| 孙迪,丁雪萍,林玉芳,林炎彬,乔红元,赵俊,周赵薇.基于无创检测技术探讨慢性心力衰竭中医证型与心功能及神经内分泌的相关性[J].浙江中西医结合杂志,2025,35(11): |
| 基于无创检测技术探讨慢性心力衰竭中医证型与心功能及神经内分泌的相关性 |
| Exploring the correlation between traditional Chinese medicine syndrome types, cardiac function, and neuroendocrine in chronic heart failure based on non-invasive detection technology |
| 投稿时间：2025-03-25 修订日期：2025-06-24 |
| DOI： |
| 中文关键词: 慢性心力衰竭 中医证型 心功能 神经内分泌 |
| 英文关键词:Chronic heart failure,TCM syndrome,Heart function,Neuroendocrine |
| 基金项目:浙江省中医药科技计划项目(NO.2023ZL709) |
|
| 摘要点击次数: 72 |
| 全文下载次数: 0 |
| 中文摘要: |
| [摘要]目的：探索中医证型在CHF中的演变规律以及与心功能、RAAS之间的内在联系，为提升CHF的中医精准辨证，完善中医诊疗方案提供新的思路。方法：收集本院符合纳入标准的CHF住院患者335例作为研究病例。结合信息系统，对病例资料进行收集、整理并分析，获取研究指标RAAS,NT-ProBNP,Hcy,UA,心超,心功能分级等无创心功能数据。同时，对每例CHF病例进行中医辨证，分别纳入气虚血瘀、气阴两虚血瘀和阳气亏虚血瘀三组证型中。运用统计学方法，明确各中医证型的心功能状态与神经内分泌特点。结果：1. CHF中医证型演变规律早期多为气虚血瘀型，随心脏衰竭程度加重，逐渐转变至气阴两虚血瘀型，后期则呈现以阳气亏虚血瘀为主，相关系数rs=0.782，P=0.016（P<0.05）。2.心超指标比较中，阳气亏虚血瘀型患者心超指标LVEDD明显高于气虚血瘀型和气阴两虚血瘀型（P＜0.05）；心超总分比较中，阳气亏虚血瘀型高于气阴两虚血瘀型，气阴两虚血瘀型高于气虚血瘀型，组间比较有统计学差异（P＜0.05）。3.血化验指标比较中，RAAS中血管紧张素I水平在阳气亏虚血瘀型与气虚血瘀型、气阴两虚血瘀型之间存在统计学差异（P＜0.05）。NT-proBNP水平在阳气亏虚血瘀型和气阴两虚血瘀型中高于气虚血瘀型（P＜0.05），UA水平在阳气亏虚血瘀型中高于气阴两虚血瘀型（P＜0.05）。结论：1.CHF中医证型随心功能恶化由早期的气虚血瘀型渐至气阴两虚血瘀转变，晚期多呈现为阳气亏虚血瘀型。2.中医证型与CHF心功能、RAAS之间存在着紧密的联系，该研究既是对现代西医从神经内分泌着手临床治疗CHF有效性的客观验证，也为该病患者中医证型精准辨证提供了新的思路。 |
| 英文摘要: |
| [Abstract] Objective: To explore the evolution law of TCM syndromes in CHF and their intrinsic relationship with cardiac function and RAAS, so as to provide new ideas for improving the precision of TCM syndrome differentiation and the TCM diagnosis and treatment program for CHF.Methods:A total of 335 patients with CHF who met the inclusion criteria in our hospital were collected as study cases. Combined with the information system, the case data were collected, sorted out and analyzed, and the cardiac function data such as RAAS, NT-ProBNP, Hcy, UA, cardiac ultrasound and cardiac function classification were obtained. At the same time, the TCM syndrome differentiation of each case of CHF was divided into three types: Qi deficiency and Blood stasis, Qi Yin deficiency and Blood stasis and Yangqi deficiency and Blood stasis. By using statistical methods,the relationship between TCM syndrome types and RAAS,eart function was clarified, and the distribution law of each syndrome type in the progression of CHF was revealed.Results: 1.The evolution of TCM syndromes in CHF patients often begins with the pattern of Qi deficiency and blood stasis, which gradually transforms into the pattern of Qi Yin deficiency and blood stasis as the severity of heart failure increases, and in the later stage, it mainly presents as the pattern of Yang deficiency and blood stasis and the correlation coefficient is rs=0.782,P=0.016(P<0.05).2.In the comparison of cardiac ultrasound indexes,LVEDD was significantly higher in patients with Yangqi deficiency and Blood stasis type than those with Qi deficiency and Blood stasis type and Qi Yin deficiency and Blood stasis type (P<0.05), while the total score of Cardiac ultrasound increased gradually from Qi deficiency and Blood stasis type to Qi Yin deficiency and Blood stasis type,Yangqi deficiency and Blood stasis type (P<0.05). 3.In the comparison of Blood test indexes,there were significant differences in the level of angiotensin I in RAAS between Yangqi deficiency and Blood stasis type, Qi deficiency and Blood stasis type and Qi Yin deficiency and Blood stasis type(P<0.05).The level of NT-proBNP was higher in Yangqi deficiency and blood stasis or Qi Yin deficiency and blood stasis than in Qi deficiency and blood stasis (P < 0.05), while The level of UA was higher in Yangqi deficiency and blood stasis than in Qi Yin deficiency and blood stasis (P < 0.05).Conclusion:1.The TCM syndrome types of CHF change from the early stage of Qi deficiency and blood stasis to Qi Yin deficiency and blood stasis as heart function deteriorates, and in the late stage, it mostly presents as Yangqi deficiency and blood stasis.2. There is a close relationship between TCM syndrome type and heart function and RAAS in CHF. This study is not only an objective verification of the effectiveness of neuroendocrine clinical treatment of CHF by Western medicine, but also provides a new idea and basis for accurate differentiation of TCM syndrome type in patients with CHF. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
