Shi Jun, Luo Liangtao, Chen Jing, Wang Juan, Zhao Huihui, Wang Wei
Beijing University of Chinese Medicine (Institute of Traditional Chinese Medicine; Beijing Key Laboratory of TCM Syndrome and Formula; Ministry of Education Key Laboratory of TCM Syndrome and Formula), Bei San Huan Dong Lu, Chao Yang District, Beijing 100029, China.
Basic Medical School of Inner Mongolia Medical University, Hohhot 010010, China.
Evid Based Complement Alternat Med. 2019 Feb 3;2019:2543413. doi: 10.1155/2019/2543413. eCollection 2019.
This study investigated the distribution of characteristics of traditional Chinese medicine syndromes and their association with symptoms in 1027 patients with chronic heart failure (CHF).
An observational study was performed by researchers, collecting data from 1036 patients with CHF from 24 Chinese medicine hospitals from May 2009 to December 2014. Due to incomplete information from nine patients, 1027 patients with CHF were analysed. The distribution of syndromes in CHF and association between high-frequency syndromes and symptoms were investigated.
The primary syndromes were qi deficiency, blood stasis, fluid retention, yin deficiency, phlegm turbidity, and yang deficiency. The primary sites of disease were the heart, kidney, lung, and spleen. In patients with CHF of differing cardiac function, there was no significant difference in the frequency of yin deficiency (P>0.05). The distribution of yang deficiency was significantly different between New York Heat Association (NYHA) classes II, III, and IV and between classes I+II and III+IV (P<0.05). The frequency of phlegm turbidity was significantly different between NYHA classes II and III, between classes III and IV, and between classes I+II and III+IV (P<0.05). The frequency of fluid retention was significantly different between NYHA classes I and IV, between classes II, III, and IV, and between classes I+II and III+IV (P<0.05). Regarding associations between syndromes and symptoms, qi deficiency was diagnosed in 87.43% of patients with insomnia and spiritlessness; blood stasis in 84.85% of patients with spontaneous sweating + cyanosis of the lips; fluid retention in 75% of patients with a hard pulse and oedema; and yin deficiency in 72.92% of patients with feverish sensation in the chest, palms, and soles and spontaneous sweating.
The frequency of yang deficiency and fluid retention was higher and that of phlegm turbidity was lower in classes III and IV than in classes I and II.
本研究调查了1027例慢性心力衰竭（CHF）患者的中医证候特征分布及其与症状的相关性。
研究人员进行了一项观察性研究，收集了2009年5月至2014年12月期间来自24所中医医院的1036例CHF患者的数据。由于9例患者信息不完整，对1027例CHF患者进行了分析。调查了CHF的证候分布以及高频证候与症状之间的相关性。
主要证候为气虚、血瘀、水饮、阴虚、痰浊、阳虚。主要病位在心、肾、肺、脾。不同心功能的CHF患者中，阴虚频率无显著差异（P>0.05）。阳虚分布在纽约心脏协会（NYHA）II、III、IV级之间以及I+II级和III+IV级之间有显著差异（P<0.05）。痰浊频率在NYHA II级和III级之间、III级和IV级之间以及I+II级和III+IV级之间有显著差异（P<0.05）。水饮频率在NYHA I级和IV级之间、II、III、IV级之间以及I+II级和III+IV级之间有显著差异（P<0.05）。关于证候与症状的相关性，87.43%失眠且精神萎靡的患者诊断为气虚；84.85%自汗且唇色青紫的患者诊断为血瘀；75%脉象硬且水肿的患者诊断为水饮；72.92%胸、掌、 soles发热且自汗的患者诊断为阴虚。
III级和IV级患者阳虚和水饮的频率高于I级和II级，痰浊频率低于I级和II级。
