韦葭蔚 黄幸 赵慧辉 王娟 王金平 李雪丽 曾紫凡 王伟

摘要 目的：探讨慢性心力衰竭患者中医四诊信息与生命质量的关系。方法：选取2013年9月至2014年12月325例符合纳入标准的慢性心力衰竭患者，通过横断面调查研究，多中心收集患者基本信息及中医四诊信息，采用简明健康状况调查问卷（SF-36）评价其生命质量，运用Spearman等级相关分析SF-36中生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能以及精神健康等8个维度与出现频率位于前15位的中医症状及频率大于40%的舌诊及脉诊之间的相关关系。结果：位于前15位的中医症状中呼吸困难、少气懒言、神疲、气短、食欲不振、乏力、下肢浮肿、失眠与SF-36一个或多个维度及总分呈负相关（P<0.05），舌诊结果与SF-36一个或多个维度及总分呈低相关（P<0.05），脈诊结果与SF-36各维度及总分呈低相关，但差异无统计学意义（P>0.05）。结论：慢性心力衰竭中医四诊信息与患者生命质量具有相关性，其中呼吸困难、少气懒言、神疲、气短、食欲不振、乏力、下肢浮肿、失眠等8个症状与患者生命质量存在显著负相关，改善以上症状能提高患者生命质量。

关键词 慢性心力衰竭;中医症状;舌诊;脉诊;生命质量;SF-36;横断面调查;相关性

Correlation between Four Diagnosis Methods of Traditional Chinese Medicine and Quality

of Life of Patients with Chronic Heart Failure

Wei Jiawei1， Huang Xing2， Zhao Huihui1， Wang Juan1， Wang Jinping2， Li Xueli1， Zeng Zifan1， Wang Wei1

（1 School of Traditional Chinese Medicine， Beijing University of Chinese Medicine， Beijing 100029， China;

2 Dongzhimen Hospital， Beijing University of Chinese Medicine， Beijing 100700， China）

Abstract Objective：To investigate correlation between four diagnosis methods of traditional Chinese medicine and quality of life of patients with chronic heart failure. Methods：Through the method of multi center cross-sectional study， the basic information and TCM diagnosis information of 325 patients met the inclusion criteria of chronic heart failure were collected from September 2013 to December 2014. A total of 36-item Short-Form Health Survey （SF-36） was used to evaluate the correlation between physiological function， physiological role， body pain， general health， vitality， social function， emotional function and mental health and TCM symptoms， which were listed on top 15 and tongue and pulse that frequency of which was greater than 40%. Results：In the symptoms in the top 15， dyspnea， shortage of qi， laziness to speak， fatigue， shortness of breath， loss of appetite， fatigue， edema of lower limbs， and insomnia were remarkably negatively correlated with one or more dimensions and total scores of SF-36 （P<0.05）; tongue inspection was lowly correlated with one or more dimensions and total scores of SF-36 （P<0.05）; pulse diagnosis was lowly correlated with dimensions and total scores of SF-36， without statistically significant difference （P>0.05）. Conclusion：The quality of life of patients with chronic heart failure was associated with four diagnostic information. And the 8 symptoms of dyspnea， shortage of qi， laziness to speak， fatigue， shortness of breath， loss of appetite， fatigue， edema of lower limbs， and insomnia have significant negative correlation with the quality of life of patients. Improvement of the above symptoms can greatly improve the quality of life of patients.

Key Words Chronic heart failure; Traditional Chinese syndrome; Tongue inspection; Pulse diagnosis; Quality of life; SF-36; Cross-sectional study; Correlation study

中图分类号：R241.2;R541.6文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.051

慢性心力衰竭（Chronic Heart Failure，CHF）是由于任何心脏结构或功能异常导致心室充盈或射血能力受损的复杂临床综合征，其主要临床表现为呼吸困难、乏力以及体液潴留[1]。CHF患者預后不良，病死率高，5年生存率不足50%，即使在生存期间，患者也处于生命质量十分低下的状态[2]。生命质量作为一个衡量健康状况的综合指标，已被广泛应用于国内外CHF患者的健康评价当中[3]。……