慢性心力衰竭中医证素分布与心脏彩超、NT-proBNP的相关性研究

Study on correlations between TCM syndrome distribution, echocardiography, and NT-pro BNP of chronic heart failure

目的:探讨慢性心力衰竭(CHF)中医证素、证型分布与心脏彩超、NT-pro BNP的相关性。方法:将90例患者分为心肺气虚证、气阴两虚证、气虚血瘀证、阳虚水泛证和心肾阳虚证5组证型,提取分析CHF证素分布情况。以18例健康志愿者作为正常对照组,研究CHF的NYHA心功能分级与心脏彩超、NT-pro BNP的相关性。结果:CHF的证素分布:病位以心(94.4%)为主;病性是以气虚(82.2%)为主的本虚证素和以血瘀(70.0%)为主的标实证素。结论:CHF病机特点为本虚标实,病位以心为主,病性证素以气虚为本,以血瘀为标。心脏彩超作为CHF的重要检查手段,其各项参数在各证型组之间具有明显的差异,可作为CHF中医辨证的重要辅助手段。CHF各证型的NT-pro BNP水平具有明显的差异,可作为CHF中医辨证的重要参考指标。

Objective： To investigate the relationship between TCM syndrome distribution, echocardiography, and NTpro BNP of chronic heart failure（CHF）. Methods： 90 patients were divided into 5 groups as syndrome of qi deficiency of heart and lung, syndrome of deficiency of both qi and yin, syndrome of blood stasis due to deficient qi, syndrome of water overflowing due to yang deficiency, and syndrome of yang deficiency of heart and kidney, and the distribution of syndrome elements of CHF were extracted and analyzed. The correlations among cardiac functional grading of NYHA, echocardiography, and NT-pro BNP were studied with 18 healthy volunteers as the control group. Results： The distribution of syndrome elements was as follows： the disease location was given priority to heart（94.4%）, and the nature of disease is given priority to qi deficiency（82.2%） and blood stasis（70.0%）. Conclusion： The pathogenic characteristic of CHF is asthenia in origin and asthenia in superficiality, disease location is in heart, and the syndrome elements are qi deficiency and blood stasis. Echocardiography as an important examinational mean for CHF, and the difference in its various parameters between different syndrome groups are significant, which could be used as an important auxiliary means for TCM syndrome differentiation of CHF. The difference in NT-pro BNP levels between different syndrome groups is significant, and it also could be as an important auxiliary means for TCM syndrome differentiation of CHF.