| Objective:The purpose of this study is to explore the correlation between blood stasis syndrome and insulin resistance in different types of chronic heart failure,and to provide direction for improving the level of TCM diagnosis and clinical efficacy of TCM.Methods:One hundred and eighty patients with chronic heart failure were divided into blood stasis group(n=105)and non-blood stasis group(n=75).Then the blood stasis group was divided into qi deficiency and blood stasis group(n=34),qi-yin deficiency and blood stasis group(n=40)and yang-qi deficiency and blood stasis group(n=31).Finally,the blood stasis group was divided into HFpEF group(n=45),HFrEF group(n=36)and HFmrEF group(n=24).The data of sex,age,height,weight,BMI,smoking and drinking history,medication history and basic diseases of the patients were collected,and the related indexes of blood pressure,heart rate,blood lipids,blood glucose and insulin resistance were measured.SPSS 2 6.0 was used for statistical analysis.The differences of basic data and related indexes between blood stasis group and non-blood stasis group were compared,and the relationship between syndrome types of blood stasis group and insulin resistance was analyzed.And the relationship between various types of heart failure and insulin resistance in blood stasis group.Results:1.There was no significant difference in age,sex,height,weight,BMI,heart rate and drinking history between blood stasis group and non-blood stasis group(P>0.05).The history of smoking in the blood stasis group was significantly higher than that in the non-blood stasis group(P<0.05).2.The number of hypertension and old myocardial infarction in blood stasis group was higher than that in non-blood stasis group,and the difference was statistically significant(P<0.05).3.There was no significant difference in cardiac function grade and blood pressure between blood stasis group and non-blood stasis group(P>0.05).4.The levels of TG,TC,LDL-C,FPG,FINS and HbAlc in blood stasis group were higher than those in non-blood stasis group(P<0.05).However,there was no significant difference in HDL-C between the two groups(P>0.05).5.The levels of HOMA-IR,TYG index and TG/HDL were higher and insulin sensitivity index was lower in blood stasis group.Logistic regression analysis showed that TYG index was an independent risk factor for blood stasis syndrome(P<0.05).6.The indexes of FPG,HOMA-IR and TYG in qi-yin deficiency and blood stasis group were higher than those in qi deficiency and blood stasis group and yang-qi deficiency and blood stasis group.ISI of qi-yin deficiency and blood stasis group was significantly lower than that in the other two groups.The HbA1c of qi-yin deficiency and blood stasis group was higher than that of qi deficiency and blood stasis group,and the above differences were statistically significant(P<0.05).7.The FPG,HOMA-IR and TYG index of ejection fraction retention heart failure were higher than those of ejection fraction reduction and intermediate heart failure,and the ISI of ejection fraction retention heart failure was lower than that of the other two groups.In addition,TG/HDL and HbA1c in patients with preserved heart failure were significantly higher than those in patients with reduced ejection fraction(P<0.05).Conclusion:1.Compared with non-blood stasis syndrome,patients with blood stasis syndrome of chronic heart failure have more disorder of glucose and lipid metabolism and more serious insulin resistance.2.The degree of insulin resistance of different syndrome types of chronic heart failure patients with blood stasis syndrome is different,and the insulin resistance of qi-yin deficiency and blood stasis syndrome is more obvious;TYG index is an independent risk factor of blood stasis syndrome.3.The degree of insulin resistance was obvious in patients with heart failure with preserved ejection fraction. |
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