上海某社区65岁以上老年人脂肪肝的中医体质及相关因素分析  

Analysis of TCM constitution and related factors of fatty liver in the elderly people over 65 years old in a community of Shanghai

作　　者：叶艳 韦全华 YE Yan;WEI Quanhua(General Practice Department of Traditional Chinese Medicine of Qilian Community Health Service Center of Dachang Town of Baoshan District,Shanghai 200444,China;Department of Traditional Chinese Medicine of Wusong Hospital of Zhongshan Hospital Affiliated to Fudan University,Shanghai 200940,China)

机构地区：[1]上海市宝山区大场镇祁连社区卫生服务中心中医全科,上海200444 [2]复旦大学附属中山医院吴淞医院中医科,上海200940

出　　处：《上海医药》2021年第20期58-62,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：宝山区名中医传承工作室(BSMZYGZS-201905)。

摘　　要：目的:分析上海某社区65岁以上老年人脂肪肝与高血压、糖尿病、血液生化指标和中医体质的关系。方法:研究对象为2020年5-8月在上海某社区卫生服务中心接受免费体检的1043例65岁以上老年人,年龄65~96岁;其中女性559例,男性475例。通过调查问卷、腹部B超和实验室检查等方法,将老年人群分成脂肪肝组及非脂肪肝组,比较两组的血压、糖尿病、血液生化指标和中医体质等影响因素。结果:脂肪肝组中患高血压、糖尿病以及体重超重、肥胖、腹型肥胖、中心性肥胖的比率高于非脂肪肝组(P<0.05)。脂肪肝组的血清天门冬氨酸氨基转移酶(AST),血清丙氨酸氨基转移酶(ALT),三酰甘油(TG)和空腹血糖(FPG)指标均高于非脂肪肝组(P<0.05),而高密度脂蛋白胆固醇(HDL-C)则低于非脂肪肝组(P<0.05)。脂肪肝组患者中痰湿体质位居首位(12.1%),其次是气虚体质(11.6%),而非脂肪肝组中比例最高的是平和质,占31%,两组构成分布差异具有统计学意义(P<0.05)。logistic回归分析结果显示,体质量指数(BMI)、高血压、中心性肥胖、ALT、TG、HDL-C和部分体质类型是脂肪肝的影响因素(P<0.05)。结论:BMI升高、高血压、中心性肥胖、ALT、TG、部分体质类型是65岁以上老年人脂肪肝的危险因素,HDL-C是保护因素。Objective:To analyze the relationship between fatty liver and hypertension,diabetes,blood biochemical indexes and constitution of traditional Chinese medicine(TCM)in the elderly people over 65 years old in a community of Shanghai.Methods:The research objects were 1043 elderly people over 65 years old who underwent free physical examination in a community health service center in Shanghai from May to August 2020,and the age was from 65 to 96 years old;there were 559 females and 475 males.By means of questionnaire,abdominal B ultrasound and laboratory examination,the elderly people were divided into a fatty liver group and a non-fatty liver group,and the influencing factors of blood pressure,diabetes,blood biochemical parameters and TCM constitution were compared between the two groups.Results:The rates of hypertension,diabetes,overweight,obesity,abdominal obesity and central obesity in the fatty liver group were higher than those in the nonfatty liver group(P<0.05).The indexes of serum aspartate aminotransferase(AST),serum alanine aminotransferase(ALT),triacylglycerol(TG)and fasting blood glucose(FPG)in the fatty liver group were higher than those in the non fatty liver group(P<0.05),and high density lipoprotein cholesterol(HDL-C)in the fatty liver group was lower than that in non fatty liver group(P<0.05).In fatty liver group,phlegm dampness constitution ranked first(12.1%),followed by qi deficiency constitution(11.6%),the highest proportion of the non fatty liver group was pinghe quality,accounting for 31%,and there was significant difference in composition and distribution between the two groups(P<0.05).Logistic regression analysis showed that BMI,hypertension,central obesity,ALT,TG,HDL-C and some physical types were the influencing factors of fatty liver(P<0.05).Conclusion:increased BMI,hypertension,central obesity,ALT,TG and some physical types are the risk factors of fatty liver in the elderly over 65 years old,and HDL-C is the protective factor.

关 键 词：脂肪肝 老年人 中医体质 影响因素 

分 类 号：R589.2[医药卫生—内分泌]