Clinical Study On Relationship Between Syndrome Differentiation Of TCM And Plasma Brain Natriuretic Peptide (BNP), Plasma Tumor Necrosis Factor-Alpha (TNF-α), Interleukin-6 (IL-6), High Sensitive C-reactive Protein (hs-CRP) And Doppler Echocardiography I

Objective: To study the relationship among syndrome differentiation of TCM and Plasma Brain Natriuretic Peptide(BNP),Plasma tumor necrosis factor-alpha (TNF-α), interleukin-6(IL-6),high sensitive-C-reactive protein(hs-CRP) and Doppler Echocardio- graphy in the chronic heart failure (CHF),which supplies objective index for microcosmic syndrome differentiation of TCM in CHF.Methods: 88 patients with CHF were selected and classified into qi deficiency of both heart and Lung syndrome(CQDHLS), deficiency of both qi and yin syndrome(DQYS), qi-deficiency and blood-stasis syndrome(QDBSS), yang deficiency of both heart and kidney syndrome(YDHKS) and fluid retention due to Yang-deficiency syndrome(FRYDS) according to syndrome differentiation classified in TCM, and 15 cases of healthy people were selected as the normal control group(NCG). The 5 different types of TCM of CHF were compared with each other by BNP, TNF-α, hs-CRP, IL-6and Doppler Echocar- diography, and then were compared with the normal control group, for observing the change of index to study the relationship.The results:⑴Comparison of the five groups'BNP: the serum level of BNP of 5 groups was as follows: FRYDS > YDHKS > QDBSS > CQDHLS and DQYS > NCG. the level of BNP in the five types was significantly higher than that in NCG (P<0.01); the level of BNP of FRYDS was significantly higher than that in the other three types (P<0.01); the level of BNP of YDHKS was significantly higher than that of QDBSS, CQDHLS and DQYS (P<0.01); the level of BNP of the QDBSS was significantly higher than that of CQDHLS and DQYS (P<0.01); the difference of BNP between CQDHLS and DQYS was not significant(P>0.05).⑵Comparison of the five groups'TNF-α: the serum level of TNF-αof 5 groups was as follows: FRYDS>YDHKS>QDBSS, DQYS > CQDHLS, NCG.. In addition to CQDHLS, the level of TNF-αin the other four types was significantly higher than that in NCG (P<0.01); the level of TNF-αof FRYDS was significantly higher than that in the other four types (P<0.01); the level of TNF-αof YDHKS was significantly higher than that of DQYS and CQDHLS (P<0.01); the level of TNF-αof YDHKS was higher than that of QDBSS (P<0.05); the level of TNF-αbothQDBSS and DQYS were significantly higher than that of CQDHLS (P<0.01). the difference of TNF-αbetween QDBSS and DQYS was not significant(P>0.05).⑶Comparison of the five groups'hs-CRP: the serum level of hs-CRPof 5 groups was as follows: FRYDS> YDHKS> QDBSS> CQDHLS, DQYS > NCG. the level of hs-CRP in the five types was significantly higher than that in NCG (P<0.01); the level of hs-CRP of FRYDS was significantly higher than that in the other three types (P<0.01); the level of hs-CRP of YDHKS was significantly higher than that of QDBSS, CQDHLS and DQYS (P<0.01); the level of hs-CRP of QDBSS was significantly higher than that of CQDHLS and DQYS (P<0.01); the difference of hs-CRP between CQDHLS and DQYS was not significant(P>0.05).⑷Comparison of the five groups'IL-6:the serum level of IL-6 of 5 groups was as follows: FRYDS> YDHKS> QDBSS>DQYS> CQDHLS > NCG. the level of IL-6 in the five types was significantly higher than that in NCG (P<0.01); the level of IL-6 of FRYDS was significantly higher than that in the other three types (P<0.01); the level of IL-6 of YDHKS was significantly higher than that of QDBSS, DQYS and CQDHLS (P<0.01); the level of IL-6 of QDBSS was significantly higher than that of DQYS and CQDHLS (P<0.01); the difference of IL-6 of DQYS and CQDHLS was significant(P<0.01).⑸Comparison of the five groups'Doppler echocardiography (left ventricular end-diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF)): ①the LVEDV of 5 groups was as follows: FRYDS > YDHKS > QDBSS > DQYS, CQDHLS and NCG.. the level of LVEDV in FRYDS, YDHKS and QDBSS was significantly higher than that in NCG (P<0.01); the LVEDV of FRYDS was significantly higher than that in the other types (P<0.01); the LVEDV of YDHKS was significantly higher than that QDBSS, DQYS and CQDHLS (P<0.01); the LVEDV of the QDBSS was significantly higher than that DQYS and CQDHLS (P<0.01); the LVEDV of DQYS and CQDHLS was not significantly higher than that NCG (P>0.05).②Comparison of the five groups'LVESV:the serum level of LVESV of 5 groups was as follows: FRYDS > YDHKS > QDBSS, DQYS, CQDHLS > NCG.. the LVESV in the other five types was significantly higher than that in NCG (P<0.01); the LVESV of FRYDS was significantly higher than that in the other types (P<0.01); the LVESV of YDHKS was significantly higher than that QDBSS, DQYS and CQDHLS (P<0.01); the LVESV of QDBSS, DQYS and CQDHLS was not significant P>0.05).③Comparison of the five groups'LVEF: the serum level of LVEF of 5 groups was as follows: FRYDS < YDHKS< QDBSS, DQYS, CQDHLS< NCG.. the level of LVEF in the other five types was significantly lower than that in NCG (P<0.01); the level of LVEF of FRYDS was significantly lower than that in the other types (P<0.01); the level of LVEF of YDHKS was significantly lower than that QDBSS, DQYS and CQDHLS (P<0.01); the level of LVEF of QDBSS, DQYS and CQDHLS was not significant(P>0.05).Conclusion:⑴The relationship between syndrome differentiation of TCM and BNP, TNF-α, hs-CRP, IL-6 with CHF is clear. They may offer reference to syndrome differentiation of TCM of CHF.⑵As an important examination technique of CHF, the difference of the parameters of Doppler Echocardiography among the five types is significant, Doppler Echocardiography may become supplementary means of syndrome differentiation of TCM of CHF.