世界中医药

目的：探索DHF中医证候要素及应证组合分布规律，阐明DHF中医证候分布与患者基础疾病、心力衰竭严重程度以及相关理化指标的相关性。方法：采用临床流行病学横断面研究方法，通过对200例DHF患者中医四诊信息的收集与分析，阐明舒张性心力衰竭的常见中医证候要素及证候组成；通过对患者中医证候要素、脏腑虚症分布与年龄、E/E的相关性分析，阐明不同年龄、不同严重程度舒张性心力衰竭患者中医证候要素及证候分布特点结果：患者中医证候要素分布特点以气虚（94.5%）、阴虚（39.5%）、血瘀（43.5%）为主。中医脏腑虚证分布提示舒张性心力衰竭患者脏腑虚证多见于心虚（96%）、肾虚（67%）、肺虚（21%）三脏。分析发现，不同年龄组中医症候气虚，阴虚，血瘀，气滞（P>0.05）无统计学意义。阳虚、水饮、痰浊在不同年龄组具有显著统计学意义，与年龄具有明显相关性。不同年龄组脏腑虚证在心、脾、胃、肝（P>0.05）无统计学意义,肺虚，肾虚（P<0.05）具有显著统计学意义，与年龄具有相关性。不同E/E值在中医证候要素中，气虚、阴虚、血瘀、痰浊、气滞无统计学意义（P>0.05），阳虚、水饮具有统计学意义（P<0.05）。进而说明，阳虚、水饮与E/E具有相关性。结论：舒张性心力衰竭以气虚为本，气虚血瘀，气阴两虚为其主要证候特点，且心气虚应为舒张性心力衰竭的始动因素，且伴随该病的整个过程，研究结果为舒张性心力衰竭的中医规范化诊断提供一定理论依据，同时可以此证侯特点为依据为研制院内制剂提供方向，将中医学介入到舒张性心力衰竭治疗当中，以治本为出发点延缓甚至阻止病情发展，因此对于舒张性心力衰竭的研究具有广泛的社会效益和经济效益。

English Summary:

To explore the essences of TCM syndromes of Diastolic Heart Failure (DHF) and the distribution of the syndromes and to clarify the correlation between the distribution of the syndromes and the basic diseases, severity of heart failure and the related physical and chemical index. Methods: This study used a cross-sectional method of clinical epidemiology, through collecting and analyzing of 200 cases of DHF patients with four diagnoses information of TCM. Through the correlation analysis of zang-fu organ deficiency syndrome distribution of TCM in patients with essential factors, age, and E/E analysis, the distribution characteristics of TCM syndromes and syndromes of different ages and different severity levels were clarified. Results: Distribution of TCM syndrome essences were mainly characterized with qi deficiency (94.5%), yin deficiency (39.5%), blood stasis (43.5%). As for the deficiency of zang-fu organs, the syndromes were mainly about the deficiency of heart (94.5%), kidney (67%), lung (21%) and others. In different age groups, no significant differences were found in yin deficiency, blood stasis and qi stagnation as well as those in heart, spleen, liver (P>0.05). There were significant differences in yang deficiency, water retention, and phlegm-turbidity among different age groups as well as those in lung deficiency and kidney deficiency (P>0.05). Therefore, yang deficiency and water retention has correlation with E/E. Conclusion: The syndromes of diastolic heart failure were characterized with qi deficiency, qi deficiency with blood stasis, deficiency of qi and yin. And heart qi is the initiating factor of DHF along with the whole process of the disease. The results can provide a theoretical basis for the diagnosis of chronic heart failure, and guidance for the manipulation of formula to help delay and even stop the development of the disease, reduce the mortality rate and disability rate, and lessen the economic burden of patients.

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