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《广州医药》编辑部
因气候与生活习惯影响,广东地区老年性肩周炎临床特点及康复需求具有独特性,亟待制定规范、具有当地特色的康复方案。为制订适合地区差异化的康复方案,广东省中西医结合学会康复专业委员会联合广东省康复医学发展研究会疼痛康复发展研究分会牵头发起,省内多家机构专家学者共同制订《老年性肩周炎中医全周期康复广东专家共识(2026年版)》。该共识以ICF框架为基础,立足肩周炎康复循证医学证据,结合多学科专家产教研实践经验,对肩周炎 ICF评定、中医适宜技术及康复治疗技术运用、阶梯式干预性措施制定和中西医全周期康复协同等方面形成共识性意见。本共识的发布,将为老年性肩周炎中医全周期康复提供规范化、本土化的“广东方案”。
Due to climatic and lifestyle influences,the clinical characteristics and rehabilitation needs of senile periarthritis of the shoulder in Guangdong region exhibit unique features,necessitating the development of standardized and locally tailored rehabilitation protocols.To formulate regionally differentiated rehabilitation plans,the Rehabilitation Professional Committee of Guangdong Association of Integrative Medicine and the Pain Rehabilitation Development Research Branch of Guangdong Rehabilitation Medicine Development Research Association jointly initiated the development of the “Guangdong Expert Consensus on TCM Full-Cycle Rehabilitation for Senile Periarthritis of the Shoulder(2026 Edition)” through collaboration with multiple provincial institutions and experts.Based on the International Classification of Functioning,Disability and Health(ICF)framework and evidence-based rehabilitation medicine for periarthritis of the shoulder,this consensus integrates multidisciplinary expertise from industry,academia,and research to establish unified guidelines on ICF assessment,application of appropriate TCM techniques and rehabilitation therapies,implementation of stepwise intervention measures,and integrated TCM-Western medicine full-cycle rehabilitation approaches.The publication of this consensus will provide a standardized and localized “Guangdong Solution” for TCM-based full-cycle rehabilitation of senile periarthritis of the shoulder.
目的 调查住院老年患者因经外周静脉置入中心静脉导管(PICC)而引发的血栓情况,并分析其影响因素,为老年患者置入PICC产生的相关性血栓(PICC-CRT)和症状性血栓的评估与干预提供借鉴。方法 在2023年1月—2023年12月期间,选取广州市第一人民医院接受PICC置管的317例住院老年患者。采用包括患者一般情况调查表、运动功能评定、肌力检测、 Barthel指数评定、Padua评分等多种工具进行综合评估。采用多因素 Logistic 回归构建 PICC-CRT 及症状性血栓的预测模型,并应用逐步回归法优化变量筛选过程。模型性能通过 ROC 曲线进行评估。结果 去除临床资料不完整的患者40例,最终纳入277例患者的完整资料,其中123例患者出现了PICC-CRT,发生率为44.40%(123/277)。血栓分级中,I级78例,Ⅱ级37例,Ⅲ级8例。无症状血栓83例,占67.48%,发生率29.96%(83/277);症状性血栓40例,占32.52 %,发生率14.44%(40/277)。单因素分析联合多因素Logistic回归显示,卒中史、凝血酶原时间(PT)、导管留置时间是住院老年患者PICC-CRT的关键因素(P<0.05),预测模型ROC曲线下面积为0.719;置管史、恶性肿瘤史、导管留置时间、置管后并发症数量是住院老年患者PICC症状性血栓的独立影响因素(P<0.05),预测模型ROC曲线下面积为0.812。结论 文章总结了PICC-CRT和症状性血栓独特的影响因素,基于关键因素构建了预测模型预测其发生,为护理人员预防PICC-CRT和症状性血栓的发生提供了参考。
Objective To explore the incidence of thrombosis associated with peripherally inserted central catheter(PICC)placement in hospitalized elderly patients and to analyze its influencing factors,in order to provide a reference for the assessment and prevention of PICC-catheter related thrombosis(PICC-CRT)and symptomatic thrombosis in this population.Methods A total of 317 elderly inpatients who underwent PICC placement at a tertiary hospital in Guangzhou between January and December 2023 were enrolled.Comprehensive assessments were conducted using general patient information forms,motor function evaluation,muscle strength testing,Barthel Index,and Padua score.Multivariate Logistic regression analysis was used to construct predictive models for PICC-CRT and symptomatic thrombosis,with variable selection optimized via stepwise regression.Model performance was evaluated using receiver operating characteristic(ROC)curve analysis.Results After excluding 40 patients with incomplete clinical data,277 cases were included in the final analysis.Among them,123 patients developed PICC-CRT,with an incidence rate of 44.40%(123/277).Thrombosis was graded as Grade I in 78 cases,Grade II in 37 cases,and Grade III in 8 