Analysis Of TCM Syndrome Element And Study Of Quality Of Life In Ischemic Cardiomyopathy

Objective:By studying the distribution characteristics of the TCM syndrome elements in ICM patients,and exploring the correlations of each syndrome element with clinical physical and chemical indicators,NYHA classification and other factors,the differentiation of the TCM syndromes can be made objective in ICM.To provide clinical ideas for individualized diagnosis and treatment of Chinese medicine,the correlation between the TCM syndrome elements and the quality of life in ICM patients is preliminarily discussed.Methods:The subjects of this study were collected from the Department of Cardiology in Fujian Provincial People's Hospital,and a number of 200 patients in ICM were included.The related data were collected from all patients,which included general informations,TCM four diagnostic informations and related physical and chemical indicators.By using the TCM health status recognition system,the overall TCM syndrome elements distribution in ICM were extracted.To explore the correlations of each syndrome element with cardiac function,and analyze the distribution of syndrome elements in ICM patients with different clinical characteristics,all patients were divided into several groups according to the NYHA classification.The Minnesota scale was used to score the quality of life,and then it's explored that the correlations between quality of life and the distribution of syndrome elements.Results:1.The main disease locations of ICM are heart,lung,kidney and spleen.The syndrome elements of asthenia are deficiencies of Qi,yang,yin and blood.The main syndrome elements of excess are phlegm,stasis,dampness and Qi stagnation,also including fluid retention,cold,yang hyperactivity and heat.2.In NYHA class II,the disease is located in the heart,mainly with the deficiencies of Qi and yin,and the dominant sthenia factors are phlegm,blood stasis,dampness and Qi stagnation.In NYHA class III,the disease is located in the heart and lungs,mainly with the deficiencies of Qi,yang and yin,and the dominant sthenia factors are phlegm,blood stasis,dampness and Qi stagnation.In NYHA class IV,the disease is located in the heart,lungs,kidneys and spleen,with the deficiencies of Qi,yang,yin and blood,and the dominant sthenia factors are phlegm,blood stasis,dampness,Qi stagnation and fluid retention.3.Left ventricular ejection fraction(LVEF)is negatively correlated with kidney,yang deficiency,Qi deficiency,heart,lung and other syndrome elements(P<0.01),and the correlations of LVEF with kidney and yang deficiency is the highest(?rs?>0.4).4.The TCM syndrome elements of heart,yang deficiency,fluid retention,lung and Qi deficiency are positively correlated with NT-pro BNP(P<0.01),and the correlation is moderate.5.The TCM syndrome elements of yang deficiency,Qi deficiency,heart,fluid retention and lung are negatively correlated with MLHFQ score(P<0.01),and the correlation is strong.6.The age,NYHA classification and NT-pro BNP are negatively correlated with MLHFQ scores(P<0.01),and the correlation is strong.LVEF is positively correlated with MLHFQ scores(P<0.01),and the correlation is moderate.Conclusion:1.During the period of ICM,the disease is mostly located in the heart.With the weakening of the heart function,the lung,kidney and spleen are also involved in the later stage of the disease.The deficiencies of Qi,yang,yin and blood are the dominant factors about the asthenia in origin.The dominant sthenia factors include phlegm,blood stasis,dampness and Qi stagnation.The appearance of the syndrome elments of fluid retention and cold can reflect the weakness of viscera's yang.2.According to NYHA classification,the TCM syndromes about ICM can be combined as the following types:Class II:Phlegm Blocking Heart Pulse syndrome,Heart Deficiencies in Qi and Yin syndrome;Class III:Heart-Yang Deficiency complicated with Blocking of Phlegm,Dampness and Stasis syndrome,Deficiencies in Heart-Lung-Yang complicated with Phlegm Blocking syndrome;Class IV:Heart-Yang Deficiency complicated with Fluid Retention syndrome,Heart Deficiencies in Yin,Yang,Qi and Blood syndrome,Heart Deficiencies in Yang and Qi complicated with Fluid-Retained in Lung syndrome,Deficiencies in Heart-Kidney-Yang syndrome,Deficiencies in Heart-Lung-Spleen-Kidney-Yang syndrome.3.The class of TCM syndrome elements can reflect the degree of heart failure in ICM patients.As the levels of syndromes of Xin,yang deficiency and fluid retention go up,the level of NT-pro BNP increases as well.As the levels of syndromes of Shen,yang deficiency,Qi deficiency and Xin go up,the level of NT-pro BNP increases as well.Need pay attention to the warming of the heart and kidney and the steaming of fluid retention.4.The relevant syndrome elements that affect the quality of life of ICM patients include Yang deficiency,Qi deficiency,heart,fluid retention,lung,spleen and kidney.Other major factors include age,NYHA classification,NT-pro BNP and LVEF.