Correlation Analysis Of Traditional Chinese Medical Syndrome Elements Of Elderly Chronic Heart Failure With Atrial Fibrillation

Objective: To explore the distribution and combination characteristics of TCM syndrome elements in elderly patients with chronic heart failure complicated with atrial fibrillation by syndrome differentiation,summarize the clinical syndrome differentiation,and try to provide new understanding and more reference for clinical syndrome differentiation and treatment.Methods: With reference to syndrome differentiation,a TCM syndrome differentiation scale was developed in line with the clinical characteristics of elderly patients with chronic heart failure and atrial fibrillation.The inpatients who met the inclusion criteria in the Department of Geriatrics and Cardiology of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2017 to November2022 were selected.The general data,symptoms,signs,laboratory tests and basic diseases of the collected patients were input into the scale,and a database was established.The syndrome factor scores were calculated according to the weights specified in the syndrome differentiation factors,and the syndrome factors were extracted.SPSS 27 software was used for statistical analysis of the data,and the syndrome types were summarized according to the distribution and combination characteristics of high-frequency syndrome factors.Results:1.A total of 183 cases of elderly patients who met the diagnostic criteria and inclusion criteria were collected.Sixteen cases that did not meet the diagnostic threshold of syndrome elements were excluded,and 167 cases were effectively included.2.TCM syndrome elements : A total of 16 TCM syndrome elements were extracted from elderly patients with chronic heart failure and atrial fibrillation.Among them,6syndrome elements of disease location : heart > lung > kidney > spleen > liver > chest diaphragm;there are 10 syndrome elements of disease nature : qi deficiency > yang deficiency > blood stasis > blood deficiency > water retention > yin deficiency > phlegm >dampness > drink > qi stagnation.3.The distribution characteristics of TCM disease location syndrome elements : the distribution of kidney and spleen disease location in different age groups was different(P< 0.05),the distribution of lung,kidney and spleen disease location in different cardiac function grades was different(P < 0.05),and the distribution of kidney and spleen disease location in different types of atrial fibrillation was different(P < 0.05).4.Distribution characteristics of TCM syndrome elements : There were differences in the distribution of blood deficiency and water retention in different age stages(P < 0.05).There were differences in the distribution of Yang deficiency,blood deficiency and water retention in different cardiac function grades(P < 0.05).There were differences in the distribution of water retention and phlegm in different types of atrial fibrillation(P <0.05).5.The distribution of syndromes of chronic heart failure complicated with atrial fibrillation in the elderly is complex and diverse.The main TCM syndromes are : heart qi deficiency and blood stasis syndrome,heart qi and yin deficiency syndrome,heart qi deficiency and yang deficiency and blood stasis syndrome(phlegm and dampness can be seen simultaneously),blood stasis and heart and lung syndrome,qi and yang deficiency,heart and kidney qi and yang deficiency syndrome(blood stasis,yin deficiency and blood deficiency can be seen simultaneously),heart and lung spleen and kidney deficiency,yang deficiency and water flooding syndrome(often accompanied by blood stasis,phlegm and drinking).Conclusion:1.The main disease location of elderly patients with chronic heart failure complicated with atrial fibrillation is in the heart,and it involves the disease location of lung,kidney and spleen.2.With the increase of age,the syndrome elements of disease location evolved from heart and lung to heart,lung,spleen and kidney;with the increase of cardiac function classification from heart → heart and lung → heart,lung,spleen and kidney;with the increase of the frequency and duration of atrial fibrillation,the spleen and kidney are gradually involved.3.Elderly chronic heart failure combined with atrial fibrillation always belongs to deficiency in origin and excess in superficiality,mainly deficiency syndrome,mixed deficiency and excess.Qi deficiency runs through the development of the disease.Yang deficiency,blood stasis,water retention,phlegm,dampness and drinking are all important factors in the occurrence and development of the disease.Blood deficiency also plays an important role in the combined disease.4.Blood deficiency and water retention syndrome elements gradually become prominent with age;yang deficiency,blood deficiency,water stop disease syndrome elements are more serious with the increase of cardiac function classification;water retention and phlegm syndrome elements gradually become prominent with the increase of atrial fibrillation frequency and duration.5.The distribution of syndromes of chronic heart failure complicated with atrial fibrillation in the elderly is complex and diverse.The main TCM syndromes are : heart qi deficiency and blood stasis syndrome,heart qi and yin deficiency syndrome,heart qi deficiency and yang deficiency and blood stasis syndrome(phlegm and dampness can be seen simultaneously),blood stasis and heart and lung syndrome,qi and yang deficiency,heart and kidney qi and yang deficiency syndrome(blood stasis,yin deficiency and blood deficiency can be seen simultaneously),heart and lung spleen and kidney deficiency,yang deficiency and water flooding syndrome(often accompanied by blood stasis,phlegm and drinking).