cases.Asymptomatic thrombosis occurred in 83 cases(29.96%),accounting for 67.48% of PICC-CRT;symptomatic thrombosis occurred in 40 cases(14.44%),accounting for 32.52%.Univariate and multivariate Logistic regression analyses identified history of stroke,prothrombin time(PT),and catheter dwell time as key risk factors for PICC-CRT(P<0.05),with the area under the curve(AUC)of 0.719.History of catheterization,malignancy,catheter dwell time,and number of post-catheterization complications were independent predictors of symptomatic thrombosis(P<0.05),with an AUC of 0.812.Conclusions This study identified distinct risk factors for PICC-CRT and symptomatic thrombosis in elderly inpatients.Predictive models based on key variables may provide useful references for clinical staff in preventing the occurrence of PICC-related and symptomatic thrombosis.
目的 探讨基于肺康复的阻抗训练联合营养支持对老年慢性阻塞性肺疾病(COPD)衰弱患者肌少症及运动耐量的影响。方法 将2024年1月—2025年5月收治的80例老年COPD衰弱合并肌少症患者,分为对照组、观察组,各40例。所有患者均采取常规药物治疗,对照组予以营养支持,观察组在对照组基础上增加基于肺康复的阻抗训练。比较两组治疗前、治疗3个月后肌少症改善情况,运动耐量,肺功能指标,衰弱状态及生活质量。结果 治疗3个月后,观察组骨骼肌指数、握力、股四头肌肌厚度均较治疗前提高,且与对照组相比,观察组更高(P<0.05);治疗3个月后,两组6 min步行距离、日常活动代谢当量均较治疗前提高,Borg量表评分降低,且与对照组相比,观察组改善幅度更大(P<0.05);治疗3个月后,两组第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、最大通气量(MVV)均较治疗前改善,且与对照组相比,观察组更优(P<0.05);治疗3个月后,两组Fried衰弱表型评分、COPD评估测试(CAT)总分、圣乔治呼吸问卷(SGRQ)总分均较治疗前降低,且与对照组相比,观察组更低(P<0.05)。结论 老年COPD衰弱合并肌少症患者采取基于肺康复的阻抗训练联合营养支持可改善其肌少症情况,提升运动耐量,并且提升患者肺功能水平,改善衰弱状态,提升生活质量。
Objective To explore the effects of impedance training based on pulmonary rehabilitation combined with nutritional support on sarcopenia and exercise tolerance in elderly patients with chronic obstructive pulmonary disease(COPD)and frailty.Methods Eighty elderly patients with COPD and frailty complicated by sarcopenia,admitted from January 2024 to May 2025,were selected as the study subjects and divided into a control group and an observation group,with 40 patients in each group.All patients received conventional drug therapy.The control group received nutritional support,while the observation group received additional impedance training based on pulmonary rehabilitation on top of the matched group’s treatment.The improvement of sarcopenia,exercise tolerance,pulmonary function index,weakness status and quality of life before and 3 months after treatment were compared between the two groups.Results After 3 months of treatment,the skeletal muscle index,grip strength and quadriceps thickness of the observation group increased compared with that before treatment,and compared with the control group,the observation group was higher(P<0.05).After 3 months of treatment,the 6 min walking distance and daily activity metabolic equivalent of both groups increased compared with that before treatment,and the Borg Scale score decreased.Compared with the control group,the improvement of the observation group was better(P<0.05).After 3 months of treatment,Forced Expiratory Volume in one second(FEV1),FEV1/Forced Vital Capacity(FVC)and Maximal Voluntary Ventilation(MVV)of both groups improved compared with that before treatment,and the observation group was better than that of the control group(P<0.05).After 3 months of treatment,the Fried weakness phenotype score,COPD Assessment Test(CAT)total score and St. George’s Respiratory Questionnaire(SGRQ)total score of both groups were lower than that before treatment,and the observation group was lower than that of the control group(P<0.05).Conclusions Impedance training based on pulmonary rehabilitation combined with nutritional support can improve sarcopenia,enhance exercise tolerance,and improve pulmonary function levels,frailty status,and quality of life in elderly patients with COPD and frailty complicated by sarcopenia.
