摘要
目的：探讨慢性心力衰竭患者中医证型分布情况及相关影响因素。方法：收集288例慢性心力衰竭住院患者的临床资料和中医证型信息,采用二分类Logistic回归方法分析各中医证型与年龄、性别、基础疾病、血红蛋白、肝肾功能及MAP等指标的相关性。结果：288例心衰患者中男148例,女140例,平均年龄（75.24±11.29）岁,其中心肺气虚证4例,气阴两亏证73例,心肾阳虚证10例,气虚血瘀证139例,阳虚水泛证12例,痰饮阻肺证50例。影响因素方面,男性与气虚血瘀型、阳虚水泛型心衰呈正相关（P=0.045、P=0.047,OR值分别为1.786、9.77）,而与气阴两亏型心衰呈负相关（P=0.023,OR=0.489）;冠心病与气虚血瘀型心衰呈正相关（P〈0.001,OR=8.244）,与气阴两亏型、痰饮阻肺型心衰呈负相关（P=0.027、P〈0.001,OR值分别为0.489、0.2）;高血压与心衰气阴两亏型心衰呈负相关（P=0.018,OR=0.44）,与痰饮阻肺型心衰呈正相关（P=0.013,OR=4.261）;扩张性心肌病与心肾阳虚型心衰呈正相关（P=0.023,OR=14.179）,BUN与阳虚水泛型心衰呈正相关（P=0.036,OR=5.043）。结论：慢性心力衰竭住院患者中气虚血瘀证患者偏多。男性心衰患者可能更易表现为气虚血瘀型和阳虚水泛型,女性可能更易表现为气阴两亏型,合并冠心病的心衰患者可能更易表现为气虚血瘀型,合并高血压的心衰患者可能更易表现为痰饮阻肺型,合并扩张性心肌病的心衰患者可能更易表现为心肾阳虚型,血BUN升高的患者可能更易表现为阳虚水泛型心衰。
Objective：To explore the distribution of traditional Chinese medicine（TCM）syndromes and related influence factors of chronic heart failure（CHF）. Methods：The clinical and TCM syndromes data of 288 inpatients were collected,which was analyzed by Logistic regression for the relationshipanalysis between TCM syndrome and age,sex,primary diseases,hemoglobin,hepatic and renal function,and MAP. Results：There were 148 male and 140 female in this 288 CHF patients,with the average age was（75.24±11.29）years old. The distribution of TCM syndromes is that 4 syndrome of Qi deficiency of heart and lung,73 syndrome of deficiency of both Qi and Yin,10 syndrome of yang deficiency of heart and kidney,139 Qi-deficiency causing blood stasis syndrome,12 edema syndrome due to Yang deficiency and 50 phlegm obstructing lung syndrome. Male was positively related to Qi-deficiency causing blood stasis syndrome and edema syndrome due to Yang deficiency（P=0.045,P=0.047,OR=1.786,OR=9.77）,and negatively related to syndrome of deficiency of both Qi and Yin（P=0.023,OR=0.489）. Coronary heart disease（CHD）was positively related to Qideficiency causing blood stasis syndrome（P0.001,OR=8.244）,and negatively related to syndrome of deficiency of both Qi and Yin and phlegm obstructing lung syndrome（P=0.027,P0.001,OR=0.489,OR=0.2）. Hypertension was negatively related to syndrome of deficiency of both Qi and Yin（P=0.018,OR=0.44）,and positively related to phlegm obstructing lung syndrome（P=0.013,OR=4.261）. Dilated cardiomyopathy was positively related to Yang deficiency of heart and kidney（P=0.023,OR=14.179）,BUN was positively related to edema syndrome due to Yang deficiency（P=0.036,OR=5.043）. Conclusion：Qi-deficiency causing blood stasis syndrome is more popular in CHF inpatients. Male CHF patients are probably easier to suffer Qi-deficiency causing blood stasis syndrome and edema syndrome due to Yang deficiency,with syndrome of deficiency of both Qi and Yin more popular in female. CHF patients combined with CHD may be easier to suffer Qi-deficiency causing blood stasis syndrome,while combined with hypertension to phlegm obstructing lung syndrome. CHF patients combined with dilated cardiomyopathy may be more susceptible to Yang deficiency of heart and kidney and CHF patients combined with high serum BUN may be more likely to suffer Yang deficiency.
作者
颜蕾
魏易洪
周忠焱
邓兵
周端
唐靖一
李广浩
李翠
YAN Lei;WEI Yihong;ZHOU Zhongyan;DENG Bing;ZHOU Duan;TANG Jingyi;LI Guanghao;LI Cui(Shanghai Changning Tianshan Traditional Chinese Medicine Hospital, Shanghai 200051, China;Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China)
出处
《辽宁中医药大学学报》
CAS
2018年第7期97-100,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金项目(81603549)
上海市加强公共卫生体系建设三年行动计划资助项目(GWIV-28)
上海市卫计委科研基金项目(20154Y0052)
上海中医药大学预算内项目(2014YSN31)
关键词
心力衰竭
中医证型
影响因素
heart failure
traditional Chinese medicine syndrome
influence factors
