Syndrome Distribution Characteristics Of Patients With Dilated Cardiomyopathy Retrospective Analysis Of Medical Records

Objective:In this study,449 hospitalized cases of dilated cardiomyopathy were retrospectively studied,and the common symptoms and syndromes of DCM were obtained.The syndromes were divided into basic syndrome elements,and the distribution rules of common symptoms,syndromes and syndrome elements were discussed by using statistical methods,in order to provide a certain reference for formulating the diagnostic criteria based on syndromes of DCM.Methods:On the basis of previous literature analysis and research on clinical experience of treating DCM by famous doctors and experts,combined with expert group’s opinions,a DCM inpatient case collection form was established.The hospitalized cases diagnosed as DCM in Henan Provincial Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2010 to June 2020 were collected by retrospective analysis.Epidate 3.1software was used to establish case data database,and IBM SPSS 25.0 software was used to analyze the data by Logistic regression analysis and cluster analysis.Results:1.General data: A total of 449 cases were included,including 297 males and 152 females.Among them,Han nationality is the majority,with 443 cases accounting for98.7%.The age of onset was 57.2% between 50 and 69 years old,including 119 cases between 50 and 59 years old and 138 cases between 60 and 69 years old.There are more than 30 kinds of concomitant diseases,among which heart failure(391 cases)is the most,followed by arrhythmia,hypertension,coronary heart disease,diabetes,cerebrovascular disease,pulmonary infection and chronic gastritis.The incidence of solar terms often occurs in the summer heat,beginning of autumn,Chushu,beginning of spring,beginning of winter,the spring equinox and so on.According to NYHA’s cardiac function classification,cardiac function grade III(149 cases)and cardiac function grade IV(242 cases)were the main ones.Among them,there were 116 cases with genetic history,accounting for 26%.The time of onset was less than 0.5 years(including the first discovery),with 130 cases accounting for 29%.2.Common symptoms,syndromes and syndrome elements:A total of 128 symptoms of DCM were collected,including 6 main symptoms,6 edema symptoms according to their distribution,17 systemic symptoms,15 lung and chest symptoms,14 hepatobiliary,spleen and stomach and abdominal symptoms,5 kidney and waist and limbs symptoms,17 facial symptoms,5 food and taste symptoms,4 sleep symptoms,6 stool symptoms,3 body symptoms and tongue symptoms.There are 38 common syndrome types with a total frequency of 813 times,among which the syndrome types with a frequency greater than 5% are water-dampness stagnation(151cases),blood stasis blocking collaterals(132 cases),qi-yin deficiency(114 cases),qi-deficiency and blood stasis(88 cases),heart-spleen deficiency(37 cases),yang deficiency and water invasion(31 cases).There are 8 syndrome elements in common diseases,involving a total frequency of 1095 times.The syndrome elements in common diseases with a frequency greater than 10% are heart(443 cases),spleen(301cases),lung(154 cases),kidney(85 cases)and liver(74 cases).There are 13 common syndrome elements with a total frequency of 1217 times.The syndrome elements with a frequency greater than 10% are qi deficiency(279 cases),blood stasis(239 cases),water stagnation(223 cases),yin deficiency(144 cases),phlegm(82 cases),yang deficiency(79 cases)and qi depression(58 cases).Regression analysis: the common syndrome elements and corresponding symptoms of DCM were analyzed by Logistic regression method.the disease location:heart(shortness of breath,chest pain,weak pulse,asthma,pulse knot,dry cough without phlegm,etc.);Spleen(pale lips,loose stool,fatigue,etc.);Lung(sweating,delayed pulse,low cough,aversion to cold and fever,chest pain,etc.);Kidney(low back pain,trance,dark complexion,night sweat,red tongue tip,etc.);Liver(hypochondriac pain,sticky sputum,delayed pulse,fatigue,thick and greasy tongue coating,etc.).Disease: qi deficiency(diarrhea,fatigue,slippery pulse,palpitation,fatigue,shortness of breath,etc.);Blood stasis(blue veins,blue lips,etc.);Yin deficiency(trance,pulse,dizziness,hot flashes,dizziness,etc.);Water stop(edema,diarrhea,thin tongue coating,little urine,deep pulse,greasy tongue coating,pale mouth,etc.);Phlegm(slippery pulse,white sputum,thin pulse,numbness of limbs,dizziness,thick sputum,etc.);Yang deficiency(drowsiness,dizziness,trance,white tongue coating,thin pulse,cold limbs,etc.).4.Cluster analysis: 128 collected symptoms were classified according to TCM knowledge,and 24 cluster results were obtained.According to TCM basic knowledge,the related syndromes and syndrome elements were explained,among which the common symptom elements were heart,spleen,lung,kidney,qi deficiency,water stagnation,blood stasis,yin deficiency and phlegm.Secondly,the syndrome elements are liver,gallbladder,dampness,stomach,heat,qi stagnation,yang withdrawal,yin withdrawal and blood deficiency.Conclusion:1.The most common core symptoms of DCM are chest tightness,asthma,edema,fatigue,palpitation,anorexia,dark tongue and light tongue.2.The most common syndromes of DCM are: stagnation of water and dampness,obstruction of collaterals by blood stasis,deficiency of qi and yin,deficiency of qi and blood stasis,deficiency of heart and spleen,deficiency of yang and water,and internal disturbance of phlegm and heat.3.The most common syndrome elements of DCM are heart,spleen and lung,followed by liver and kidney,and the most common syndrome elements are qi deficiency,blood stasis,yin deficiency and water stagnation.Liver,kidney,phlegm,yang deficiency,and qi deficiency are the second.