目的 探究单髁膝关节置换(UKA)联合注射布比卡因脂质体治疗老年孤立性内侧间室骨关节炎(OA)的效果,并分析其对患者术后长效镇痛的作用。方法 前瞻性选取2023年11月—2025年11月期间收治的80例老年孤立性内侧间室OA患者,分为对照组与研究组,各40例。两组患者均接受UKA手术治疗,研究组在术中于相同部位注射布比卡因脂质体,对照组于术中关节周围注射等体积的生理盐水混合物。比较两组术后疼痛强度,镇痛药物消耗与需求,早期膝关节功能恢复情况、早期膝关节功能,以及两组不良反应发生率。结果 研究组术后6 h、12 h、24 h及48 h VAS评分均低于对照组,术后48 h内,研究组中重度疼痛发生率较对照组低(P<0.05);研究组术后首次请求镇痛的时间晚于对照组,48 h内曲马多总消耗量及补救镇痛需求率均较对照组低(P<0.05);研究组在术后24 h、48 h、72 h的膝关节主动活动度较对照组大,研究组首次直腿抬高时间、术后下地行走时间及住院时间均较对照组短(P<0.05);术前两组膝关节协会评分(KSS)和牛津膝关节评分(OKS)评分无差异(P>0.05)。术后1周,两组评分均改善,且研究组优于对照组(P<0.05);两组不良反应发生率无差异(P>0.05)。结论 UKA术中联合应用布比卡因脂质体,能安全、有效地为老年孤立性内侧间室OA患者提供长效术后镇痛。且该方案不仅能显著减轻患者早期疼痛、减少阿片类药物依赖,更能有效促进膝关节早期功能恢复、缩短住院时间,并为患者获得更优的早膝关节功能奠定基础。
Objective To investigate the efficacy of unicompartmental knee arthroplasty(UKA) combined with injection of bupivacaine liposomes in the treatment of elderly isolated medial compartment osteoarthritis(OA),and analyze its long-term analgesic effect on patients after surgery.Methods A prospective study was conducted on 80 elderly patients with isolated medial compartment OA admitted between November 2023 and November 2025.They were divided into a control group and a study group,with 40 patients in each group.Both groups of patients received UKA treatment.The study group received injection of bupivacaine liposomes at the same site during surgery,while the control group received injection of an equal volume of physiological saline mixture around the joints during surgery.Postoperative pain intensity,analgesic drug consumption and demand,early knee joint function recovery,early knee joint function were compared between two groups,and the incidence of adverse reactions was compared between the two groups.Results The study group had lower VAS scores at 6 h,12 h,24 h,and 48 h postoperatively compared to the control group.Within 48 hours after surgery,the incidence of moderate to severe pain in the study group was lower than that in the control group(P<0.05).The time to first postoperative analgesic request in the study group was later than that in the control group,and the total tramadol consumption and the need for analgesia within 48 hours were lower(P<0.05).The active range of motion of the knee at 24 h,48 h,and 72 h postoperatively was greater in the study group compared to the control group.Additionally,the time to first straight leg raise,time to ambulation,and length of hospital stay were all shorter in the study group(P<0.05).Preoperatively,there were no differences between the two groups in the Knee Society Score(KSS) and the Oxford Knee Score(OKS)(P>0.05).One week postoperatively,both groups showed improved scores,with the study group showing greater improvement than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The combined use of bupivacaine liposomes during UKA can provide safe and effective long-term postoperative analgesia for elderly patients with isolated medial compartment OA.And this plan not only reduces early pain and opioid dependence in patients,but also effectively promotes early knee joint function recovery,shortens hospitalization time,and lays a solid foundation for patients to achieve better early knee joint function.
