| Objective: The aim of this study was to investigate the distribution of TCM symptoms and cardiac function-related indicators in patients with chronic heart failure with different ejection fractions,in order to gain a deeper understanding of the distribution pattern,characteristics and clinical features of TCM symptoms in patients with different types of heart failure,so as to provide a scientific theoretical basis for the prevention,diagnosis and treatment of different types of heart failure by combining Chinese and Western medicine.Methods: 488 patients who were hospitalized in the Department of Cardiology of the Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine and the First Affiliated Hospital of Guangxi University of Chinese medicine and diagnosed with HFr EF,HFmr EF,and HFp EF during the period from January 2020 to December 2021 were selected(173 patients in the HFr EF group,83 patients in the HFmr EF group,and 232 patients in the HFp EF group).The general data of patients,primary causes of heart failure,cardiac function-related indexes(NYHA cardiac function classification,BNP,LVESD,LVEDD,IVST,LVEF)and TCM symptoms were obtained and entered into a Microsoft Excel 2019 table,and statistical analysis of data was performed using statistical software to analyze the data of the HEr EF group,HFmr EF group,and The distribution of TCM symptoms,symptom characteristics and cardiac function markers and other related factors of patients in the HEp EF group were studied.Results:1.The HFp EF group had the highest number of patients(47.54% of the total),followed by the HFr EF group(35.45% of the total),and the HFmr EF group had the least(17.01% of the total).Chronic heart failure was most common in HFp EF,which is in accordance with the current trend of epidemiological statistics.2.Different genders showed highly significant differences for different heart failure types.Among all patients with chronic heart failure,there were more male patients(59.42% of the total number)than female;patients in the HFr EF and HFmr EF groups were more male than female,and the proportion of males in the HFr EF group was the highest among all groups(44.14% of the same group);patients in the HFp EF group were mainly female,and the proportion of females was the highest among the three groups(62.12% of the same group).3.The different heart failure types showed highly significant differences for all age groups.Among all patients with chronic heart failure,the largest number of heart failure patients were in the age groups of 70-79 years and >80 years,accounting for 27.05% and 31.35% of the total number of patients,respectively;among patients in the HFr EF and HFmr EF groups,the largest number of heart failure patients were in the age group of 70-79 years,while the largest number of patients in the HFp EF group were in the age group of >80 years.With increasing age,the proportion of patients in the same age group gradually decreased in the HFr EF group and increased in the HFp EF group,while the number of patients in the HFmr EF group did not change too significantly in each age group.the mean age of patients in the HFr EF group was the lowest among the three groups,while the mean age in the HFp EF group was the highest among the three groups.4.In the HFrEF group,coronary heart disease was the most frequentprimary cause,followed by hypertension and dilated cardiomyopathy,etc.In the HFmr EF group,similar to the HFr EF group,the top three primary causes were coronary heart disease,hypertension,and dilated cardiomyopathy,in that order,while in the HFp EF group,hypertension was the most frequent primary cause,followed by coronary heart disease,heart valve disease,and dilated cardiomyopathy,etc.In the HFmr EF group,the top three primary causes were coronary heart disease,hypertension,and dilated cardiomyopathy,in that order.5.In the HFrEF group,patients with NYHA grade III and IV were mainly in the end stage of heart failure;in the HFp EF group,cardiac function was mainly in grade II and III,in the early to middle stage of heart failure.the proportion of the HFr EF group,HFmr EF group and HFp EF group in cardiac function grade II and III increased from left to right,and decreased in cardiac function grade IV.6.In the HFrEF group and HFp EF group,the most patients had syndrome of qi deficiency of heart and lung,and in the HFmr EF group,the most patients had deficiency of both qi and yin;while in all patients with chronic heart failure,the most patients had syndrome of qi deficiency of heart and lung,followed by syndrome of blood stasis due to qi deficiency,deficiency of both qi and yin,syndrome of turbid phlegm obstructing lung,heart-kidney Yang deficiency,and syndrome of water overflowing due to yang deficiency.The TCM symptoms in patients with chronic heart failure gradually changed from heart function class II with syndrome of qi deficiency of heart and lung to heart function class IV with heart-kidney Yang deficiency.7.With the NYHA classification from II to IV,BNP levels also ranged from low to high,and BNP levels were positively correlated with NYHA classification;BNP levels in the HFr EF group were the highest among thethree groups,the HFp EF group was the lowest,and the HFmr EF group was in between,which indicated above that BNP levels were closely related to cardiac function.Among all the TCM symptoms,BNP concentration was the lowest in syndrome of blood stasis due to qi deficiency,followed by syndrome of qi deficiency of heart and lung,and the highest in syndrome of water overflowing due to yang deficiency,which showed that BNP levels increased with the aggravation of heart failure,and the TCM symptoms of patients gradually changed from syndrome of blood stasis due to qi deficiency to syndrome of water overflowing due to yang deficienc.8.In the study of correlation between different types of chronic heart failure patients and echocardiographic indices,LVESD,LVEDD,and LVEF were found to be statistically significant,and IVST was not statistically significant.LVESD and LVEDD indexes in the HFr EF group were the highest among the three groups,while LVEF indexes were the lowest among the three groups;patients in the HFp EF group had the lowest LVESD and LVEDD indexes among the three groups and Patients in the HFp EF group had the lowest LVESD and LVEDD indexes and the highest LVEF indexes among the three groups;patients in the HFmr EF group were in between.In the classification of cardiac function in patients with chronic heart failure,LVESD and LVEDD indexes were the lowest in cardiac function class II and the highest in class IV.The above indicates that the poorer the cardiac function,the lower the ejection fraction and the more severe the degree of LV dilatation.Conclusion(s): 1.The patients in the HFrEF group had the most TCM symptoms with syndrome of qi deficiency of heart and lung;cardiac function grading was mainly grade III and IV;BNP,LVESD,and LVEDD were the highest among the three groups.2.Patients in the HFmr EF group had the most Chinese medical symptoms with deficiency of both qi and yin;cardiacfunction grading was mainly grade III and IV;BNP,LVESD,and LVEDD values in the HFmr EF group were between the HFr EF and HFp EF groups.3.Patients in the HFp EF group had the most Chinese medical symptoms with syndrome of qi deficiency of heart and lung;cardiac function grading was mainly grade II and III;BNP,LVESD,and LVEDD indexes were the lowest among the three groups.4.In this study,it was found that as LVEF indexes decreased,cardiac function decreased,BNP,LVESD,and LVEDD indexes increased,and the type of ejection fraction heart failure gradually changed,and the TCM symptoms in all three groups of heart failure patients eventually evolved into syndrome of water overflowing due to yang deficiency.Therefore,the above findings suggest that the TCM syndromes and cardiac function-related indexes of different types of chronic heart failure patients can,to a certain extent,provide scientific theoretical basis for the prevention,diagnosis and treatment of different types of heart failure by combining Chinese and Western medicine. |
PDF Full Text Request