慢性心力衰竭患者中医证候要素分布特征

Study on distribution characteristics of TCM syndrome elements of patients with chronic heart failure

目的运用回顾性研究方法研究慢性心衰患者的中医证候要素分布特征。方法采用回顾性调查的方式,提取慢性心衰患者的证侯要素,采集心衰患者的性别、年龄及心功能等相关信息,对各证侯要素分布规律及其在不同性别、年龄及心功能中分布的差异进行统计学分析。结果研究共提取病位类证素5种,分别为心、肺、肾、脾、肝,出现频次合计576次,构成比39.61%,在各级心功能中出现频次构成比由大到小排列均为心>肺>肾>脾>肝,其分布构成比均具有显著性差异;病性类证素12种,其中气虚、阳虚、阴虚、痰浊、水饮、血瘀是心衰的基本病性要素,按各证素出现频次所占百分比由高到低排列为气虚234次(26.65%)、痰浊159次(18.10%)、血瘀131次(14.92%)、水饮106次(12.07%)、阴虚105次(11.96%)、阳虚69次(7.86%),6种基本证素在不同性别和不同心功能心衰患者中的分布均具有显著性差异。结论随着心衰病情的发展,心衰的病位是动态变化的,其由心→心肺→心肺脾肾。心衰的证候多为虚实夹杂,出现以痰浊、水饮、血瘀等实证类证素占比例增大时,病情相对较轻;而以气虚、阴虚或阳虚等虚证类证素占比例加大时,病情多较重。通过分析慢性心衰中医证候要素分布特征,可为慢性心衰证候的标准化研究提供依据及参考。

Objective To study the distribution characteristics of TCM syndromes in patients with chronic heart failure by retrospective study. Methods A retrospective survey, in patients with chronic heart failure syndrome factor extraction collected information related to heart failure patients gender, age and cardiac function, of each syndrome factor distribution and difference in different gender, age and heart function in the distribution of statistical analysis. Results A total of extraction disease syndromes（5, heart, lung, kidney, spleen, liver, respectively, frequency of occurrence of a total 576 times, constituent ratio 39.61%; in all levels of cardiac function in frequency than arranged in order from big to small are heartlungkidneyspleenliver. The distribution of constituent ratio were significant differences. Disease of syndrome elements in 12 kinds, including Qi deficiency, Yang deficiency, yin deficiency, phlegm, drink water,blood stasis is basic disease factor for heart failure, according to the prime frequency percentage from high to low order to Qi deficiency and 234（26.65%）, phlegm 159（18.10%）, blood stasis 131（14.92%）, drinking water, 106（12.07%）,yin deficiency with 105 times（11.96%）, deficiency of Yang 69（7.86%）, 6 kinds of basic card prime distribution in different gender and cardiac function of heart failure patients has significant difference. Conclusion With the development of heart failure, the position of heart failure is dynamic, and it is composed of heart, heart, lung, heart, lung,spleen and kidney. Heart failure syndrome multi for the actual situation inclusions, appear to phlegm, water retention,blood stasis and other empirical evidence） proportion increased, the condition is relatively light; and with Qi deficiency,yin deficiency or yang deficiency syndrome element proportion is increasing, the condition is serious. By analyzing the distribution characteristics of TCM Syndromes of chronic heart failure, this study can provide the basis and reference for the standardization of chronic heart failure syndrome.