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上海市中医老年医学研究所(上海 200031)
陈川,男,硕士,主任医师,主要从事中医老年医学研究工作
收稿:2024-11-12,
纸质出版:2025-11-10
移动端阅览
陈川,吴蓓玲,齐真,等.上海社区老年人衰弱患病状况及中医证型研究[J].上海中医药杂志,2025,59(11):57-61.
CHEN Chuan,WU Beiling,QI Zhen,et al.Study on frailty prevalence and its correlation with traditional Chinese medicine syndromes in elderly community residents of Shanghai[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(11):57-61.
陈川,吴蓓玲,齐真,等.上海社区老年人衰弱患病状况及中医证型研究[J].上海中医药杂志,2025,59(11):57-61. DOI: 10.16305/j.1007-1334.2025.z20241112003.
CHEN Chuan,WU Beiling,QI Zhen,et al.Study on frailty prevalence and its correlation with traditional Chinese medicine syndromes in elderly community residents of Shanghai[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(11):57-61. DOI: 10.16305/j.1007-1334.2025.z20241112003.
目的
2
探讨上海社区老年人衰弱患病状况及其与中医五脏虚证的相关性。
方法
2
2018年9月至2021年12月在上海10个社区以分层整群随机抽样方法选取60岁以上老年人3 725例,采用衰弱表型(FP)评估方法和老年人五脏虚证辨证评估模型进行分析。
结果
2
①衰弱患病情况:衰弱(FP≥3分)者404例、占10.85%,衰弱前期(FP=1~2分)者1 519例、占40.78%。男性与女性FP异常(FP≥1分)比例分别为49.55%、53.36%,差异无统计学意义(
P
>
0.05);60~69岁、70~79岁、80岁及以上的FP异常占比分别为44.15%、51.98%、79.47%,差异有统计学意义(
P
<
0.05)。②中医五脏虚证辨证情况:FP≥1分组的26个五脏虚证症状和7个五脏虚证证型的出现频数均高于FP=0分组(
P
<
0.05);FP≥1分组的肾虚证型、心虚证型、肝虚证型、肺虚证型、脾虚证型分别占72.54%、49.82%、39.42%、16.22%、16.02%。③多因素 logistic回归分析: 6个五脏虚证症状和8个五脏虚证证型对FP异常的影响具有统计学意义(
P
<
0.05),影响最大的前3个症状为足软无力难久立或易跌倒[
OR
=1.867,95%
CI
(1.483~2.352)]、动作变慢或不灵活[
OR
=1.706,95%
CI
(1.252~2.326)]、懒言懒动[
OR
=1.447,95%
CI
(1.138~1.841)],影响最大的前3个证型为肾阳虚[
OR
=3.988,95
%
CI
(2.007~7.927)]、肾精虚[
OR
=2.942,95%
CI
(1.190~7.276)]、心气虚[
OR
=2.286,95%
CI
(1.681~3.108)]。
结论
2
3 725例社区老年人衰弱患病率为10.85%、衰弱前期患病率为40.78%;FP异常与肾阳虚、肾精虚、心气虚等证型及足软无力难久立或易跌倒、动作变慢或不灵活、懒言懒动等症状具有相关性。
Objective
2
To explore the frailty prevalence in elderly community residents of Shanghai and its correlation with traditional Chinese medicine (TCM) deficiency syndromes of the five zang organs.
Methods
2
A total of 3,725 elderly individuals aged 60 and above were selected from 10 communities in Shanghai using stratified cluster random sampling between September 2018 and December 2021. The frailty phenotype (FP) assessment and the TCM syndrome differentiation model for deficiency syndromes of five Zang organs were used for analysis.
Results
2
①Frailty prevalence: Among the participants, 404 (10.85%) were classified as frail (FP≥3 points), and 1,519 (40.78%) were pre-frail (FP=1-2 points). The proportion of abnormal FP scores (FP≥1) was 49.55% in males and 53.36% in females, with no statistically significant difference (
P
>
0.05). The abnormal FP proportions were 44.15%, 51.98%, and 79.47% for the 60-69, 70-79, and 80+ age groups, respectively, with significant statistical differences (
P
<
0.05). ②Syndrome differentiation of TCM five zang-organ deficiency syndromes: The occurrence frequencies of 26 symptoms and 7 types of five zang-organ deficiency syndromes in the FP≥1 group were higher than those in the FP=0 group (
P
<
0.05); in the FP≥1 group, the kidney deficiency syndrome, heart deficiency syndrome, liver deficiency syndrome, lung deficiency syndrome, and spleen deficiency syndrome accounted for 72.54%, 49.82%, 39.42%, 16.22%, and 16.02% respectively. ③Multivariate logistic regression analysis: 6 symptoms and 8
five zang-organ deficiency syndromes had statistically significant effects on abnormal FP (
P
<
0.05). The top 3 symptoms with the greatest impact were weak feet, difficulty in standing for a long time or tendency to fall [
OR
=1.867, 95%
CI
(1.483-2.352)], slow or inflexible movements [
OR
=1.706, 95%
CI
(1.252-2.326)], and reluctance to speak or move [
OR
=1.447, 95%
CI
(1.138-1.841)]. The top 3 syndromes with the greatest impact were kidney-yang deficiency [
OR
=3.988, 95%
CI
(2.007-7.927)], kidney-essence deficiency [
OR
=2.942, 95%
CI
(1.190-7.276)], and heart-qi deficiency [
OR
=2.286, 95%
CI
(1.681-3.108)].
Conclusions
2
The prevalence of frailty and pre-frailty among 3,725 elderly people in communities was 10.85% and 40.78%, respectively. Abnormal FP scores were correlated with TCM syndromes such as kidney-yang deficiency, kidney-essence deficiency, and heart-qi deficiency, as well as symptoms such as weak feet, difficulty in standing for a long time or tendency to fall, slow or inflexible movements, and being reluctant to speak or move.
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