Analysis Of TCM Syndrome Elements And Research On The TCM Syndromes Distribution In Chronic Heart Failure With Depression

Objective: Exploring the characteristics of TCM syndrome elements and the distribution of TCM syndromes in patients with chronic heart failure and depression,it is to provide the clinical and objective basis for TCM prevention and treatment of chronic heart failure with depression.Methods: From October 2017 to January 2019,230 patients with chronic heart failure in Qingdao Haici Medical Group were selected for case collection and questionnaire survey.The self-rating depression scale(SDS)was used as a testing tool to evaluate the depression status.To review the relevant literatures on TCM syndromes of chronic heart failure and depression,refer to the "Guidelines for New Drugs of Traditional Chinese Medicine",the National Standard of the People’s Republic of China,"Traditional Chinese Medicine Clinical Diagnosis Terminology-Syndrome" and "Traditional Chinese Medicine Diagnostics" to extract TCM syndrome elements and standardize them.Integration of TCM syndrome elements extracted to form TCM syndromes.The collected data information was statistically analyzed using SPSS21.0 statistical software.Rsult: 1.(1)Among the 230 patients with chronic heart failure,98 patients had depression.(2)The primary disease of chronic heart failure is including 127 cases of coronary heart disease> 79 cases of hypertension> 10 cases of pulmonary heart disease> 7 cases of rheumatic heart valve disease> 3 cases of dilated cardiomyopathy> 2 cases of hyperthyroidism> 1 case of hypertrophic cardiomyopathy and 1 case of myocarditis.(3)There are correlations between cardiac function grading,heart failure classification,left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-pro BNP)and depression status in patients with chronic heart failure(P<0.01).2.(1)Among 230 patients with chronic heart failure,7 kinds of TCM disease elements were extracted 650 times,according to the frequency from high to low,182 times of qi deficiency> 163 times of blood stasis>109 times of yang deficiency> 70 times of qi stagnation > 49 times of water suspension> 45 times of yin deficiency> 32 times of phlegm.Among98 patients with chronic heart failure and depression,qi deficiency,yang deficiency and qi stagnation occurred more frequently;the remaining132 patients without depression,qi deficiency,blood stasis,and yang deficiency occurred more frequently.(2)There are correlations between different syndrome elements and cardiac function grading,heart failure classification in patients with chronic heart failure and depression(P<0.01).(4)There is no correlation between different syndrome elements of patients with chronic heart failure and depression(P>0.05).3.(1)In 230 patients with chronic heart failure,the total number of 5kands of TCM syndrome factors is 565,which are arranged in order: 230 times of heart> 94 times of lung> 93 times of kidney> 85 times of spleen>63 times of liver.Among the 98 patients with depression,heart,kidney,lung,and liver.Among 132 patients without depression,heart,lung and kidney.(2)There are correlations between different disease factors and cardiac function grading,heart failure classification in patients with chronic heart failure and depression(P<0.01).4.There are 6 kinds of syndrome combinations in 98 patients with chronic heart failure and depression.Among them,there are more combinations of six syndromes and five syndromes.There are 7 syndrome combinations in 132 patients with chronic heart failure without depression.More combinations of prime,four syndromes and six syndromes.5.(1)132 syndromes with chronic heart failure without depression are combined with a composition ratio of >5.0%: qi deficiency and blood stasis syndrome,qi and yin deficiency and blood stasis syndrome,qi deficiency and phlegm and blood stasis syndrome,yang deficiency and blood stasis syndrome,yang deficiency blood stasis and water suspension syndrome,the qi and yin deficiency syndrome,yang deficiency water suspension syndrome,7 types.(2)The syndromes with a composition ratio of >5.0% in 98 cases of chronic heart failure combined with depression are: yang deficiency qi stagnation syndrome,yang deficiency water suspension syndrome,yang deficiency qi stagnation and blood stasis syndrome,qi stagnation and blood stasis syndrome,qi and yin deficiency and blood stasis syndrome,yang deficiency and qi stagnation,qi deficiency qi stagnation and blood stasis syndrome,yang deficiency blood stasis water suspension syndrome,8 types.(3)Different TCM syndromes of chronic heart failure and depression are associated with NT-pro BNP and LVEF(P<0.01,P<0.05,respectively).Conclution: 1.The higher the severity of chronic heart failure,the higher the degree of depression.2.Chronic heart failure with depression is mainly in the heart,and can reach the lungs,kidneys,liver and spleen.With heart function level II→III→IV,heart failure classification HFp EF→HFmr EF→HFr EF,the disease position is from heart,liver to kidney.3.Chronic heart failure with depression status with heart function grade II→III→IV,heart failure classification HFp EF→HFmr EF→HFr EF,syndrome type consists of qi stagnation,blood stasis → yang deficiency,water suspension.Among them,qi deficiency runs through the disease.4.The main syndromes of chronic heart failure with depression are: yang deficiency qi stagnation syndrome,yang deficiency water suspension syndrome,yang deficiency qi stagnation and blood stasis syndrome,qi stagnation and blood stasis syndrome,qi and yin deficiency blood stasis syndrome,yang deficiency qi stagnation water suspension syndrome,qi deficiency qi stagnation and blood stasis syndrome,and yang deficiency blood stasis water suspension syndrome,8 types.5.With the increase of NT-pro BNP and the decrease of LVEF in chronic heart failure with depression,the general development order of syndrome type: qi stagnation and blood stasis syndrome → qi deficiency qi stagnation and blood stasis syndrome → yang deficiency qi stagnation syndrome → yang deficiency qi stagnation and blood stasis syndrome → qi and yin deficiency blood stasis syndrome,yang deficiency water suspension syndrome → yang deficiency qi stagnation water stop syndrome→ yang deficiency blood stasis water suspension syndrome.6.Chronic heart failure with depression is mainly in the heart,and can be related to lung,kidney,liver and spleen.The overall pathogenesis is heart damage,lack of consciousness,and loss of physiological and spirit.qi deficiency,yin deficiency,and yang deficiency are the main ones.The actual ones are blood stasis,qi stagnation,phlegm,and water suspension.The syndrome differentiation are qi stagnation and blood stasis syndrome,qi deficiency qi stagnation and blood stasis syndrome,yang deficiency qi stagnation syndrome,yang deficiency qi stagnation and blood stasis syndrome,qi and yin deficiency blood stasis syndrome,yang deficiency water suspension syndrome,yang deficiency qi stagnation water stop syndrome,yang deficiency blood stasis water suspension syndrome.Treatment should pay attention to the same treatment of physiological and spirit,syndrome differentiation and treatment.