Correlation Between TCM Syndrome Types and Physicochemical Indicators as well as the Prognosis in Patients with Chronic Heart Failure Complicated with Chronic Kidney Disease
10.13359/j.cnki.gzxbtcm.2025.11.001
- VernacularTitle:慢性心力衰竭合并肾功能不全患者中医证型与理化指标及预后的相关性研究
- Author:
Yuxin WANG
1
;
Qingqiao SONG
Author Information
1. 中国中医科学院广安门医院,北京 100053
- Keywords:
chronic heart failure(CHF);
chronic kidney disease(CKD);
TCM syndrome type;
physicochemical indicators;
prognosis and outcome;
phlegm-stasis concretion;
intermingled deficiency and excess
- From:
Journal of Guangzhou University of Traditional Chinese Medicine
2025;42(11):2629-2636
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the distribution patterns of traditional Chinese medicine(TCM)syndrome types in patients with chronic heart failure(CHF)complicated with chronic kidney disease(CKD),and to explore the correlation between TCM syndrome types and physicochemical indicators as well as the prognosis.Methods A total of 217 patients with CHF and CKD hospitalized in the Department of Cardiology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences between January 2006 and March 2014 were included.Data from the four-examination methods of TCM were collected to determine TCM syndrome types.General information and physicochemical indicators of the patients were also recorded.SPSS 26.0 statistical software was used to analyze the distribution characteristics of TCM syndrome types and their relationships with general information,physicochemical indicators,and the prognosis.Results(1)Among the 217 patients,114 were male and 103 were female,with a male-to-female ratio of 1.11∶1,indicating similar incidence between genders.(2)The distribution of TCM syndrome types in descending order was as follows:yang deficiency with phlegm-stasis syndrome(23.04％),yin deficiency with phlegm-stasis syndrome(22.12％),blood stasis and phlegm turbidity syndrome(21.20％),qi and yin deficiency syndrome(17.51％),and qi deficiency with blood stasis syndrome(16.13％).(3)Regarding age,the blood stasis and phlegm turbidity syndrome group was the youngest,while the qi and yin deficiency syndrome group and the yin deficiency with phlegm-stasis syndrome group were relatively old.The differences between the blood stasis and phlegm turbidity syndrome group and the other two groups were statistically significant(P＜0.05).In terms of disease duration,the blood stasis and phlegm turbidity syndrome group had a shorter course than the yang deficiency with phlegm-stasis syndrome group,with a statistically significant difference(P＜0.01).Regarding mortality,the blood stasis and phlegm turbidity syndrome group had a lower mortality rate compared to the qi and yin deficiency syndrome,yin deficiency with phlegm-stasis syndrome,and yang deficiency with phlegm-stasis syndrome groups,with statistically significant differences(P＜0.01).(4)The N-terminal pro-brain natriuretic peptide(NT-proBNP)level in the qi and yin deficiency syndrome group was higher than that in the blood stasis and phlegm turbidity syndrome group.The estimated glomerular filtration rate(eGFR-EPI)level in the yin deficiency with phlegm-stasis syndrome,yang deficiency with phlegm-stasis syndrome,and qi and yin deficiency syndrome groups was higher than that in the blood stasis and phlegm turbidity syndrome group.The very low-density lipoprotein(VLDL)level in the yin deficiency with phlegm-stasis syndrome and yang deficiency with phlegm-stasis syndrome groups was higher than that in the qi and yin deficiency syndrome group.The blood chloride(Cl-)level in the qi and yin deficiency syndrome group was lower than that in the yin deficiency with phlegm-stasis syndrome group.All these differences were statistically significant(P＜0.05 or P＜0.01).Additionally,no statistically significant differences were observed among different syndrome types in terms of gender,time of death,platelet count(PLT),white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),C-reactive protein(CRP),uric acid(UA),blood potassium(K+),blood sodium(Na+),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),ejection fraction(EF),fractional shortening(FS),serum creatinine(Scr),blood urea nitrogen(BUN),and New York Heart Association(NYHA)functional classification(P＞0.05).Conclusion In clinical assessment of patients with CHF and CKD,it is essential to focus on the transition between deficiency and excess syndromes and to emphasize the intervention for the underlying deficiency.Efforts should be made to delay disease progression,prolong the timeline of transformation from excess to deficiency,and extend survival.Furthermore,the phlegm-stasis concretion is the core pathogenesis in these patients.Based on the TCM theory of the spleen being the source of phlegm production,interventions for mixed deficiency-excess syndromes should not only eliminate pathogenic factors but also reinforce spleen qi.Concurrently,attention should be paid to accompanying symptoms such as blood stasis and qi deficiency.By addressing the root cause and cutting off the source of internal phlegm formation while ensuring pathways for its elimination,targeted treatment can be achieved through clarifying the etiology and pathogenesis.
