Objectives To discuss the characteristics of TCM syndrome factors and distribution discipline of congestive heart failure, and provide basis for the establishment of diagnosis criteria on essential syndromes.
Methods 1) Based on databases of CNKI(1980-2012) and VIP(1989-2012), satisfactory modern documents on congestive heart failure were reorganised and analysed, and factors of compound syndromes were extracted. All the syndromes were classified to deficiency syndrome, excess syndrome, and deficiency complicated with excess syndrome. Compound syndromes were detached to separate syndrome factor in terms of single factor, two factors, three factors and four factors, and then each frequency of occurrence had been counted. 2) 1451 CHF cases from grade 3 and first-class hospitals (from December, 2010 to September, 2012) were collected, with statistical analysing by SPSS18.0. The correlations in CHF syndromes and age, sex, primary illnesses, clinical manifestations, BNP and cardiac functional grading had been studied, and the clinical distribution discipline on common syndromes of CHF had been summarised.
Results 1) Literature analysis indicates: Syndrome factors on disease location of CHF are the heart, kidney, lung, and the spleen. Factors on natures of this disease sorted from more to less is qi deficiency, blood stasis, yang deficiency, yin deficiency, yang exhausted, water retention, phlegm, retained fluid, yin exhausted, heat, and blood deficiency. Qi deficiency of the heart was the most common syndrome in single factor of deficiency syndrome, qi and yin deficiency syndrome in two factors of deficiency syndrome, and blood stasis syndrome of the heart in single factor of excess syndrome, blood stasis and water retention in two factors of excess syndrome, qi deficiency and blood stasis in two factors of deficiency complicated with excess syndromes, qi deficiency and blood stasis mixed with water retention in three factors, and yang deficiency of the heart and spleen mixed with blood stasis and water retention in four factors. 2) Retrospective analysis of clinical cases indicates: The primary disease mainly is coronary heart disease. CHF is an ageing disease, patients aged over 80 years old are most common and that less than 50 years old are little. Stagnation of the heart blood syndrome and deficiency of both qi and yin syndrome are mostly seen in female patients. Syndrome of phlegm blocking heart vessel and qi deficiency and blood stasis syndrome are mostly seen in male patients. Deficiency syndrome of the heart qi and qi deficiency and blood stasis syndrome are mostly seen in patients aged 50-60. And that aged over 60 years old are likely manifested with deficiency of both qi and yin syndrome and stagnation of the heart blood syndrome. Syndrome aggravates with the going up of BNP level and cardiac functional grading.
Conclusions The essential syndromes of congestive heart failure are qi deficiency and blood stasis syndrome, deficiency of both qi and yin syndrome. Besides, qi deficiency and blood stasis mixed with water retention syndrome can be seen with the extension of disease course. The clinical distribution discipline links to patients’ age and gender. Congestive heart failure mostly develops from coronary heart disease. BNP closely relates to cardiac functional grading and syndromes of CHF, which can be an expected indicator weighting the severity of TCM syndromes.