| Coronary Heart Disease (CHD) is seriously harmful to human health as a common cardiovascular disease. Diastolic Heart Failure (DHF), a type of Heart Failure(HF), which is definited as the impairment of heart active relaxation and decrease of filling or dilatation function with normal left ventricular systolic function. Owing to the depression of ventricular lusitropic and compliance, the filling of left ventricle descend and the filling pressures ascend, which lead to the clinic syndrome of pulmonary circulation or systemic circulation congestion. According to the epidemiological survey, over half of the HF cases are DHF. In recently, researches show that the fatality of DHF is similar as Systolic Heart Failure (SHF). In addition, the re-admission rate and complication rate are basically same.However, there has been no agreement about the pathogensis of DHF. Therefore, the diagnosis is still uncertain and the treatment is mainly belonged to empirical therapy. The interventions of multiple international studies are similar with SHF, and the researches have not received expected positive result.There has been rich experience in treatment of DHF by Traditional Chinese Medicine and achieved satisfactory effect to improve symptoms and quality of life of patients. Therefore, Traditional Chinese Medicine has wide prospect on treatment of DHF.Objec tive:1. To study the clinical value of ultrasonic cardiography indexes in DHF with qi deficiency and blood stasis syndrome with Factor-Analysis, in order to clear and enhance the precision of diagnosis by ultrasonic cardiography.2. Based on the Western Medicine therapy, observe the effect on ultrasonic cardiography indexes and the influence of quality of life with Yiqixiefei formula on curing qi deficiency and blood stasis syndrome of DHF patients by supplement qi, invigorating blood and promoting dieresis method. Therefore survey the advantages of Yiqixiefei formula on curing DHF with qi deficiency and blood stasis syndrome and evaluate the efficacy of Traditional Chinese Medicine on curing DHF.Methods:The objects of the research are60in-patients who diagnosed definitely with DHF of qi deficiency and blood stasis syndrome in the Dongfang Hospital from June,2011to Dec,2012.Study Ⅰ:60patients were examined by routine ultrasonic cardiography, mitral valve flow pattern and tissue Doppler imaging of mitral valve annular by the constant ultrasonic cardiography doctor. Record the observation indexs of ultrasonic cardiography including LA, LVd, LVs, IVSd, IVSs, LVPWd, LVPWs, E, Λ, Ea, Λa, E/Λ, Ea/Λa, E/Ea, DT and IVRT. Choose SPSS17.0statistical software for statistical analysis, use Factor-Analysis to analyze the indexes, and to study the underlying law between the indexes of ultrasonic cardiography and DHF with qi deficiency and blood stasis syndrome.Study Ⅱ:60patients were randomly divided into the treat men t group and control group. Both groups were given Western Medicine routine therapy, the treatment group was given the Yiqixiefei formula on the basis of Western Medicine for four weeks. Observe the change of the ultrasonic cardiography indexes and CHF-QOL scale scores in two groups. Choose SPSS17.0software for statistical analysis. Measurement data use t-test or non-parametric test. Enumeration date use chi-square test or non-parametric test.Results:Study Ⅰ:1.4common factors (ratio, time, thickness, inner)were extracted from the ultrasonic cardiography indexes, the cumulative contribution rate reached to75.38%. The result of the contribution rate shown that ratio factor (E/Λ, Ea/Λa, E/Ea) Mime factor (DT, IVRT)> thickness factor (IVSd, IVSs, LVPWd, LVPWs)>inner diameter factor (LA, LVd, LVs).2. According to factor loading matrix, the correlation coefficient of the rat io factor and E/Ea. Ea/Λa, E/Ais E/Ea>Ea/Aa>E/A, which shown that E/Ea had significant related to the ratio factor while E/A had no significant effect on it.Study Ⅱ:Based on the Western Medicine therapy, the t rea tment group were given the Yiqixiefei formula:1. The improvement of ultrasonic c a r d i o g r a p h y indexes:Both the treatment group and the control group shown significant difference in E, Λ, E/Λ, Ea/Λa, E/Ea, DT, IVRT, Ea and Aa between before and after treatment (P<0.05). The improvement of E, Λ, E/Λ, Ea/Λa, E/Ea, DT and IVRT of the treatment group was superior to the control group, which had significantly difference (P<0.05). And there was no significant difference of Ea and Λa between the two groups.2. The improvement of the evaluation of quality of life:Compare with the improvement of CHF-QOL scale scores, both the two groups shown significant difference between before and after treatment (P<0.05). The improvement of CHF-QOL scale scores of the treatment group was superior to the control group, which had significantly difference (P<0.05)Conclusion:1. The ratio factor (E/Λ, Ea/Λa, E/Ea) are indicated to be more closely related to DHF with qi deficiency and blood stasis syndrome than the other indicatrixes. E/Ea and Ea/Λa play important roles for the diagnosis of DHF with qi deficiency and blood stasis syndrome.2. Based on the Western Medicine therapy, Yiqixiefei formula has affirmatory curative effect in the treatment of qi deficiency and blood stasis syndrome of DHF. The method could improve the diastolic function as well as the quality of life of patients. |
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