冠心病慢性心力衰竭不同中医证型临床特征研究OA

Objective To explore the clinical differences of different Chinese medicine(CM)syndrome types in coronary heart disease of chronic heart failure(CHD-CHF)and the auxiliary dialectical basis of yang qi deficiency and blood stasis syndrome(YBS).Methods Totally 578 patients with CHD-CHF admitted to the Cardiovascular Department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2020 to December 2024 were retrospectively included,including 303 cases of qi deficiency and blood stasis syndrome(QBS),154 cases of qi and yin deficiency and blood stasis syndrome(QYBS),and 121 cases of YBS.General information,coronary artery disease status(number of coronary artery lesions,interventional treatment status),New York Heart Association(NYHA)functional classification,heart function related indicators[B-type natriuretic peptide(BNP),echocardiographic indicators],heart failure classification[heart failure with preserved ejection fraction(HFpEF),heart failure with mid-range ejection fraction(HFmrEF),heart failure with reduced ejection fraction(HFrEF)],tongue features and laboratory test indicators were collected.The clinical characteristics differences of various CM syndrome types were analyzed and compared.The correlation between YBS of CHD-CHF and the above factors was explored based on single factor and multiple factors Logistic regression,receiver operating characteristic(ROC)curve was used to evaluate the performance of regression model.Results There were statistically significant differences in the comparison of the following parameters among the three CM syndrome types:age,combined hyperlipidemia and old myocardial infarction,smoking history,rehospitalization within one year,coronary artery lesion branches,received interventional therapy status,NYHA cardiac function classification,BNP,left ventricular ejection fraction(LVEF),heart failure classification,red tongue,dark red tongue,fat big tongue,alanine aminotransferase(ALT),total cholesterol(TC),red blood cell count(RBC),and hemoglobin(Hb)(P＜0.05,P＜0.01).Multiple factors Logistic regression analysis showed that rehospitalization within one year,triple coronary artery lesions,NYHA class Ⅳ,HFmrEF,HFrEF,fat big tongue were auxiliary dialectical bases of YBS.The ROC curve analysis showed that the area under curve(AUC)of YBS was 0.842.Conclusions The clinical characteristics of CHD-CHF patients with different CM syndrome types are different.The constructed regression model of YBS has good performance and certain clinical application value.