目的 探讨肌少症性肥胖(SO)诊断标准的演进及其在中国老年人群中的本土化综合干预路径。方法 评述ESPEN/EASO最新共识,结合我国老年人代谢特征,系统分析“筛查-诊断-分期”流程及运动营养协同干预的临床效能。结果 SO诊断核心在于识别“隐性肥胖”,建议在AWGS2019标准基础上,叠加中国特异性腰围切点(男≥90 cm,女≥85 cm)或体脂率指标,并应用ALM/BMI校正肌肉质量。研究证实,以渐进式抗阻训练联合高蛋白营养(1.2~1.5 g·kg-1·d-1)为核心的协同模式,通过激活mTOR通路可显著逆转肌肉流失并改善胰岛素抵抗。融入八段锦等传统功法及乳清蛋白补充,能有效重塑中国患者“高碳水、低蛋白”的膳食习惯,提升依从性。结论 构建护士主导、社区依托的多学科管理模式,并借助远程健康工具实现闭环监测,是提升我国SO精准诊疗水平的关键路径。
Objective To explore the evolution of diagnostic criteria for sarcopenic obesity(SO)and its localized comprehensive intervention pathways tailored to the metabolic characteristics of the Chinese elderly population.Methods The latest ESPEN/EASO consensus was reviewed.Combined with the metabolic profile of Chinese older adults,the “screening-diagnosis-staging” workflow and the clinical efficacy of synergistic exercise and nutrition interventions were systematically analyzed.Results The core of SO diagnosis lies in identifying “hidden obesity.”It is recommended to incorporate Chinese-specific waist circumference cut-offs(male≥90 cm,female≥85 cm)or body fat percentage into the AWGS2019 framework,utilizing ALM/BMI for muscle mass calibration.Evidence suggests that a synergistic model,centered on progressive resistance training(PRT)and high-protein nutrition(1.2~1.5 g·kg-1·d-1),can significantly reverse muscle loss and improve insulin resistance by activating the mTOR pathway.Integrating traditional Chinese exercises(e. g. ,Baduanjin)and whey protein supplementation effectively reshapes the “high-carbohydrate,low-protein” dietary habits of Chinese patients,thereby enhancing intervention adherence.Conclusions Establishing a nurse-led,community-based multidisciplinary management model,integrated with digital health tools for closed-loop monitoring,is a pivotal strategy for enhancing the precision of SO diagnosis and treatment in China.
