世界中医药

目的：探讨高血压所致慢性心力衰竭患者中医证候分型规律，并对其进行相关因素的Logistic回归分析。方法：选取符合标准的506例慢性心力衰竭患者进行中医辨证分型，并详细记录患者的有关资料。1）通过利用Pearson相关性分析，研究中医证型分布与年龄、性别、病程、收缩压、舒张压、NYHA分级、EF值、心肌重构（心房重构、心室重构、房室重构）、心律失常及NT-proBNP、SCR、BUN、hs-CRP等检查指标之间的相关性。2）采用二分类Logistics回归分析对年龄、性别、病程、收缩压、舒张压、NYHA分级、EF值、心肌重构（心房重构、心室重构、房室重构）、心律失常及NT-proBNP、SCR、BUN、Hs-CRP等因素对中医证型分布情况的影响进行回归分析。结果：随着年龄的增长，高血压心力衰竭患者易表现为气虚血瘀证、气阴两虚证；随着病程的进展，患者易出现气虚血瘀证、阳虚水泛证；随着心功能的下降，患者易出现阳虚水泛证；随着肌酐(Scr)和尿素氮(BUN)的升高，患者易出现痰浊闭阻证；随着高敏C反应蛋白(hs-CRP)的升高，患者易出现痰瘀互结证。结论高血压导致慢性心力衰竭的主要证型为气阴两虚证和痰瘀互结证。年龄为气虚血瘀证、气阴两虚证的危险因素；病程为气虚血瘀证和阳虚水泛证的危险因素；NT-proBNP为阳虚水泛证的危险因素；SCR、BUN为痰浊闭阻证的危险因素；hs-CRP为痰瘀互结证的危险因素；心功能为阳虚水泛证的保护性因素。

English Summary:

To discuss the laws of TCM differentiation patterns in patients with chronic heart failure caused by hypertension，and to conduct logistic regression analysis of related factors.Methods:A total of 506 patients with chronic heart failure were classified according to TCM pattern differentiation，and relevant data were recorded in detail.Results:It was found that，with age，hypertensive heart failure patients tend to develop into the pattern of qi deficiency and blood stasis，and the pattern of deficiency of both qi and yin.With the progress of the disease course，patients were prone to qi deficiency and blood stasis pattern，and yang deficiency with water flooding pattern.With the decline of cardiac function，patients were prone to the pattern of yang deficiency with water flooding.With the increase of SCR and BUN，patients are prone to the pattern of sputum turbidity and obstruction.With the increase of Hs-CRP，patients were prone to phlegm stasis binding pattern.Conclusion:The study of pattern classification laws of chronic heart failure caused by hypertension，and the logistic regression analysis of its related factors，certain references were provided for the rationality and norms of the prevention and treatment of such disease via Chinese medicine.

查看全文查看/发表评论下载PDF阅读器