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BMC Complement Altern Med. 2016 Sep 2;16:342. doi: 10.1186/s12906-016-1306-7.

Validation of a new simple scale to measure symptoms in heart failure from traditional Chinese medicine view: a cross-sectional questionnaire study.

Author information

1
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, No. 222, MaiJin Road, Anle District, Keelung, 20401, Taiwan.
2
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, No. 259, Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 33302, Taiwan.
3
Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, No. 259, Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 33302, Taiwan.
4
Center for Traditional Medicine, Taipei Veterans General Hospital, No.201 Sec. 2, Shipai Road, Beitou District, Taipei City, 11217, Taiwan.
5
Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 222 MaiJin Road, Anle District, Keelung, 20401, Taiwan.
6
Heart Failure Center, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, College of Medicine, Chang Gung University, Tao-Yuan, No. 222 MaiJin Road, Anle District, Keelung, 20401, Taiwan.
7
Department of Statistics and Information Science, Fu Jen Catholic University, No. 510 Zhongzheng Road, Xinzhuang District, New Taipei City, 24205, Taiwan.
8
Research Center for Chinese Medicine & Acupuncture, and School of Chinese Medicine, College of Chinese Medicine, China Medical University, No. 91 Hsueh-Shih Road, North District, Taichung City, 40402, Taiwan, Republic of China. tcmchh55@gmail.com.
9
School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.
10
Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
11
Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.

Abstract

BACKGROUND:

Current clinical practices used to functionally classify heart failure (HF) are time-consuming, expensive, or require complex calculations. This study aimed to design an inquiry list from the perspective of traditional Chinese medicine (TCM) that could be used in routine clinical practice to resolve these problems.

METHODS:

The severity of documented HF in 115 patients was classified according to their performance in maximal exercise tests into New York Heart Association (NYHA) functional classification (FC) II or NYHA FC III. Concomitantly, the patients were assessed using the new TCM inquiry list and two validated quality of life questionnaires, namely, the Short Form 36 (SF-36) generic scale and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Factor analysis was applied to extract the core factors from the responses to the items in TCM inquiry list; logistic regression analysis was then used to predict the severity of HF according to the extracted factors.

RESULTS:

The TCM inquiry list showed moderate levels of correlation with the physical and emotional components of the SF-36 and the MLHFQ, and predicted the functional class of HF patients reliably using logistic regression analysis, with a correct prediction rate with 64.3 %. Factor analysis of the TCM inquiry list extracted five core factors, namely, Qi Depression, Heart Qi Vacuity and Blood Stasis, Heart Blood Vacuity, Dual Qi-Blood Vacuity, and Yang Vacuity, from the list, which aligned with the perspective of TCM as it relates to the pattern of HF. The correct prediction rate rose to 70.4 % when Dual Qi-Blood Vacuity was combined with the MLHFQ. The excessive false-negative rate is a problem associated with the TCM inquiry list.

CONCLUSIONS:

The TCM inquiry list is a simple scale and similar to patient-reported subjective measures of quality of life in HF, and may help to classify patients into NYHA FC II or NYHA FC III. Factor 4 addresses dizziness, dizzy vision and general weakness, which are critical parameters that distinguish between NYHA FC II and NYHA FC III. Incorporating these three items into the management of HF may help to classify patients from a functional perspective.

KEYWORDS:

Aerobic capacity; Heart failure; Inquiry; Traditional Chinese medicine

PMID:
27590703
PMCID:
PMC5010704
DOI:
10.1186/s12906-016-1306-7
[Indexed for MEDLINE]
Free PMC Article

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