148例慢性心力衰竭患者中医证候分布规律研究

[目的]研究内蒙古自治区呼和浩特市及周边慢性心力衰竭(CHF)患者中医证候规律,探索证候要素分布特点,为中医临床辨证论治提供可鉴思路。[方法]课题组收集入组148例CHF患者临床资料,按照中医诊断标准,统计分析并探讨其分布规律。[结果]CHF病例男女比例0.83∶1,平均年龄(64.6±11.2)岁。CHF中医证型分布以气阴两虚证为主,其次为气虚血瘀证,之后依次是心肺气虚证、心肾阳虚证、阳虚水泛证、痰饮阻肺证;证候要素组合特征以两证组合为最多,之后依次是三证、单证、四证、五证组合。[结论]148例CHF患者中医证候要素组合中多数以心肺气虚为基础,中医证型分布及变化有其特定的规律性,阳虚水泛证的病情稍重;从病位来看,CHF病位不仅在心,还可涉及肺、肝、肾、脾等其他脏器,随着CHF病程的延长,病因病机也在随时发生变化,证型则趋向于由气虚到气阴两虚或气虚血瘀,最终发展为阳虚水泛为主的转化过程。

Distribution of traditional Chinese medicine syndrome of in 148 patients with chronic heart failure

[Objective] To study the rule of traditional Chinese medicine (TCM) syndrome of chronic heart failure (CHF) at Hohhot in the Inner Mongolia and it''s Region, to explore the distribution characteristics of syndrome elements, which can provide a reference for the clinical syndrome differentiation of TCM. [Methods] Using the method of clinical epidemiology, the clinical data of 148 patients CHF were collected and analyzed by clinical epidemiology. [Results] the distribution of CHF was characterized, The overall proportion of male and female was 0.83:1, and mean age were (64.6±11.2) years old. TCM Syndromes distribution: CHF syndromes distribution with qi and yin deficiency syndrome mainly, secondly is qi deficiency and blood stasis, followed by heart and lung qi deficiency syndrome, heart and kidney yang deficiency syndrome, yang deficiency and water retention and turbid phlegm obstructing in the lung. Syndrome combination characteristics: 2-syndrome combinations were common, then 3-syndrome, single syndrome, 4-syndrome and 5-syndrome combinations were less. [Conclusion] Heart and lung qi deficiency was the basic syndrome in 148 CHF patients. TCM syndrome type distribution and change have its specific regularity, yang deficiency and water retention is slightly heavier; from disease point of view, heart failure disease not only in the heart, but also relates to the lung, liver, kidney, spleen and other the other organs, with the extension of the course of heart failure, etiology and pathogenesis also in change at any time, syndrome types tend to by asthenia to deficiency of both qi and yin or qi deficiency and blood stasis, and ultimately the development of yang deficiency and water retention based transformation process.