| Objective:Through the research of traditional chinese medicine syndromes distribution regularities of type2 and type4 cardiorenal syndromes as well as age,gender,primary disease,renal function,the correlation bteween laboratory index factors such as research,promote the establishment of TCM characteristic of dialectical and diagnosis and treatment plan,to guide individualized treatment.Methods:It acquire acquistion and record patients basic information,symptoms,signs,tongue and pulse,laboratory indexes,heart kidney function,the primary disease and lelated data.With reference to the ?internal medicine diagnosis and treatment of common diseases of traditional Chinese medicine guide ?syndrome classification standard for heart failure and renal failure,?Term in the clinical diagnosis and treatment of TCM syndrome part?and?The traditional Chinese medicine for the treatment of chronic renal failure and chronic cardiac failure clinical research guiding principle of 2002?,Which is the TCM symptom classfying quantization standard and develop chronic heart kidneysyndrome of traditional Chinese medicine standard to observe the record.For the traditional Chinese medicine to determine the heart kidney syndrome classification,finally carries on the statistical analysis.Results:(1)A total of 15 cases of hypertension(37.50%)is in the first place among the primary diseases of CRS ?,a total of 22 cases of diabetic nephropathy(43.14%)is in the first place among the primary diseases of CRS ?.(2)Distribution of TCM syndromes: The qi-yin deficiency of syndrome is the largest proportion,total 37 cases,accounting for 40.66% among the deficiency syndromes,Secondly deficiency syndromes are 31 cases(34.06%),Yang deficiency syndromes are 20 cases(21.98%),Yin deficiency syndromes are 2 cases(2.20%),Yin and yang deficiency syndrome is 1 case(1.10%).Blood stasis syndrome with 33 cases,accounted for 36.26% is the main empirical syndrome types,secondly phlegm retention syndromes are 31cases(34.07%),moisture certificate are 26 cases(28.57%),hot and humid card are 22 cases(24.18%),wet muddy are 14 cases(15.38%).(3)Relationship between the deficiency syndrome and the empirical syndrome:Qi deficiency syndrome combined with blood stasis syndrome?phlegm retention syndrome with high incidence rate,respectively are58.06%,48.39%;the incidence rate of yang deficiency syndrome combined with moisture certificate syndrome is higher,account for 70%;the incidence rate of qi and Yin deficiency syndrome combined with hot and humid card syndrome is higher,account for 43.24%.The incidence rate of blood stasis syndrome and phlegm retention syndrome among qi deficiency syndrome,hot and humid card syndrome among yin deficiency syndrome,moisture certificate syndrome among yang deficiency syndrome are higher.(4)Syndromes relationship with age,gender:The relationship about deficiency syndrome with age:there is significant differences betweenyang deficiency syndrome(P=0.017<0.05)and age,Spearman rank correlation coefficient=0.245,P=0.019<0.05,so there is positive correlation between yang deficiency syndrome and age.With the increase of patients age,incidence of yang deficiency syndrome.The relationship about empirical syndrome with age:there are significant differences between the moisture certificate syndrome(P=0.021<0.05),phlegm retention syndrome(P=0.010<0.05)and age,the Spearman rank correlation coefficient between moisture certificatesyndrome and age is 0.224,P=0.037<0.05,the Spearman rank correlation coefficient between phlegm retention syndrome and age is-0.272,P=0.009<0.05.so there is positive correlation between moisture certificate syndrome and age,there is negative correlation between phlegm retention syndrome and age.With the increase of patients age,incidence of moisture certificate syndrome,falling of phlegm retention syndrome.There is no significant difference between TCM syndromes distribution and gender(P>0.05).(5)Distribution characteristics of clinical symptoms:The top five of clinical symptoms are respectively shortness of breath weak,totally88 cases,account for 96.70%,chest tightness and chest pain,totally 75 cases,account for 82.42%,edema,totally71 cases,account for 78.02%,heart palpitations,totally 65 cases,account for 71.43%,heavy body,totally 64 cases,account for 70.33%.