110例射血分数中间值心衰患者的中医证候、体质、心功能指标的相关性研究  

Correlation Study on TCM Syndrome,TCM Constitution,and Cardiac Function Indexes in 11o Patients with HFmrEF

作　　者：金东林 蒙定水[2] 史洋阳 赵继尧 兰昌林 别梦迪 曹伟 谢璋庆 康善平[2] Jin Donglin;Meng Dingshui;Shi Yangyang;Zhao Jiyao;Lan Changlin;Bie Mengdi;Cao Wei;Xie Zhangqing;Kang Shanping(Guangxi University of Chinese Medicine,Guangxi,Nanning 530001,China)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学附属瑞康医院,广西南宁530011

出　　处：《中国中医急症》2023年第6期995-998,1007,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：桂派中医大师培养项目(桂财社函[2022]136号);广西中医药大学研究生教育创新计划项目(YCXJ2021107)。

摘　　要：目的通过观察射血分数中间值心力衰竭(HFmrEF)患者的中医证候、体质、心脏功能指标的相关性,进而为中医的辨病、辨证、辨体防治HFmrEF提供理论依据。方法110例患者严格选择样本,采集患者姓名、性别、年龄、NYHA心功能分级、脑钠肽(BNP)、超声心动图指标[左心室射血分数(LVEF)、左心室收缩末内径(LVESD)、左心室舒张末内径(LVEDD)、室间隔厚度(IVST)]以及中医证候、中医体质类型等信息,对其相关性进行统计学分析。结果110例HFmrEF患者中,证候按频数大小依次为阳虚水泛、痰饮阻肺、气虚血瘀、心肾阳虚、心肺气虚、气阴两虚;体质按频数大小依次为阳虚质、气虚质、血瘀质、痰湿质、阴虚质。HFmrEF患者各证候、体质与NYHA心功能分级呈正相关。不同证候的LVEF、LVESD、LVEDD、IVST比较,差异均无统计学意义(均P>0.05)。不同体质的LVEF、LVEDD、LVESD比较差异均无统计学意义(均P>0.05),但IVST比较则差异具有统计学意义(P<0.01)。结论HFmrEF患者心功能相关指标的水平可以在一定程度上为中医指标客观化作参考,为中西医相结合的诊疗模式对患者的预防发病及改善预后提供指导性建议。Objective:To provide a theoretical basis for combining of diseases differentiation,syndromes differ-entiation and constitution differentiation to prevent and treat heart failure with mid-range ejection fraction(HFm-rEF)by observing the correlation of traditional Chinese medicine(TCM)syndromes,TCM constitution,and cardi-ac function indexes in patients with HFmrEF.Methods:110 patients with HFmrEF were collected,and the sam-ple was strictly selected to collect information on patients'name,gender,age,NYHA cardiac function classifica-tion,B-type natriuretic peptide(BNP),echocardiographic indexes(LVEF,LVESD,LVEDD,IVST),as well as TCM syndromes and TCM constitution,and their correlations were statistically analyzed.Results:In 110 patients with HFmrEF,the TCM syndromes were,in order of frequency,syndrome of water overflowing due to yang deficiency,syndrome of turbid phlegm obstructing lung,syndrome of blood stasis due to qi deficiency,heart-kidney Yang defi-ciency,syndrome of qi deficiency of heart and lung,and deficiency of both qi and yin;the TCM constitutions were,in order of frequency,yang deficiency constitution,qi deficiency constitution,blood stasis constitution,phlegm-dampness constitution,and yin deficiency.There was a positive correlation between the TCM syndromes and con-stitutions and NYNH cardiac function classification in HFmrEF patients.The differences were not statistically sig-nificant when comparing LVEF,LVESD,LVEDD,and IVST of dfferent TCM syndromes(all P>0.05).There was no statistically significant difference in the comparison of LVEF,LVEDD,and LVESD among different TCM consti-tutions(all P>0.05),but the difference in IVST was statistically significant(P<0.01).Conclusion:The level of cardiac function related indicators of HFmrEF patients can be used as a reference for the objectivity of TCM indi-cators to a certain extent,and provide guiding suggestions for the prevention of morbidity and improvement of prog-nosis of patients based on the diagnosis and treatment mode of combining TCM and western medic

关 键 词：射血分数中间值心衰 证候 中医体质 脑钠肽 超声心动图 

分 类 号：R541.61[医药卫生—心血管疾病]