The Retrospectively Analyze About Risk Factors And Treatment Which Were From Hospitalized Patients With Chronic Heart Failure Of 406 Cases

Chronic heart failure(CHF),which is a complex clinical syndrome that caused by any initial myocardial injury,include the vary of cardiac structural or functional change, and further lead to the lower ventricular function of pumping out or filling in the blood. It has gradually become the most important cardiovascular disease of the 21 st century. The mortality is higher, and the 5 years survival rate is similar as the malignant tumor. Someone called the treatment of heart failure as the last of the "battlefield" in the cardiovascular disease. With the rapid development of aging society, the incidence of heart failure increased year by year. According to incomplete statistics,the rate of our nation is about 0.9%,the number is about 4million. So on one hand, we should intensify efforts to the study of pathogenesis and treatment of heart failure, and make the treatment of heart failure window moved forward as far as possible, delay the onset age and progression of heart failure, with minimal input to obtain the biggest benefit. At the same time,we should accord to the characteristics of our country, Strengthen the research of the regional, make heart failure prevention regionalization, rationalization and standardization, adjust the measures to local conditions, reduce differences with guide. Objective:To understand the differenceofhandbooks at home and abroad to obtaining a more safe, effective and economical clinical medication in prevention and delay the process of congestive heart failure, andprovide the epidemiology basis to promoting the quality of living of the congestive heart failure patients, andthen make the prevention and cure of congestive heart failure more localization, rationalization and standardization. Method:The information about 406 casescongestive heart failure patients in department of cardiology of our hospital, including the patient’s agecomposition, gender composition, pathogenesis, dangerous factors andtraditional Chinese medicine and/or Western medicine treatment condition, was recorded by using retrospective analysis. Results:1.Byanalyzing the information of 406 patientswith congestive heart failure, we found that the onset age range from 11 to 95 years, mean age was60.2years, 50.7% of the patient’s age were less than 60 years old(206 cases), 20.9%of the patient’s age were range from 60 to 69 years old, 18.7% of the patient’s age were range from 70 to 79 years old, and about 9.6%patient’s age were more than 80 years old; the average onset age of female(about 62.8±14.3 years old) was larger than male’s(about 62.8±14.3 years old); the averageage of patient with cardiac functionⅡ, Ⅲand Ⅳwere57.3±14.6, 60.6±14.3 and 62.0±15.8, individually.2.The male to female ratio in 406 patients was about 1:1, 204 male patients(~ 50.2%) and 202 female patients(~50.2%).3.The New York Heart Association(NYHA) classⅠwas the compensated stage of cardiac function, and the patients doesn’t need hospital treatment; there were 96 patients(~23.6%) with NYHA classⅡ, 212(~52.2%) with NYHA class and 98 with ⅢNYHA classⅣ.4. In the all cause of congestive heart failure, rheumatic heart disease was the first one, about 37.9%(154 cases); the second one was dilated cardiomyopathy, about 32.5 %(132 cases); the others were coronary heart disease, pulmonary heart disease, hypertrophic cardiomyopathy and congenital heart disease, counting for 27.6%(112 cases), 1.0%(4 cases), 0.5%(2 cases) and 0.5%(2 cases) respectively, and there were no congestive heart failure cases caused by pure high blood pressure, and the obvious gender differences were found in rheumatic heart disease and dilated cardiomyopathy.5.In total of 406 patients with congestive heart failure, cardiac arrhythmia and hyperlipidemia were the most commondangerous factors. Among them, cardiac arrhythmia was the first one, counting for 149 cases(~36.7%). And the second one was hyperlipidemia, counting for 124cases(~36.7%). And the others factors were high blood pressure,smoking, drinking, diabetes mellitus, neuropsychological diseases and disease of respiratory system, counting for118 cases(~29.1%), 97 cases(~23.9%),58 cases(~14.5%), 49 cases(~12.1%), 30 cases(~7.4%) and 27 cases(6.7%) respectively.6.For patients with cardiac functionⅡ, the utilization rate of diuretic drugs(including spirolactone) was 69.8%, ACEI/ARB was 55.2%, beta blockers was 57.2%, digitalis drugs was 51.0%, aldosterone receptor antagonist drugs was 60.4%, nitrate drugs was 19.8%; for patients with cardiac functionⅢ,the utilization rate of