(6)The correlation between heart kidney function and syndrome distribution :There is no statistical significance between cardiac function(NYHA classification)and the distribution of deficiency syndrome(P>0.05).Hot and humid card syndrome is the main empirical syndrome of cardiac function grade ?,account for 44.44%,phlegm retention syndrome is the main empirical syndrome of cardiac function grade ?,account for 42.42%,moisture certificate syndrome is the main empirical syndrome of cardiac function grade ?,account for 48.39%.Usingrank sum test and Spearman rank correlation analysis,there is statistical significance between cardiac function(NYHA classification)and hot and humid card syndrome(P=0.006<0.05),moisture certificate syndrome(P=0.011<0.05).There is no statistical significance between renal function stage and syndrome distributions(P>0.05).(7)Regularities of TCM syndromes distribution with type CRS ? and type CRS ?:There is no statistical significance between deficiency syndrome and CRS??CRS?(P>0.05).Blood stasis syndrome is the main empirical syndrome of CRS?,account for 55%,followed by phlegm retention syndrome,account for 42.5%.Moisture certificate syndrome is the main empirical syndrome of CRS?,account for35.29%,followed by phlegm retention syndrome,account for 27.45%.Among them,blood stasis syndrome(P=0.001<0.05),moisture certificate syndrome(P=0.023<0.05)have statistical significance.(8)The correlation between the primary disease and TCM syndrome distribution:There is no statistical significance between the primary heart disease and TCM syndrome distribution of CRS.There is no statistical significance between the primary kidney disease and deficiency syndrome of CRS.There is statistical significance between Phlegm retention syndrome(P=0.049<0.05)of the empirical syndromes and the primary kidney disease.(9)The correlation between clinical examination indicators and Syndrome distribution : The correlation test between TCM syndrome distribution and clinical examination indicators of CRS? and CRS? show that there is no statistical significance between damp pathogen syndrome,moisture certificate syndrome and clinical examination indicators(P>0.05).The cases of yin deficiency syndrome and yin-yangdeficiency syndrome are less,so there is no statistical significance.There is statistical significance between qi deficiency syndrome(P=0.000<0.05),qi-yin deficiency syndrome(P=0.035<0.05)and NT-proBNP.There is statistical significance between phlegm retention syndrome(P=0.037<0.05)SCR.There is no statistical significance between GFR and syndrome distribution(P >0.05).There is statistical significance between syndrome of blood stasis(P=0.024<0.05),damp-heat syndrome(P=0.031<0.05)and the value of UCG LVEF.There is statistical significance between yang deficiency syndrome(P=0.011<0.05)and hs-CRP.Conclusion:(1)Qi-yin deficiency syndrome is the main deficiency syndrome of CRS? and CRS?.Blood stasis syndrome is the main empirical syndrome of CRS? and CRS?.The incidences of qi deficiency syndrome combined with blood stasis syndrome,phlegm retention syndrome,yang deficiency syndrome combined with moisture certificate syndrome,qi-yin deficiency syndrome combined with damp-heat syndrome are higher.(2)There is positive correlation between yang deficiency syndrome,moisture certificate syndrome and age.With the increase of patients age,incidence of yang deficiency syndrome and moisture certificate syndrome.(3)The top five of clinical symptoms are respectively shortness of breath weak,chest tightness and chest pain,edema,heart palpitations,heavy body.(4)There is negative correlation between moisture certificate syndrome and cardiac functional grading.With the decrease of cardiac function,incidence of moisture certificate syndrome.(5)Blood stasis syndrome is the main empirical syndrome of CRS?,moisture certificate syndrome is the main empirical syndrome of CRS(6)Diabetic nephropathy is the main primary disease of CRS?,hypertension is the main primary disease of CRS?.(7)There is positive correlation between NT-proBNP and qi deficiency syndrome,qi-yin deficiency syndrome.With the incrase of NT-proBNP,symptom increased of qi deficiency syndrome and qi-yin deficiency syndrome.There is positive correlation between phlegm retention syndrome and SCR.With the incrase of SCR,deteriorating of phlegm retention syndrome.There is negative correlation between EF value and blood stasis.With the decrease of EF value,deteriorating of blood stasis.There is negative correlation between hs-CRP and yang deficiency syndrome.With the increase of hs-CRP,incidence decrease of yang deficiency syndrome. |
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