Study On The Characteristics Of TCM Syndromes Of Chronic Heart Failure With Depression

Objective:To collect the information and general data of TCM diagnosis in patients with chronic heart failure with depression from the point of view of syndrome,and to summarize the disease syndrome element,disease location syndrome element and syndrome-syndrome relationship through frequency analysis and cluster analysis.In addition explore the distribution characteristics of each syndrome element in general data.Methods:A Cross-sectional study was used to collect patients from March 2018 to March 2019 in out-patient departments and wards of Department of Cardiology in the third affiliated Hospital of Beijing University of traditional Chinese Medicine.Patients who met the inclusion and exclusion criteria and voluntarily cooperated with the investigation filled in complete information of the scale,Including basic information collection table,Hamilton depression scale(HAMD-24),Hamilton anxiety scale(HAMA),TCM symptom questionnaire,etc.On this basis,the data were analyzed by frequency analysis and cluster analysis in SPSS Statistics23.0.Under the guidance of traditional Chinese medicine theory and Chinese medicine experts,the TCM syndrome characteristics of chronic heart failure with depression were analyzed.Results:(1)132 patients with chronic heart failure complicated with depression were enrolled in this study.There were 84 males and 48 females,with a male-to-female ratio of 1.75:1.The patients with age?71 years old accounted for 61.4%of the total,followed by patients aged 51 to 70 years old,accounting for 31.1%of the total number of patients.The age of the patients was 35 years old,the oldest age was 95 years old,and the number of patients?71 years old was the largest,accounting for 61.4%of the total population.(2)Among the 132 patients,63(47.7%)were manual workers,69(52.3%)were mental workers,and The ratio of manual workers to mental workers in the nature of work is 0.91:1.There were 83(62.9%)in junior middle school and below,49(37.1%)in senior middle school and above.89 smokers and 43 non-smokers,and the ratio of smoking and non-smokers was 2.06:1.There were 81 drinkers and 51 non-drinnkers.The ratio of drinkers to non-drinkers was 1.56:1.(3)There were 92 patients with mild or moderate depression,accounting for 69.7%of the total,and 40 patients with severe depression,accounting for 30.3%of the total.The number of patients with CHF complicated with depression showed an increasing trend with the higher the cardiac function grade.35 patients with cardiac function grade 2 and 2/3 accounted for 26.3%of the total,43 cases with grade 3 and 3/4 cardiac function,accounting for 32.6%of the total.There were 54 patients with cardiac function grade 4,accounting for 40.9%of the total.(4)By cluster analysis and frequency analysis of TCM symptoms and signs,the results showed that the seven syndrome elements from small to large were qi depression,yin deficiency,qi deficiency,heat of fire,phlegm turbidity,blood deficiency,yang deficiency.The four location syndrome elements from small to large were as follows:liver,heart,kidney,spleen,and concluded the syndrome-syndrome relationship:(disease syndrome element)Qi depression:irritable irritability,dry mouth,bitter mouth,low mood,sad hopeless,difficult to fall asleep,wake up early,many dreams,Silence,less words,frequent night urination;Yin deficiency:slow thinking,five boredom,soft waist and knee,tinnitus,eyes,chest pain,abdominal pain,sweating,night sweating,lipstick red;Qi deficiency:decreased interest,anxiety,timidity,forgetfulness,chest tightness,palpitation,wheezing,fatigue,shortness of breath,shallow sleep,poor appetite;Fire-heat:dry mouth,bitter mouth,dryness and heat,dry,sad and hopeless,silent,low mood,many dreams,red lips;phlegm:timidity,easy to startle,narcissistic,sleepiness,absence of mind,dizziness,light sleep,edema;Blood deficiency:mouth lip color is light,dizziness,sleepiness,god thought does not gather;Yang deficiency:chest pain,fear cold,loose stool,guilt self-blame,mouth sticky,self-sweat;(disease location syndrome element)liverirritable,dry mouth,bitter mouth,dryness and heat,low mood,silence,sadness,hopeless,difficult to fall asleep,wake up early,many dreams,frequent night urination,dry mouth,lips red;Heart:chest tightness,palpitation,wheezing,fatigue,shallow sleep,timid and easily frightened;kidney;guilt and self-blame,slow thinking,fear of cold,weak waist and knee,tinnitus,loose stool;Spleen:decreased interest,worrying,forgetful,sticky mouth,loose stool,abdominal pain full,sticky,poor.(5)The distribution of TCM syndrome in 132 patients with chronic heart failure complicated with depression showed correlation with sex,age,nature of work,education degree,drinking and cardiac function grade.In terms of gender,male patients with Qi deficiency,Yang deficiency more than female,female patients with blood deficiency more than male;In different age groups,there were more heat in 51-70-year-old patients,more blood-deficiency,Qi-deficiency and yang-deficiency in patients>71 years old,and the distribution of Qi-depression and Yin-deficiency was more balanced in these two age groups In the nature of work,brain workers more phlegm turbid,most of the disease in the spleen,manual workers Yin deficiency,more heat,the disease in the liver,kidney is more balanced distribution;In terms of educational level,there were more patients with yin deficiency in junior middle school and below,more patients with blood deficiency in senior middle school and above,and the distribution of qi depression was more balanced in the two groups.In the aspect of drinking,qi depression was more in drinkers and qi deficiency was more in non-drinkers;in the classification of cardiac function,the patients with cardiac function 2,2 and 3 were mostly heat of fire,and the patients with grade 4 heart function were mostly qi depression and yin deficiency.Conclusion:(1)In the disease of chronic heart failure with depression,there were 7 syndrome element for qi depression,Yin deficiency,qi deficiency,heat of fire,phlegm turbidity and blood deficiency,Yang deficiency,four disease location syndrome element for liver,heart,kidney,spleen.On the basis of deficiency of qi-blood yin-yang deficiency,qi depression was the first,fire-heat,phlegm turbidity and so on.The disease location syndrome element was most closely related to liver and heart,and the syndrome-symptom relationship of 11 syndrome elements was preliminarily summarized.(2)The distribution of TCM syndrome in patients with chronic heart failure with depression was related to the sex,age,nature of work,education level,alcohol consumption and cardiac function grading.