of breath,fatigue,aversion to cold and cold limbs as well as favor to warmth,pallid complexion,plump tongue with tooth prints,4 objective indicators including physical sign items and cardiac ejection fractions,cardiac function grading(3 grade),cardiac function grading(4 grade)and NT-proBNP/BNP.3.By including medical records of ancient famous doctors and applying mathematical analysis,the diagnostic scale with combination of the western medicine and traditional chinese medicine for chronic heart failure classified as heart-yang deficiency was drawn up: One of the main indicators that accorded with objective indicators: ejection fraction ≤ 50%,or two secondary indicators: NT-proBNP ≥ 125 ng/L or BNP ≥ 35 ng/L,NYHA cardiac function grading(3 grade or above),combined with the scale((palpitation × 6.5)+(chest tightness × 7)+(chest pain × 2)+(fatigue× 2)+(aversion to cold and cold limbs as well as favor to warmth × 12)+(pallid complexion× 8)+(plump tongue with tooth prints × 9)),chronic heart failure classified as heart-yang deficiency could be diagnosed if the score was more than 25 points.Conclusion: Based on the literature research,the excavated diagnostic items related to chronic heart failure classified as heart-yang deficiency,the collected expert opinions through Delphi method expert consultation questionnaire,the screened items,the included medical records of ancient famous doctors and the applied mathematical analysis method,an objective draft involved in diagnostic scale with combination of the western medicine and traditional chinese medicine for chronic heart failure was formulated.