Preliminary Study On The Distribution Characteristics Of TCM Syndromes Of Pulmonary Hypertension And Its Correlation With Disease Prognosis Indicators

Background:Pulmonary Hypertension is characterized by progressive Pulmonary vascular resistance increases,then the right ventricle hypertrophy expansion,even a kind of right heart failure,Pulmonary vascular disease,the incidence,morbidity and mortality is higher.Seriously affect the patients life quality and life.In recent years,modern medicine in the diagnosis of this disease has been clear about the etiology and classification,treatment of targeted drugs are also improved the curative effect,but there are still unsolved problems,such as curative effect of certain types of pulmonary hypertension treatment is poor,targeted drugs are expensive,side effect is big,poor prognosis,etc.Clinical founding,Traditional Chinese medicine in the treatment of pulmonary hypertension had certain curative effect,but in recent years,large-scale clinical research data is lack to support,and the evidence of syndrome study is insufficient.Objective:To explore the TCM syndrome distribution characteristics of pulmonary hypertension patients and prognosis index correlation with disease,in order to make clear advantage of pulmonary hypertension syndrome,and the correlation of disease prognosis index,etc,to provide basis for clinical dialectical treatment.Methods:1.Collecting TCM clinical syndrome of pulmonary hypertension patients,analyzing TCM clinical syndrome differentiation and initially exploring syndrome characteristics of pulmonary hypertension patients.2.Analyzing correlation between type of TCM syndrome and prognostic indicators,such as 6 minutes walking distance,cardiac function classification,NT-proBNP.Result:1.In the aspect of the nature of disease syndrome element:32 cases of pulmonary hypertension patients with syndromes incidence in turn is Qi deficiency(100.00%)= blood stasis(100.00%)>water fluid(50.00%)>Yang deficiency(40.62%)>Yin deficiency(40.62%)>phlegm syndrome(15.62%)>Qi depression(18.75%)>blood deficiency(9.38%),further respectively analyzing statistical PAH and CTEPH syndrome factor distribution,found that two types of patient disease syndrome factor distribution there was no significant difference in statistics,Qi deficiency and blood stasis syndrome is the highest incidence of pulmonary hypertension syndromes,about half of the patients with water fluid syndrome,some patients with Yang deficiency,Yin deficiency,phlegm turbidity,and qi depression,blood deficiency,etc.2.In the aspect of the location of disease syndrome element:lung,spleen and kidney play an important role in the incidence of pulmonary hypertension.And PAH disease syndrome factor distribution frequency was followed by lung(100.00%)>spleen(58.33%)>kidney(41.67%)>heart(41.67%)>liver(16.67%),CTEPH disease syndrome factor distribution frequency in turn were lung(100.00%)>spleen(60.00%)>kidney(55.00%)>heart(25.00%)>liver(20.00%),PAH and CTEPH disease syndrome factor distribution were statistically significant differences,compared with CTEPH,PAH proportion of lung,heart in PAH proportion of larger,and larger proportion of the spleen and kidney in CTEPH.3.Look from the syndrome distribution:dividing into 4 patterns of syndrome:Qi deficiency and blood stasis syndrome(31.25%),Yang deficiency and blood stasis and water fluid syndrome(28.13%),Yin deficiency and blood stasis and water fluid syndrome(21.88%),Qi and Yin deficiency and blood stasis syndrome(18.75%).4 patterns of syndrome of PAH and CTEPH statistical analysis distribution of no significant difference in statistics.Qi deficiency and blood stasis syndrome is the main type.4.The relationship between pattern of syndrome and NT-ProBNP,6 minutes walking distance,cardiac function classification:respectively analysing statistical NT-ProBNP syndrome patients,6 minutes walking distance,cardiac function classification of four pattern of syndrome patients,found that the NT-ProBNP level of Yin deficiency and blood stasis and water fluid syndrome is the highest,followed by Yang deficiency and blood stasis and water fluid syndrome,Qi deficiency and blood stasis syndrome,Qi and Yin deficiency and blood stasis syndrome issues lowest levels;six minutes walking distance of Qi and Yin deficiency and blood stasis syndrome is the longest,followed by Qi deficiency and blood stasis syndrome,Yang deficiency and blood stasis and water fluid syndrome,Yin deficiency and blood stasis and water fluid syndrome issues the shortest distance.cardiac function classification of 4 patterns of syndrome has no statistically significant difference.5.The pattern of syndrome and the correlation of the NT-ProBNP and six minutes walking distance Logistic regression analysis:water fluid syndrome with the NT-ProBNP and six minutes walking distance to do binary Logistic regression analysis,the results showed that the NT-ProBNP level positively correlated with water fluid syndrome,six minutes walking distance negatively correlated with water fluid syndrome.Conclusion:Pulmonary hypertension patients with Qi deficiency and blood stasis syndrome is the basic pathogenesis,as the disease progression arising water fluid syndrome,according to the different partial tide of Yin and Yang,Qi deficiency and blood stasis syndrome can be divided into 4 patterns of syndrome:Qi deficiency and blood stasis syndrome,Qi and Yin deficiency and blood stasis syndrome,Yang deficiency and blood stasis and water fluid syndrome,Yin deficiency and blood stasis and water fluid syndrome.With water fluid syndrome and the NT-ProBNP were positively correlated,and negatively correlated with six minutes walking distance,and in the water fluid syndrome,Yin deficiency and blood stasis and water fluid syndrome accompanying NT-ProBNP bigger,six minutes walking distance shorter,more severe illness.