Chinical Study On Relationship Of TCM Differentiation In Heart Failure With The Change Of Plasma Adrenonmedulling,Endothelin,Nitric Oxide And Hemorheology

ChinicaI StUdy on ReIationship of TCM Differentiation in HeartFailure with the Change of Plasma Adrenonmedulling, Endothelin,Nitric Otide and HemorheologyMajor: Clinic of the Integratcd TraditionalChinese and Western MedicinePostgraduate: Chen MingDirextor: Pro f. Mei-Hua ChenABSTRACTBackground: The imbalance of synthesis and releasing ofadrenonmedulling(AM), endothelin (ET) and nitric oxide (NO) has been imp1icated in the pathogenesesof heart fai1ure (HF), and then due to the change of temorheology.Objective: To investigate the change of AM, ET, NO and Temorheology inpatients with HF. To discuss the relationship between syndrome differentiation ofTCM and the change of AM, ET, NO and Temorheology in patients with HF.Subjects and Methods: 40 patients (26 male and l4 female ) with HF, theaverage age was 55.82 I l3 .2l years (aged 24-76 years ), were abserved,amony theml4 cases in group of the heart function II level, l6 cases in group of the heart fiJnctionIIJ level, and l0 cases in group of heart function IV level. Through the TCMdifferentiation, the 40 patients included 9 with the deficienCy syndrome of heart qi andyin, 8 with the deficiency syndrome of the heart yang and kidney yand, 9 Wth thedeficiency syndrome of qi with b1ood stasis, 8 with the syndrome of edema caused by'deficiency of yang and 6 with the syndrome of the exhaustion of the yang of the heart.At the same tthee, 30 healthy people (l9 male and l l femal ), aged 26-67 years weretaken as the conctrol group. To determine the plasma adrenonmedulling andendothelin by RlA method, the serum nitric okide by reductase nitrate colorimetericmethod, and hemorheology by instrument.Results:l' The leve1 of AM' ET' NO and Hemorheology was significantlyincreased (P<0.0l), but the levels NOmT significanly lowered in patients with1HF compared with the control group (P<0.01).2~ The level of AM, ET and NO was increased with the deteriorating of heart function (P<0. 01) ; the level of NO/ET was lowered with the deteriorating of heart function; but the level of Hemorheology was not obviously changed with the deteriorating of heart function.3 .~ Through the TCM differentiation, the level of AM and ET in the groups with the syndrome of the exhaustion of the yang of the heart and the deficiency syndrome of the heart yang and kidney yand was significantly higher than the group with the deficiency syndrome of heart qi and yin and the deficiency syndrome of qi with blood stasis (P<0.01) ; the level of NO in the group with the syndrome of the exhaustion of the yang of the heart was significantly higher than the group with the deficiency syndrome of heart qi and yin , the deficiency syndrome of qi with blood stasis and the deficiency syndrome of the heart yang and kidney yand (P<0.05) ;but the level of NO! ET in the groups with the deficiency syndrome of the heart yang and kidney yand and the syndrome of the exhaustion of the yang of the heart was significantly lowered than the group with the deficiency syndrome of heart qi and yin and the deficiencysyndrome of qi with blood stasis (P<0.01).4.. The level of Hemorheology in the groups with the deficiency syndrome of qi with blood stasis and the syndrome of the exhaustion of the yang of the heart was significantly higher than other groups.Conclusion :The difference between the syndrome differentiation of TCM and the change of AM, ET, NO and Temorheology provided the experimental diagnostic basis for the study of zheng differentiation-classification in I-IF...