慢性左心功能不全的中医辨证分型与心功能分级之间的关系研究

Relationship study between TCM syndrome differentiation and cardiac function classification in patients with chronic left ventricular dysfunction

目的:探究慢性左心功能不全的中医辨证分型与心功能分级之间的关系。方法:选取2015年7月-2016年9月于我院接受治疗的慢性左心功能不全患者100例,根据纽约心脏学会(NYHA)心功能分级标准将100例患者分为心功能II^IV级,随后对此100例慢性左心心功能不全患者做中医的辨证分型,依次分为气阴两虚型、气虚血瘀型、心肾阳虚型。比较心功能分级与中医的辨证分型有无相互关系。结果:心功能分级与中医的辨证分型差异具有统计学意义(P<0.05),即心功能II级患者以气阴两虚型为主,比例比较为气阴两虚型(78.00%)>气虚血瘀型(14.00%)>心肾阳虚型(8.00%)。心功能III级患者以气虚血瘀型为主,比例比较为气虚血瘀型(76.67%)>气阴两虚型(10.00%)>心肾阳虚型(13.33%)。心功能IV级患者以心肾阳虚型为主,其中心肾阳虚型(80.00%)>气虚血瘀型(15.00%)>气阴两虚型(5.00%)。结论:慢性左心功能不全的中医辨证分型与心功能分级之间有一定的关系,中医辨证分型中心肾阳虚型患者心功能最差,其次为气虚血瘀型、气阴两虚型。

Objective:To explore the relationship between TCM syndrome differentiation and cardiac function classification in patients with chronic left ventricular dysfunction.Methods:100cases of patients with chronic left cardiac insufficiency treated in our hospital from July2015to September2016were selected and divided into cardiac function grade II～IV according to NYHA classification standard;then they were divided based on TCM syndrome differentiation and divided into Qi and Yin deficiency type,Qi deficiency and blood stasis type and heart and kidney Yang deficiency type.The correlation between the cardiac functional classification and the differentiation of syndromes in Chinese medicine is compared and studied.Results:The difference of cardiac function classification and TCM syndrome differentiation was statistically significant(P<0.05);the heart function class II patients were mainly of Qi and Yin deficiency type,the proportion of Qi and Yin deficiency type(78.00%)>Qi deficiency and blood stasis type(14.00%)>heart and kidney Yang deficiency type(8.00%).Cardiac function level III patients were mainly of Qi deficiency and blood stasis type,the proportion of Qi deficiency and blood stasis type(76.67%)>Qi and Yin deficiency type(10.00%)>heart and kidney Yang deficiency type(13.33%).The heart function IV patient were mainly of heart and kidney Yang deficiency type,the proportion of heart and kidney Yang deficiency(80.00%)>Qi deficiency and blood stasis(15.00%)>Qi and Yin deficiency type(5.00%).Conclusion:Chronic left cardiac insufficiency of TCM had certain relationship with heart function classification,heart function in patients with kidney Yang deficiency type of TCM was the worst,which was followed by Qi deficiency and blood stasis,Qi and Yin deficiency type.