Study on the Differences between Traditional Chinese Medicine Syndromes in NYHA I–IV Classification of Chronic Heart Failure

Abstract

Objectives. This study investigated the distribution of characteristics of traditional Chinese medicine syndromes and their association with symptoms in 1027 patients with chronic heart failure (CHF). Methods. An observational study was performed by researchers, collecting data from 1036 patients with CHF from 24 Chinese medicine hospitals from May 2009 to December 2014. Due to incomplete information from nine patients, 1027 patients with CHF were analysed. The distribution of syndromes in CHF and association between high-frequency syndromes and symptoms were investigated. Results. The primary syndromes were qi deficiency, blood stasis, fluid retention, yin deficiency, phlegm turbidity, and yang deficiency. The primary sites of disease were the heart, kidney, lung, and spleen. In patients with CHF of differing cardiac function, there was no significant difference in the frequency of yin deficiency (P>0.05). The distribution of yang deficiency was significantly different between New York Heat Association (NYHA) classes II, III, and IV and between classes I+II and III+IV (P<0.05). The frequency of phlegm turbidity was significantly different between NYHA classes II and III, between classes III and IV, and between classes I+II and III+IV (P<0.05). The frequency of fluid retention was significantly different between NYHA classes I and IV, between classes II, III, and IV, and between classes I+II and III+IV (P<0.05). Regarding associations between syndromes and symptoms, qi deficiency was diagnosed in 87.43% of patients with insomnia and spiritlessness; blood stasis in 84.85% of patients with spontaneous sweating + cyanosis of the lips; fluid retention in 75% of patients with a hard pulse and oedema; and yin deficiency in 72.92% of patients with feverish sensation in the chest, palms, and soles and spontaneous sweating. Conclusions. The frequency of yang deficiency and fluid retention was higher and that of phlegm turbidity was lower in classes III and IV than in classes I and II.

Effect of Danqi Buxin Decoction on Chronic Function Indexes and Life Quality in Patients with Chronic Heart Failure of Yang Deficiency Type

“…TCM has accumulated a lot of experience in the treatment of cardiovascular diseases and believes that heart yang deficiency is the root of heart failure. Heart failure has gradually evolved from heart qi insufficiency to heart yang deficiency, which is caused by the weakness of heart qi and yang, and runs through the whole process of disease occurrence and development [ 12 ]. Although Western medicine has made significant progress in CHF treatment, there are still many shortcomings, such as the side effects of drugs which lead to malignant arrhythmia, affecting the therapeutic effect [ 13 , 14 ].…”

The Discriminative Efficacy of Retinal Characteristics on Two Traditional Chinese Syndromes in Association with Ischemic Stroke

“…In our study, we focused on the clinical risks of ischemic stroke and demonstrated that a history of insomnia or drinking could indicate the presence the two TCM syndromes, QDBS and PSIC. Shi [35] found that Qi deficiency was diagnosed in 87.43% of patients with insomnia and spiritlessness. is finding coincides with our result that patients of ischemic stroke with QDBS syndrome were more likely to manifest insomnia.…”

Mechanism of tonifying-kidney Chinese herbal medicine in the treatment of chronic heart failure

“…Homeostatic imbalance is directly involved in the various processes required for the progression of heart failure: oxidative stress, inflammation, cardiac hypertrophy, cell death, and tissue fibrosis. Multiple clinical investigations of hospitalized patients have found that elderly patients (average age about 73 years) with heart failure and kidney-Yang deficiency have higher plasma AngII level, slightly lower left ventricular ejection fraction (EF) and fractional shortening (FS), and much lower left ventricular diastolic function (E/A ratio) than heart failure patients with non-kidney-Yang deficiency ( 2 , 5 , 134 ). Moreover, patients with kidney-Yang deficiency are mostly distributed in NYHA class III and IV, and non-kidney-Yang deficiency exists in NYHA class II ( 2 , 5 , 134 ).…”

“…According to the combination of different traditional Chinese medicine (TCM) syndrome elements, TCM can divide chronic heart failure into 4–6 TCM syndromes ( 1 ), which are mainly related to deficiency of heart and kidney yang and heart qi deficiency. The report of Shi et al ( 2 ) compared the main TCM syndromes of chronic heart failure with the New York Heart Association (NYHA) classification, and found that there is a certain correlation between NYHA classification and the distribution of heart-kidney yang deficiency and heart-qi deficiency. Heart-qi deficiency is basically concentrated in categories I and II, and the frequency of kidney yang deficiency and body fluid retention in class III+IV is higher than that in class I and II.…”

“…Heart-qi deficiency is basically concentrated in categories I and II, and the frequency of kidney yang deficiency and body fluid retention in class III+IV is higher than that in class I and II. Obviously, in the NYHA classification, heart-kidney-yang deficiency is the stage where heart failure progresses into a more severe stage ( 2 ). Common classic and folk prescriptions for the treatment of chronic heart failure include Zhenwu decoction, Lingguizhugan decoction, Sini decoction, Shenfu decoction, Bushen Huoxue decoction, and Qili Qiangxin capsule, etc.…”