目的 探讨多组分运动训练对老年慢性阻塞性肺疾病(COPD)稳定期病人骨骼肌功能的影响。方法 前瞻性选择2022年10月—2024年10月90例COPD稳定期患者,采用抽签法随机分为观察组与对照组,对照组45例采取常规运动干预,观察组45例在对照组基础上增加多组分运动训练。干预前、干预后3个月比较两组患者四肢骨骼肌含量,四肢肌群力量,运动耐力与肺功能,生活质量。结果 干预后,两组上肢、下肢骨骼肌含量均略增加,观察组高于对照组(P<0.05);干预后,两组膝伸肌、膝屈肌、肘伸肌、肘屈肌肌群力量均增加,观察组高于对照组(P<0.05);干预后,两组6 min步行试验、用力肺活量及第一秒用力呼气量均升高,观察组高于对照组(P<0.05);干预后,两组圣乔治呼吸问卷各维度分数及总分均降低,观察组低于对照组(P<0.05)。结论 针对老年COPD稳定期患者采取多组分运动训练可提升患者四肢骨骼肌含量与四肢肌群力量,改善患者运动耐力与肺功能,减轻COPD及骨骼肌功能障碍对患者生活质量造成的负面影响。
Objective To explore the effect of multi-component exercise training on skeletal muscle function in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods From October 2022 to October 2024,90 stable COPD patients were prospectively selected and randomly divided into an observation group and a control group using a lottery method.The control group consisted of 45 patients who received routine exercise care,while the observation group consisted of 45 patients who received multi-component exercise training in addition to the routine care.Skeletal muscle content,muscle group strength,exercise endurance,lung function,and quality of life between two groups of patients were compared before and three months after intervention.Results After intervention,the skeletal muscle content of both upper and lower extremities slightly increased in both groups,with the observation group being higher than the control group(P<0.05).After intervention,the strength of the knee extensor,knee flexor,elbow extensor,and elbow flexor muscle groups increased in both groups,with the observation group had better results than the control group(P<0.05).After intervention,both groups showed an increase in six-minute walking test,forced vital capacity,and forced expiratory volume in first second,with the observation group had better results than the control group(P<0.05).After intervention,the scores of each dimension and total score of the SGRQ in both groups decreased,and the observation group had lower scores than the control group(P<0.05).Conclusions Multi-component exercise training for stable elderly COPD patients can improve the skeletal muscle content and muscle strength of the extremities,enhance exercise endurance and lung function,and alleviate the negative impact of COPD and skeletal muscle dysfunction on patients’quality of life.
目的 基于决策树构建老年患者吞咽障碍预警模型。方法 采用便利取样法对宁夏银川市宁夏回族自治区人民医院老年科住院的200例老年患者进行调查。结果 200例老年患者中,吞咽障碍发生率为40.5%。依据是否发生吞咽障碍将其患者分为两组,两组患者在性别、年龄、文化程度、职业、医保类型、家庭年收入、日常生活能力、衰弱、抑郁、营养、体质指数(BMI)比较(χ 2 值分别为13.321、4.064、31.944、36.695、18.230、19.681、52.509、10.253、20.456、9.070、9.483),差异均有统计学意义(均P<0.05)。决策树模型筛选出老年患者吞咽障碍的影响因素主要有自理能力、职业、文化程度和抑郁,决策树模型受试者工作特征曲线下面积为0.862,灵敏度为79.8%,特异度为79.0%,P<0.001。结论 基于自理能力、职业、文化程度和抑郁构建的决策树模型,能有效预测老年患者吞咽障碍风险。
Objective To construct a swallowing disorder warning model for elderly patients based on decision tree.Methods Convenience sampling was used to study 200 elderly patients admitted to the geriatric department of a tertiary comprehensive hospital in Yinchuan,Ningxia.Results Among 200 elderly patients,the incidence of swallowing disorders was 40.5%.The two groups of patients were compared in terms of gender,age,education level,occupation,medical insurance type,annual family income,daily living ability,frailty,depression,nutrition,and BMI(χ 2 values were 13.321,4.064,31.944,36.695,18.230,19.681,52.509,10.253,20.456,9.070,9.483,respectively),and the differences were statistically significant(all P<0.05).The decision tree model identified the main influencing factors of swallowing disorders in elderly patients as self-care ability,occupation,education level,and depression.The Receiver Operating Characteristic curve of the decision tree model had an area under the curve of 0.862,sensitivity of 79.8%,and specificity of 79.0%,P<0.001.Conclusions A decision tree model based on self-care ability,occupation,education level,and depression can effectively predict the risk of swallowing disorders in elderly patients.
