The Relationship between Etiology and Inflammatory Factors in Patients with Chronic Heart Failure of Different Traditional Chinese Medicine Syndrome

LAI Renkui; HUANG Jingyi; CAI Tianjin; MA Liuling; LI Jinxin

doi:10.12102/j.issn.1672-1349.2025.22.018

Abstract：Objective: To analyze the relationship between the etiology, inflammatory factors, and TCM syndrome types in patients with chronic heart failure (CHF). Methods: A total of 180 CHF patients admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2020 to May 2023 were selected. The etiology of the patients was recorded, TCM syndrome classification was analyzed, and the levels of inflammatory factors [tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and high-sensitivity C-reactive protein (hs-CRP)] were detected upon admission. The relationships between different TCM syndrome types, etiology, and inflammatory factor levels in CHF patients were analyzed. Results: The main causes of CHF among the 180 patients were coronary heart disease (41.11%), followed by hypertension (17.22%) and pulmonary heart disease (14.44%). TCM syndrome analysis showed that the main syndrome type was Qi deficiency and blood stasis syndrome (23.89%), while Yang deficiency and water retention syndrome was the least common (11.11%). CHF caused by coronary heart disease was mainly characterized by Qi deficiency and blood stasis syndrome. Compared with Qi deficiency and blood stasis syndrome, the proportion of Qi-Yin deficiency syndrome, Heart-Lung Qi deficiency syndrome, Phlegm obstruction in the lung syndrome, and Yang deficiency and water retention syndrome was lower (P < 0.05). CHF caused by hypertension was mainly characterized by Qi-Yin deficiency syndrome. Compared with Qi deficiency and blood stasis syndrome, the proportion of Qi-Yin deficiency syndrome increased (P < 0.05); compared with Qi-Yin deficiency syndrome, the proportions of Heart-Lung Qi deficiency syndrome, Phlegm obstruction in the lung syndrome, and Yang deficiency and water retention syndrome decreased (P < 0.05). CHF caused by pulmonary heart disease was mainly characterized by Heart-Lung Qi deficiency syndrome and Phlegm obstruction in the lung syndrome. Compared with Qi-Yin deficiency syndrome, the proportions of Heart-Lung Qi deficiency syndrome and Phlegm obstruction in the lung syndrome increased (P < 0.05). CHF caused by rheumatic heart disease was mainly characterized by Heart-Kidney Yang deficiency syndrome. Compared with Heart-Kidney Yang deficiency syndrome, the proportion of Phlegm obstruction in the lung syndrome decreased (P < 0.05). For valvular heart disease and hyperthyroid cardiomyopathy, the distribution of syndrome types was uniform, with no statistically significant differences among the syndrome types (P > 0.05). Through ANOVA, there were statistically significant differences in TNF-α, IL-1β, and hs-CRP levels among patients with different TCM syndrome types (P < 0.05). Compared with Qi deficiency and blood stasis syndrome, TNF-α, IL-1β, and hs-CRP levels were elevated in Heart-Kidney Yang deficiency syndrome (P < 0.05). IL-1β levels were reduced in Qi-Yin deficiency syndrome; IL-1β and hs-CRP levels were reduced in Heart-Lung Qi deficiency syndrome; TNF-α and hs-CRP levels were elevated in Phlegm obstruction in the lung syndrome and Yang deficiency and water retention syndrome; TNF-α, IL-1β, and hs-CRP levels were elevated in Yang deficiency and water retention syndrome (P < 0.05). Compared with Heart-Kidney Yang deficiency syndrome, TNF-α, IL-1β, and hs-CRP levels were reduced in Qi-Yin deficiency syndrome, Heart-Lung Qi deficiency syndrome, and Phlegm obstruction in the lung syndrome (P < 0.05); hs-CRP levels were reduced in Yang deficiency and water retention syndrome (P < 0.05). Compared with Qi-Yin deficiency syndrome, TNF-α, IL-1β, and hs-CRP levels were elevated in Phlegm obstruction in the lung syndrome and Yang deficiency and water retention syndrome (P < 0.05). Compared with Heart-Lung Qi deficiency syndrome, TNF-α, IL-1β, and hs-CRP levels were elevated in Phlegm obstruction in the lung syndrome and Yang deficiency and water retention syndrome (P < 0.05). Conclusion: Coronary heart disease is the main cause of CHF, and the main TCM syndrome type is Qi deficiency and blood stasis syndrome. There are differences in syndrome types among CHF patients caused by different etiologies. Inflammatory factor levels exacerbate CHF conditions and can serve as important reference indicators for Yang deficiency and Qi deficiency syndromes.