心力衰竭患者中医证型与血尿酸水平及心力衰竭分期的相关性研究

Correlation of TCM Syndrome Differentiation with Serum Uric Acid Level and Heart Failure

目的测定慢性心力衰竭患者血尿酸(UA)水平,探讨中医辨证分型与心力衰竭不同分期的内在关系。方法对符合临床诊断标准的120例患者,进行心力衰竭分期及中医辨证分型,同时对血清尿酸和氨基端脑钠肽前体(NT-proBNP)检测结果进行分析。结果①心力衰竭A期以心肺气虚症为主;B期以气阴两虚证为多见;而C期则以气虚血瘀证为多见。②120例患者血清UA和NT-proBNP水平在心力衰竭不同分期之间有统计学意义(P<0.05或P<0.01),即C期较B期和A期显著升高,B期又显著高于A期。③血清UA水平在中医各证型之间有统计学意义(P<0.05或P<0.01)。结论血清UA水平与中医辨证分型和心力衰竭分期有着密切的关系。血清UA水平随着心肺气虚<气阴两虚<气虚血瘀<心肾阳虚分型而增加。

Objective To investigate the correlation of traditional Chinese medicine（TCM） syndrome differentiation with serum uric acid（UA） in chronic heart failure.Methods One hundred and twenty patients（pts） with chronic heart failure were selected.The serum UA and N-terminal portion of brain natriuretic（NT-proBNP）were tested.Relationship between TCM syndrome differentiation and UA,and NT-proBNP were analyzed.Results ①Most pts with heart failure in C stage were Qi-deficiency syndrome of heart and lung.Most pts with heart failure in B stage were the deficiency syndrome of Qi and Yin.Most pts with heart failure patients in C stage were Qi-deficiency and blood-stasis syndrome.②The levels of UA and NT-proBNP were significantly different in different stages of heart failure（P0.05 or P0.01）.UA and NT-proBNP levels in C stage were significantly higher than that in B and A stage.The levels of UA and NT-proBNP in B stage were significantly higher than that in A stage.③Serum UA levels in the various TCM syndromes were different significantly（P0.05 or P0.01）.Conclusion Serum UA levels and TCM Syndrome Differentiation and stage of heart failure were closely related.Following with the increasing of serum UA levels,the syndrome types were as follow Yang-deficiency syndrome of heart and kidney,Qi-deficiency and blood-stasis syndrome,deficiency syndrome of Qi and Yin,Qi-deficiency syndrome of heart and lung.The main syndrome types in A stage of heart failure was Qi-deficiency syndrome of heart and lung.The main syndrome types in B stage of heart failure was deficiency syndrome of Qi and Yin.The main syndrome types in C stage of heart failure was Qi-deficiency and blood-stasis syndrome.