diuretic drugs(including spirolactone) was 78.8%, ACEI/ARB was 54.2%, beta blockers was 56.1%, digitalis drugs was 52.8%, aldosterone receptor antagonist drugs was 72.2%, nitrate drugs was 21.7%; for patients with cardiac functionⅣ,the utilization rate of diuretic drugs(including spirolactone) was 84.7%, ACEI/ARB was 68.3%, beta blockers was 54.1%, digitalis drugs was 64.3%, aldosterone receptor antagonist drugs was 78.6%, nitrate drugs was 27.6%;7.In total of 406 patients with congestive heart failure, the utilization rate of Chinese patent medicinewas 84.7%. And 178 cases(~43.8%) were treated w ith one kind of Chinese patent medicine only, 68 cases(~16.7%) were treated with two kinds of Chinese patent medicines simultaneously, 9 cases(~2.2%) w ere treated with three kinds of Chinese patent medicines at least. Qiliqiangxin capsule was the most used Chinese patent medicine and 124 cases(~30.5%) w ere treated with it.The next were Yangxin oral liquid and Qishenyiqi Pill, and 77 cases(~19%) and 54 cases(~13.3%) individually. In total of 406 patients wi th congestive heart failure, 269 cases were treated with Chinese patent medicin e. The therapeutic principles were shown as following:warming yang and benefi ting qi, and invigorate the circulation of the water(89 cases, ~33.1%); promo ting blood circulation to remove blood stasis,and reinforcing qi and nourishing yin(89 cases, ~33.1%); reinforcing qi and nourishing yin(49 cases, ~18.2%); promoting blood circulation to remove blood stasis(32 cases, ~11.9%); warmin g yang and benefiting qi(24 cases, ~8.9%); and others(12 cases, ~4.4%). The re were 43 mainmedical prescriptions, and 21 kinds of Chinese patent medicine s. The mainmedical prescriptions were shown as following: baoyuan decoction(125 cases, ~30.8%), pulse-activating decoction(71 cases, ~17.5%), taohongsiwu decoction(42 cases, ~10.3%), poria five powder(40 cases, ~9.9%), Xuefuzhuyu d ecoction(38cases,~9.4%),danshendecoction(36cases,~8.7%), shenfudecoction(26 cas es, ~6.4%), peach kernel and red flowerdecoction(22 cases, ~5.4%), drabanemor osa and jujubeclear lung soup(20cases, ~4.9%), lingguizhugan decoction(17 cas es, ~4.2%) and so on. The main used kinds of Chinese patent medicines were shown as following: qi-tonifying drug(699times), Blood-activating and stasis-eli minating compound(536 times), damp-clearing drug(434 times), relieving coug h and reducing sputum andantiasthmatic drugs(382 times),qi-regulating drugs(307times),drugs for relieving exterior disorder(259 times), antifebrile agents(251 ti mes), yin-tonifying drugs(151 times), blood-replenishing potion(149 times) and so on.The use frequency ranking of Chinese patent medicines was shown as fol lowing: Poriacocos(169 times, ~41.3%), Astragalusmembranaceus(151 times, ~37.2%),Atractylodes(140 times, ~34.5%), Cassia twig(118 times, ~29.1%), Seme n lepidii(112 times, ~27.6%),Licorice roots northwest origin(106 times, ~26.1%),Radix ophiopogonis(103times,~25.4%),Angelicasinensis(102times,~25.1%),Ligusti cumwallichii(101times, ~24.9%),Salvia miltiorrhiza(100 times, ~24.6%). Conclusion:1.Inthe hospitalized cases with chronic heart failure, the illness onset age wasusually under 60 years old. The illness onset age was also affected by gender, and female’s onset age was higher than male’s.2.In the hospitalized cases with chronic heart failure,the male to female ratio is about 1:1, and no significant differences was found.3.The averageillness onset age was increased with NYHA’s grade.4. Rheumatic heart disease was the leading cause of congestive heart failure, dilated cardiomyopathy was the second one, and the influence of gender on etiology had significant statistical difference.5.The main dangerous factors in hospitalized cases with chronic heart failure were cardiac arrhythmia,high blood pressure, smoking, drinking, diabetes mellitus, neuropsychological diseases and disease of respiratory system. And the numbers of female patients with cardiac arrhythmia were larger than male. The significant difference was found in smoking or drinking between male and female, and the numbers of male patients were larger than female.6.Comparing with handbook, the difference in utilization ratewere found in ethnodrugs(e.g. diuretic and digitalis drugs) and newly recommended drugs in handbook(e.g.ACEI/ARB and beta blockers). And aldosterone receptor antagonist medication is still unitary, such as spironolactone.7.A higher utilization ratein traditional Chinese medicine or Chinese patent medicine was found, which was fully illustrated the treatment concept, combination of Chinese traditional and Western medicine, in chronic heart failure treatment in our hospital.