| Objective:Through collecting Chinese traditional Chinese medicine academy of sciences hospital gate ZongHeKe2012.5to2013.2period of chronic congestive heart failure (hereinafter referred to as chronic heart failure hospitalization patients’general information, TCM syndrome characteristics, cardiac function related parameters, such as analysis of traditional Chinese medicine often witness type distribution patterns in chronic heart failure and its relationship with cardiac function parameters. This study will be noninvasive hemodynamic monitoring index and cardiac ultrasound LVEF and combination of plasma BNP level, to guide the diagnosis and treatment of chronic heart failure, thereby revealing the noninvasive hemodynamic monitoring in the patients with chronic heart failure clinical significance. And selected from patients with more than40cases, Yang jiayi temperature relatively pure western medicine and western medicine, invigorate the circulation of the water in liquid form the curative effect of treatment of chronic heart failure, and to analyze its possible mechanism.Methods:(1) To collect246cases of patients with chronic heart failure, at the same time to collect the TCM symptoms, noninvasive hemodynamic, BNP and heart colour to exceed examination results, the evolution law of TCM syndrome of chronic heart failure distribution and the correlation is analyzed, and the noninvasive hemodynamic index and plasma b-type natriuretic peptide and left ventricular ejection fraction correlation analysis between indicators.40cases (2) from the selection of the above cases, were randomly divided into treatment group and control group, control group with routine western medicine treatment, the treatment group on the basis of western medicine therapy plus use-trust temperature Yang, invigorate the circulation of the water in liquid form (astragalus, codonopsis, radix ophiopogonis, schisandra fruit, cassia twig, poria cocos, plantain seed, atractylodes, salvia miltiorrhiza, Fried almonds, baikal skullcap root, dried tangerine or orange peel, etc.),4weeks treatment, compared two groups of clinical curative effect.Results:(1) TCM syndrome type distribution of chronic heart failure: six card type structure of patients with chronic heart failure than order from big to small is:qi deficiency blood stasis> qi and Yin two=heart and lung qi deficiency syndrome> water pan Yang syndrome> phlegm retention resistance pulmonary=heart kidney Yang deficiency syndrome. Justification of the first hou qi deficiency and qi and Yin deficiency, gradually undermine the sun be the spirit, sun be the spirit deficiency warming fluid and blood, produce water dampness, phlegm retention, blood stasis, such as pathogenic factors, water pan Yang deficiency and phlegm retention resistance in lung card, the pathogenic factors and can continue to damage the sun be the spirit, aggravating heart kidney Yang deficiency syndrome.(2) the distribution of each syndrome type of heart function between statistically significant (P <0.01). Qi deficiency and blood stasis syndrome and phlegm retention resistance pulmonary Ⅲ mostly in cardiac function in patients with grade, water pan card and heart Yang deficiency of kidney Yang deficiency syndrome in patients with cardiac function distribution concentrated in IV level.(3) noninvasive dynamic index of CO, SV, SI decreased obviously as the prompt heart kidney Yang deficiency syndrome and Yang deficiency water pan card a reference; The cardiac output index CO, SV, SI declined as a hint to heart disease and kidney Yang deficiency syndrome and Yang deficiency water pan card the development of a reference. STR and comparing two in each group were statistically significant (P <0.05), prompted partly STR value is chronic heart failure syndrome type transformation and progression is sensitive indicators. STR, TFC, SVR between groups of heart kidney Yang deficiency syndrome and Yang deficiency water flooding license and certificate lung phlegm retention resistance from heart and lung qi deficiency syndrome, qi and Yin deficiency syndrome, qi deficiency blood stasis group increased significantly (P <0.05), it can be significantly higher as STR, TFC, SVR Yang deficiency and phlegm retention of a reference. TFC index according to the results of chronic heart failure in heart function had obvious statistical difference between different levels, tip TFC will be helpful to the diagnosis of chronic heart failure degree index. CO and SV, SI, SVR, heart function index of STR class II and III, level IV is statistically significant, so the CO and SV, SI, SVR, STR markers in disease progression in chronic heart failure has certain implications. Plasma BNP, LVEF, noninvasive hemodynamic index combined, can provide reference basis for early diagnosis and treatment of chronic heart failure.(4) the doctor of traditional Chinese medicine benefit temperature Yang, invigorate the circulation of the water liquid form with conventional western medicine treatment of chronic heart failure compared with pure use western medicine treatment, the index to improve cardiac function in two groups after treatment were statistically significant, but the treatment group improved more obviously. According to the noninvasive hemodynamic monitoring indicators and LVEF and BNP test results, to guide the clinical medication, the curative effect is clear.Conclusion:qi deficiency blood stasis syndrome of chronic heart failure in every other card, the largest proportion of the proportion between the remaining five card type is not very significant difference. Cardiac function indexes with Yang and the syndrome of phlegm retention type, have tended to increase. Noninvasive hcmodynamic monitoring of hemodynamic changes of the patients can be quickly and accurately understand, noninvasive, convenient operation, and timely detection of cardiovascular dysfunction, combined with the BNP and LVEF, adjust the treatment plan, can compensate for the limitations of LVEF and BNP, for early diagnosis and treatment of patients with chronic heart failure has very important clinical significance. Good temperature Yang of traditional Chinese medicine, invigorate the circulation of the water liquid form with conventional western medicine treatment of chronic heart failure than simply use western medicine the effect is more obvious. |
