北京市综合医院老年糖尿病衰弱现状及其干预的动态评估  

Frailty status of elderly diabetes patients in Beijing general hospitals and dynamic assessment for its treatment

作　　者：王宝[1] 张亚强 关欣[3] 李怡[1] WANG Bao;ZHANG Yaqiang;GUAN Xin;LI Yi(Department of Traditional Chinese Medicine,Beijing Hospital,National Center of Gerontology,Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China;Tongren Hospital Affliated to Capital Medical University Beijing 100730,China;Party Committee Offce,Beijing Hospital,National Center of Gerontology,Institute of Geriatrics,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院中医科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]首都医科大学附属北京同仁医院,北京100730 [3]北京医院党委办公室,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中华中医药杂志》2024年第6期3138-3143,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市中医药科技发展资金项目(No.JJ-2020-31);中央高水平医院临床科研专项(No.BJ-2022-153);北京市卫生健康和科技成果适宜技术推广项目(No.BHTPP202009);第六批北京市级中医药专家学术经验继承工作项目。

摘　　要：目的:调查北京市综合医院中医科就诊的老年糖尿病患者衰弱现状及干预效果。方法:采用便利抽样法,选取2021年1—12月北京市7家综合医院中医科就诊的老年糖尿病患者为研究对象,根据实际是否采用系统中医药干预分为西医组和中西医结合组,对其衰弱指数进行动态评估。结果:纳入西医组106例、中西医结合组154例,260例患者中衰弱期有170例,衰弱前期64例,无衰弱者26例,衰弱发生率65.38%;该人群证候以气虚、阴虚、血瘀证为主,气虚证、血虚证、阳虚证、湿证在衰弱期的老年糖尿病患者中的比例大于衰弱前期的患者(P<0.05);衰弱指数在气虚证、血虚证、阳虚证、痰浊证、湿证下比较,差异有统计学意义(P<0.01);相对西医组,中西医结合组可显著降低老年糖尿病患者的衰弱指数。结论:北京地区老年糖尿病患者的衰弱发生率高,中西医结合干预可有效改善其衰弱状况。Objective:To investigate the frailty status and effectiveness of traditional Chinese medicine(TCM)intervention for elderly patients with diabetes mellitus in the TCM departments of general hospitals in Beijing.Methods:Convenience sampling was used to select elderly diabetic patients who visited the TCM departments of one general hospitals in Beijing from January to December 2021 as the study subjects.According to whether systematic TCM intervention was used,the patients were divided into a Western medicine group and a combined group of Chinese and Western medicine,and their frailty index was dynamically assessed.Results:A total of 260 patients were included,106 in the western medicine treatment group and 154 in the combined Chinese and Western medicine treatment group.Among them,170 patients were in the frailty stage,64 were in the pre-frailty stage,and 26 had no frailty,with a frailty incidence rate of 65.38%.The main patterns in this population were qi deficiency pattern,yin deficiency pattern,and blood stasis pattern.The proportion of patients with qi deficiency pattern,blood deficiency pattern,yang deficiency pattern,and dampness pattern in elderly diabetic patients with frailty was higher than those without frailty or in the pre-frailty stage(P<0.05).The difference in the frailty index among qi deficiency pattern,blood deficiency pattern,yang deficiency pattern,phlegm turbidity pattern,and dampness pattern was statistically significant(P<0.01).Compared with the Western medicine group,the combined Chinese and Western medicine group significantly reduced the frailty index of elderly diabetic patients.Conclusion:The incidence of frailty in elderly diabetic patients in Beijing is high,and combined Chinese and Western medicine intervention can effectively improve their frailty status.

关 键 词：老年糖尿病 衰弱指数 衰弱状况 中西医结合 综合医院 

分 类 号：R587.1[医药卫生—内分泌]