目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭(CHF)并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低(P<0.05)。与对照组相比,观察组干预后左室射血分数(LVEF)水平明显更高,超敏心肌肌钙蛋白T(hs-cTnT)、N末端B型利钠肽前体(NT-proBNP)、左室舒张末期内径(LVEDD)水平更低(P<0.05)。与对照组相比, 观察组干预后主观整体营养状况评价表(PG-SGA)评分明显更低,血红蛋白(Hb)、前白蛋白(PA)、白蛋白(ALB)水平更高(P<0.05)。与对照组相比,观察组干预后症状、身体、情感及总分更低(P<0.05)。观察组不良事件发生率(1.96%)低于对照组(15.69%)(P<0.05)。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。
Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure(CHF)and frailty.Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included. According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention.The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups.Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention(P<0.05).Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention(P<0.05).Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention(P<0.05).Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention(P<0.05).The incidence of adverse events in the observation group(1.96%)was lower than that in the control group(15.69%)(P<0.05).Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events.
目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄(OR=1.131)、睡眠差(OR=2.557)、合并3种及以上慢性病(OR=3.990)、抑郁(OR=3.296)、营养不良风险(OR=4.005)为老年脆性骨折患者术前衰弱的危险因素,BMI正常(OR=0.206)是保护因素(均P<0.05)。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。
Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures.Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected.Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale(CES-D-10), the Generalized Anxiety Disorder Scale(GAD-7), and the Nutritional Risk Screening 2002(NRS-2002).Logistic regression was used to analyze factors influencing preoperative frailty.Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%.Logistic regression analysis revealed the following risk factors for preoperative frailty:age(OR=1.131), poor sleep quality(OR=2.557), multiple chronic comorbidities(OR=3.990), depression(OR=3.296), nutritional risk(OR=4.005).Normal body mass index(OR=0.206)was a protective factor.Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients.Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients.
目的 研究非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果。方法 选择2023年1月—2024年1月贵州中医药大学第一附属医院就诊的非酒精性脂肪性肝病老年患者70例作为研究对象,根据患者就诊顺序分配为两组。对照组35例,接受常规干预;观察组35例,其在对照组基础上予中医“治未病”理念下体质辨识干预模式。比较两组干预效果,以及干预前后血脂水平、肝功能、生存质量的变化。结果 观察组的治疗总有效率91.43%,高于对照组的68.57%,差异有统计学意义(P<0.05)。治疗前,两组各项血脂水平、肝功能、慢性肝病问卷(CLDQ)评分比较,差异无统计学意义(P>0.05);治疗后,两组各项血脂水平优于治疗前,各项肝功能低于治疗前,CLDQ评分高于治疗前,差异有统计学意义(P<0.05);治疗后,观察组的各项血脂水平优于对照组,各项肝功能低于对照组,CLDQ评分高于对照组,差异有统计学意义(P<0.05)。结论 对非酒精性脂肪性肝病老年患者而言,中医“治未病”理念下体质辨识干预服务能够提高其治疗效果,调节血脂水平的异常,改善肝功能及生存质量,值得应用。
Objective To study the physical identification of nonalcoholic fatty liver in the elderly and the therapeutic effect of traditional Chinese medicine on preventing disease before arising.Methods A total of 70 elderly patients with nonalcoholic fatty liver disease treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the study objects.Patients were assigned to two groups,control group(35 cases)received routine intervention,observation group(35 cases)received physical identification intervention based on preventing disease before arising of traditional Chinese medicine additionally.The effect of intervention and the changes of blood lipid levels,liver function and quality of life before and after intervention were compared between the two groups.Results The total effective rate of the observation group was 91.43%,higher than that of the control group(68.57%),the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in blood lipid levels,liver function and CLDQ scores between the two groups(P>0.05).After treatment,the levels of blood lipids were better than those before treatment,liver function was lower than that before treatment,CLDQ score was higher than that before treatment,the difference was statistically significant(P<0.05).After treatment,the blood lipid levels of the observation group was better than that of the control group,the liver function was lower than that of the control group,and the CLDQ score was higher than that of the control group,with statistical significance(P<0.05).Conclusions For elderly patients with nonalcoholic fatty liver disease,the intervention service of body constitution identification under the concept of preventing disease before arising of traditional Chinese medicine can improve the therapeutic effect,regulate the abnormal blood lipid levels,improve liver function and quality of life,which is worthy of application.