Analysis Of TCM Syndromes Of Heart Failure With Preserved Ejection Fraction Based On HIS “Real World”

Objective:Based on HIS "Real World",we collected the patients with Ejection fraction with preserved heart failure,analyzed and discussed the syndrome factors,the target of syndrome factors,the charac-teristics and distribution of TCM syndromes,besides established the diagnostic model of common syndromes,which laid the foundation for the establishment of mature TCM diagnostic criteria for Ejection fraction with preserved heart failure.Methods :The data of hospitalized patients who met the inclusion criteria from January 1,2014 to December 31,2019 were extracted from the HIS system of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine,finally,this study 239 cases were included.With The information of four diagnoses of TCM was collected,the rules were obtained by frequency analysis,fact or analysis and cluster analysis,and the diagnosis model of common TCM syndromes was established by using two-classification Logistic regression analysis.Results :1.A total of 239 patients were involved in this study,including105 males(4 3.94%)and 134 females(56.06%).The mean age of men was 61.54 years and that of women was 70.60 years.The age group of patients was mainly concentrated in " ≥70 years old ",with a total of138 cases(5 7.74 %).2.The top 5 symptoms and signs were palpitations(84.51%),shortness of breath(74.89%),chest tightness(57.74%),wheezing(31.79%)and fatigue(30.54%).The three most common tongue images are fat tongue(44.76 %),thin lingual fur(37.23%),lilac or purple dark tongue(34.72 %).3.Seven syndrome factors were extracted based on factor analysis,of which 4 were solid elements,including turbid phlegm,blood stasis,internal heat and water dampness.There are three deficiency elements,which are qi deficiency,yang deficiency and yin deficiency.There are 6 targets of syndrome elements,including heart,spleen,liver,lung,stomach and kidney.The three main syndrome factors are qi deficiency(19.70%),blood stasis(1 7.91%)and yang deficiency(15.52%).The targets of the three main syndrome factors were heart(3 0.54%),kidney(19.88 %)and spleen(17.57%).4.Based on cluster analysis,TCM syndromes can be divided into five types: qi deficiency and blood stasis syndrome,qi yin deficiency syndrome,heart and kidney yang deficiency syndrome,yang deficiency and water flood syndrome,phlegm and blood stasis mutual knot syndrome.5.Results of diagnostic model of qi deficiency and blood stasis syndrome and qi yin deficiency syndrome: the area under the ROC curve was 0.872 and 0.976,the sensitivity corresponding to the maximum critical value of Youden index was 80.9% and 93.4%,and the specificity was 85.7% and 93.1%.Conclusion:1.The syndrome factors of ejection fraction retained heart failure are deficiency and excess,qi deficiency and yang deficiency is mostly in deficiency factors,blood stasis are the most common in solid syndrome,the main syndrome target is heart,followed by kidney.2.Patients with ejection fraction retained heart failure can refer to the following TCM types: qi deficiency and blood stasis syndrome,qi yin deficiency syndrome,heart and kidney yang deficiency syndrome,yang deficiency and water flood syndrome,phlegm and blood stasis mutual knot syndrome.3.The diagnostic models of qi deficiency and blood stasis syndrome and qi yin deficiency syndrome fit well,which have high sensitivity and specificity,and its clinical diagnostic value needs further study.