| Objective:The clinical data of elderly patients with coronary heart failure over 80 years old,70-80 years old and 60-69 years old were analyzed retrospectively,and the differences of clinical characteristics of elderly patients with coronary heart failure in different age groups were summarized.the relevant indexes affecting the prognosis of elderly patients and TCM diagnosis and treatment were revealed,so as to improve the curative effect of clinical diagnosis and treatment.Methods: From January 2018 to April 2021,according to different age groups,stratified sampling was used to select the relevant data of elderly patients with coronary heart disease and heart failure aged over 80,70-80 and 60-69 years old,50 in each age group.The correlation analysis of TCM syndrome type,inducement of disease,course of disease,nutritional index,cardiac function index,blood routine index,renal function index,liver function index,frequency of use of traditional Chinese medicine and combination network diagram of drug pairs were analyzed.Results: 1.The constituent ratios of TCM syndrome types of heart failure in elderly patients with coronary heart disease in different ages were analyzed,P < 0.05,and there was statistical difference.According to the comparison of TCM syndrome types,it is found that the constituent ratio of qi-yin deficiency and lungheat type in the more than 80-year-old group is higher than that in the other two groups,although it does not reach statistical significance,but this trend is noteworthy.Because it is found that infection is the inducement of hospitalization in the more than 80-year-old group,while the constituent ratio of qi deficiency and blood stasis and phlegm drinking syndrome in the more than 80-year-old group is less than that in the other two groups,which is statistically significant.It shows that the pathogenesis of heart failure in 60-80 years old patients with coronary heart disease is more concentrated in cardiovascular disease itself.2.The course of heart failure in elderly patients with coronary heart disease in different age groups was analyzed(P <0.05).The course of elderly patients with coronary heart disease and heart failure in the more than 80-year-old group was significantly longer than that in the other two groups.3.The western medicine clinical index items of heart failure in elderly patients with coronary heart disease in different age groups were analyzed.The values of albumin(ALB),prealbumin(PAB),EF and hemoglobin(HB)in the more than 80 years old group were lower than those in the other two groups,while NT-pro BNP,urea nitrogen(BUN)and serum creatinine(Cr)increased.All of them were statistically significant.4.According to the statistics of the frequency and network combination map of traditional Chinese medicine in elderly patients with coronary heart disease and heart failure in different age groups,the top 10 traditional Chinese medicines in the heart failure group of 60-69-year-old patients with coronary heart disease are Poria cocos,licorice,Radix Astragali,Bupleurum,Chuanxiong,Coptis,Pinellia ternata,raw keel,fried peach kernel and red peony.The traditional Chinese medicine groups with Poria cocos,grilled licorice and Scutellaria baicalensis were obtained under the support degree of 16 and confidence level 0.9.The top 10 drugs in the heart failure group of 70-80-year-old patients with coronary heart disease were Poria cocos,Angelica sinensis,Ligusticum chuanxiong,Trichosanthes,tangerine peel,Radix Astragali,Radix Paeoniae Rubra,Radix Ophiopogonis,Cornus officinalis and Salvia miltiorrhiza.The traditional Chinese medicine group with Angelica sinensis and Poria cocos as the core was obtained under the support degree of12 and confidence level of 0.9.The top 10 drugs in CHD group over 80 years old were licorice,Poria cocos,Ophiopogon japonicus,Radix Astragali,Salvia miltiorrhiza,fried peach kernel,Angelica sinensis,Rhizoma Chuanxiong,Rhizoma Anemarrhenae and Cornus officinalis.Under the support degree 9 and confidence 0.9,the traditional Chinese medicine group with Salvia miltiorrhiza,Ophiopogon japonicus,Poria cocos and Radix Astragali as the core was obtained.Conclusion: The TCM pathogenesis of heart failure patients with coronary heart disease in more than 80 years old group is not only concerned about blood stasis and phlegm drink,but also pay attention to the existence of lung heat injuring yin;elderly patients with coronary heart failure in more than 80 years old group are more likely to develop anemia and malnutrition;elderly patients with coronary heart failure in more than 80 years old group are more likely to develop renal insufficiency,and the severity of heart failure is more serious.From the medication point of view,the core drugs of the three groups are Poria cocos,indicating that the elderly patients with coronary heart failure should first be diuretic,and the core drugs of the elderly patients with coronary heart disease and heart failure in the more than 80-year-old group are Radix Astragali and Ophiopogon,which is different from the other two groups.it shows that this part of the elderly pay special attention to replenishing qi and nourishing yin. |
PDF Full Text Request