充血性心力衰竭阳虚水泛证临床特点研究

Research on Clinical Characteristics of Yang-deficiency-water-diffusion Syndrome of Congestive Heart Failure

目的通过临床回顾性研究,探讨充血性心力衰竭（CHF）阳虚水泛证的临床特点。方法收集上海中医药大学附属龙华医院、岳阳中西医结合医院、普陀中心医院2010年12月至2012年9月所收住的CHF阳虚水泛证患者病例,探讨本病证与发病年龄、性别差异、伴发疾病以及实验室指标等的相关性。结果 CHF阳虚水泛证多见于80岁以上的患者;80岁以上的女性患者以及70岁到79岁之间的男性患者较为多发;常并发冠心病、房颤、糖尿病等疾病;中医病名多为喘病、胸痹心痛病;临床主要症状为：胸闷、气促、心悸、下肢浮肿、小便量少、舌淡红、苔白腻、脉沉弦细等;心功能Ⅲ级以及BNP在459～1006pg/ml的患者相对较多。结论 CHF阳虚水泛证在发病年龄、性别、伴发疾病以及与实验室指标的相关性等方面有一定的临床特点。

Objective To discuss clinical characteristics of Congestive Heart Failure（ CHF） Yang-deficiency-water-diffusion syndrome by clinic retrospective study. Methods Clinic retrospective cases were collected from Longhua Hospital,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,and Putuo Central Hospital affiliated to Shanghai University of Traditional Chinese Medicine from December,2010 to September,2012. The correlations in Yang-deficiency-water-diffusion syndrome of CHF and age,gender,primary illnesses,and laboratory indexes had been studied and summarized. Results CHF Yang-deficiency-water-diffusion syndrome is mostly seen in patients aged over 80,especially in male aged 70-79 and female aged over 80. The common primary diseases are coronary heart disease,atrial fibrillation,and diabetes. In Chinese Medicine,CHF belongs to the category of asthma and chest-obstruction-heartache disease. Its clinical manifestations are chest distress,shortness of breath,palpitation,edema of lower limbs,scanty urine,light and red tongue,white and greasy fur,and deep-wiry-thin pulse. Patients with this syndrome pattern of CHF are mostly in level 3 of cardiac function,and their inspection results of brain natriuretic peptide（ BNP） are mostly between 459 to 1006 pg / ml. Conclusion There are definite characteristics of CHF Yang-deficiency-water-diffusion syndrome in relations with age,gender,primary illnesses,and laboratory indicators.