Clinical Study On The Distribution Of TCM Syndrome Elements In Heart Failure

Objective:By analyzing the distribution of common TCM symptoms of heart failure,syndrome-symptom relationship,and distribution of TCM syndrome elements,this study aims to understand the combination rules of single syndrome,double syndrome,three syndrome,four syndrome and multiple syndrome,so as to provide theoretical basis for TCM syndrome differentiation and treatment of heart failure.METHODS:The author choose between January 2020 and December 2020,urumqi happiness road community,furnace courtyard street community,such as community crowd into standard heart failure sample of 303 cases through field investigation,collect demographic data,relevant laboratory indexes and collected four diagnosis in traditional Chinese medicine,Chinese medicine syndrome integral,Minnesota scale(quality of life score),such as heart failureThe information database of heart failure patients was constructed and the data were analyzed.Results:(1)There were 23 items of symptoms with frequency>30%in 303 samples of heart failure investigation:Followed by chest tightness,shortness of breath,activity after easy tired,fatigue,insomnia,heart palpitations,dizziness,shortness of breath,swelling or chest/ascites,lumbar debility,cough with phlegm,spontaneous perspiration,bitter mouth,lazy words or voice low,stay,and surface Bai Shaohua,facial oral body color or dark green,and it dried,sputum white/clear PaoMoTan cold,and cold limbs,dry mouth,irritability,and chest pain.(2)With the cardiac function grading from Ⅱ to Ⅳ grade gradually increased,Chest tightness,shortness of breath,fatigue,shortness of breath,edema or pleural effusion,Night sweats,lazy or low voice,complexion white,fear of cold limbs,dry mouth.Stomach bloating,nausea,poor appetite,bloating,poor sleep,Less urine,irritability,red cheekbones,Black or purple facial lips and limbs,cyanosis of fingers(toes),cyanosis of nails,sticky sputum.The distribution of symptoms showed a gradually increasing trend,and there were statistically significant differences in the distribution of the above same TCM symptoms in different cardiac function grades(P<0.05).(3)Analysis on the characteristics of TCM syndrome elements in 303 cases of heart failure investigation samples:①Location syndrome:single syndrome(57.1%),two syndromes(28.7%),three syndromes(11.6%),four syndromes(2%).Single locus syndrome:heart(56.1%),lung(1%);The two syndrom were combined:heart+lung(15.2%),heart+kidney(8.9%),and the other two syndrom elements accounted for less.The three syndrome elements were combined:heart+lung+kidney(8.3%),heart+kidney+spleen(1.7%).heart+lung+spleen(1.0%).The other three syndrome elements accounted for less.Four syndromes were combined:heart+lung+kidney+spleen(1.0%),and the other four syndromes accounted for less.②The syndromes of disease:single syndromes(17.1%),two syndromes(42.8%),three syndromes(31.9%).four syndromes(6.6%),five syndromes(0.6%).Single syndrome elements:blood stasis syndrome(36.6%).phlegm turbidity(26.9%),Yang deficiency(3.3%).the rest of the single syndrome elements accounted for less;The two syndromic phases were blood stasis+phlegm turbidity(33.1%),qi deficiency+blood stasis(8.3%),qi deficiency+Yin deficiency(6.6%),Yang deficiency+blood stasis(3%),and the other two syndromic phases were relatively few.Yang deficiency+blood stasis+water stagnation(5.6%).Qi deficiency+Yin deficiency+blood stasis(5%),Yang deficiency+blood stasis+phlegm turbidity(4%),Qi deficiency+blood stasis+phlegm turbidity(3.3%),and the other three syndromes were relatively small.The four syndromes were combined:qi deficiency+Yang deficiency+blood stasis+water stagnation,qi deficiency+Yang deficiency+phlegm turbidity+blood stasis accounted for 1.3%,Yang deficiency+phlegm turbidity+blood stagnation,qi deficiency+Yin deficiency+phlegm turbidity+water stagnation accounted for 1%,respectively;The combination of five syndromes is relatively rare.Conclusion:1.There were differences in the distribution of TCM symptoms in different grades of heart function in samples of heart failure investigation.2.Cluster analysis showed the relationship between syndromes and symptoms.3.The location and syndromes of heart failure are:heart,lung,kidney,spleen and stomach;The elements of the syndrome are qi deficiency,Yang deficiency,Yin deficiency,phlegm turbidity,blood stasis.water stagnation,and qi stagnation.4.After studying the syndrome elements combination rules of 303 samples of heart failure investigation,it was shown that:(1)Among the combination modes of syndrome elements in disease position,single syndrome element is the most common,with the largest proportion of heart,followed by two syndromes and three syndromes.Two syndromes are the most common heart+lung,followed by heart+kidney,three syndromes are the most common heart+lung+kidney,followed by heart+kidney+spleen,and four syndromes are the most common heart+lung+kidney+spleen.The top 4 syndrome elements of all disease sites were:heart>(heart+lung)>(heart+kidney)>(heart+lung+kidney).(2)disease syndrome factors and the most common combinations of two certificates,blood stasis and phlegm turbidity accounted for the largest,followed by blood stasis,qi deficiency+single syndrome factor,three certificates and times,single disease syndrome factors is the most common is blood stasis,the second is the phlegm turbidity,phase three certificates and Yang deficiency,blood stasis and water park is the most common,followed by qi deficiency,Yin deficiency and blood stasis,The four syndromes combined with qi deficiency+Yang deficiency+blood stasis+water stagnation,qi deficiency+Yang deficiency+phlegm turbidity+blood stasis are more common,while the five syndromes combined with qi deficiency are relatively rare.The top 6 combinations of all syndrome elements were(blood stasis+phlegm turbidity)>(qi deficiency+blood stasis)>(qi deficiency+Yin deficiency)>blood stasis>(Yang deficiency+blood stasis+water stagnation)>(qi deficiency+Yin deficiency+blood stasis).5.The syndrome-symptom relationship between syndrome elements and symptoms can be determined by cluster analysis,which is one of the important methods for the distribution of TCM syndrome elements in heart failure.