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．
目的 应用FRAX®工具评估广州社区中老年人发生骨质疏松性骨折的风险。方法 回顾性研究1 140例广州社区中老年人的临床资料,应用FRAX®工具计算未来10年发生主要骨质疏松性骨折及髋部骨折的风险,分析不同危险因素与骨折风险的关系。结果 广州社区中老年人群10年内发生主要骨质疏松性骨折概率为(4.2±3.6)%,髋部骨折概率为(1.3±2.4)%。主要骨质疏松性骨折风险及髋部骨折风险、OSTA值均随着年龄增长而增加。多因素回归分析结果显示: 年龄、性别、既往骨折、继发性骨质疏松、股骨颈T值、跌倒对主要部位骨折及髋部骨折风险具有独立性预测意义。结论 FRAX®工具可用于评估广州社区中老年人骨质疏松性骨折风险,建议在社区中老年人健康体检时应用FRAX®工具进行骨折风险评估。
Objective To predict the osteoporotic fracture risk in senile people in Guangzhou communities by FRAX,the fracture risk assessment tool published by WHO. Methods Clinical data of 1140 cases were collected for the retrospective analysis. The FRAX tool was uesed to calculate the 10-year probability of a major osteoporotic and hip fracture.The relationship between different risk factors and the fracture risk predicted by FRAX was analyzed. Results The 10-year probability of major osteoporotic fractures was (4.2±3.6)%, and the 10-year probability of hip fractures was (1.3±2.4)%.The 10-year probability of the major osteoporotic and hip fracture increased with age.Multivariate regression analysis showed that age,gender,previous fracture,secondary osteoporosis,T-score of femoral neck BMD and fall were independent predictors of the 10-year probability of major osteoporotic fracture and hip fracture. Conclusion The FRAX tool may be effectively applied to assess the fracture risk of senile population in Guangzhou communities.We recommedated that FRAX-tool should be included in routine health check-up.
目的 探讨对分课堂对《老年人健康照护技术》实训教学效果的影响,为进一步完善智慧健康养老服务与管理专业实训教学方案提供参考依据。方法 以广州卫生职业技术学院2022级智慧健康养老服务与管理专业学生为研究对象,设定其中一班为观察组,另一班为对照组,在《老年人健康照护技术》实训教学过程中,观察组采用对分课堂的实训教学模式,对照组采用传统实训教学模式;实训结束后对两组均进行理论和技能考核,并在教学前后均采用《一般自我效能感量表》对两组学生进行测评。结果 试验开始之前,对两组学生一般自我效能感测评得分进行比较,差异无统计学意义（P>0.05）;试验结束后,将观察组与对照组的理论和技能考核成绩、一般自我效能感得分进行比较,观察组均明显高于对照组,差异有统计学意义（P<0.01）;且观察组一般自我效能感得分优于本组试验前,差异有统计学意义（P<0.01）。结论 对分课堂有利于提高学生的一般自我效能感,有助于改善《老年人健康照护技术》的实训教学效果,能够为进一步完善智慧健康养老服务与管理专业实训教学方案提供参考依据。
Objective To explore the impact of split courses on the practical training and teaching effectiveness of “Elderly Health Care Technology”,and to provide reference for further improving the practical training and teaching plan of smart health and elderly care services and management．Methods A study was conducted on students majoring in Intelligent Health and Elderly Care Services and Management from Guangzhou Health Vocational and Technical College in 2022．One class was set as the observation group and the other as the control group．During the training and teaching process of “Elderly Health Care Technology”,the observation group adopted a split courses training teaching mode,while the control group adopted a traditional training teaching mode．After the practical training,theoretical and skill assessments were conducted on both groups,and the General Self Efficacy Scale was used to evaluate both groups of students before and after teaching．Results Before the start of the experiment,there was no statistically significant difference in the general self-efficacy evaluation scores between the two groups of students（P>0.05）．After the experiment,the theoretical and skill assessment scores, general self-efficacy scores of the observation group, and the control group were compared．The observation group was significantly higher than the control group,with a significant statistical difference（P<0.01）,and the general self-efficacy score of the observation group was better than before the experiment,with a statistically significant difference as well（P<0.01）．Conclusions split courses were beneficial for improving students’ general self-efficacy,enhancing teaching effectiveness,and providing reference basis for further improving the practical training teaching plan for smart health and elderly care services and management．
目的 探讨养老机构老年人死亡态度及其影响因素。方法 选取2018年1月—2022年12月广州市养老机构的593名老年人进行问卷调查,统计养老机构老年群体对死亡的态度,并分析其死亡态度发生的影响因素。结果 经过研究发现,对死亡的态度呈自然接受的老年人数量最少,为42例,占比为7.1%,其次从高到低依次为逃离接受老年人308例,占比为51.9%;死亡恐惧老年人83例,占比为14.0%;死亡逃避老年人81例,占比为13.7%;趋近接受老年人79例,占比为13.3%。患者的死亡态度与患者所患的疾病病种有关,影响死亡态度的因素包括：生理心理因素、文化思想因素、社会环境因素,其中发生概率最高的是生理心理因素,占比为50.9,其次从高到低依次为文化思想因素,占比为26.5%;社会环境因素,占比为22.6%。死亡态度中趋近接受维度的分值相对更高,其次依次为死亡恐惧、自然接受、死亡逃避以及逃离接受。单因素分析显示差异有统计学意义的项目包含家庭内讨论死亡、性别、健康自评状况、年龄、患病种数、经济结构。结论 在养老机构中,大多数老年人对死亡是无法自然接受的,大部分老年群体对死亡的态度是逃离接受,部分群体对死亡的态度是恐惧、逃避;而影响老年群体死亡态度的因素主要是生理心理因素。
Objective To explore the death attitudes and its influencing factors among the elderly in nursing institutions. Methods A questionnaire survey on death attitudes was conducted among 593 elderly individuals in nursing institutions in Guangzhou from January 2018 to December 2022,and their possible influencing factors were analyzed. Results There were 51.9% of the elderly individuals whose death attitudes were characterized by escape acceptance,while 7.1% demonstrated natural acceptance．However,the numbers of the elderly individuals with approaching acceptance,fear of death and escape from death showed no significant statistical difference,all being lower than the number of the elderly individuals with escape acceptance．The influencing factors of death attitude included physiological and psychological factors,cultural and ideological factors,and social environment factors．The probability of physiological and psychological factors influencing death attitudes was higher than that of other factors（P<0.05）．The score for the dimension of approaching acceptance in death attitudes was higher than that for other dimensions（P<0.05）. Conclusions In nursing institutions,the majority of elderly individuals cannot naturally accept death．Most elderly individuals exhibit an attitude of escape acceptance towards death,while some exhibit an attitude of fear and escape．However,the factors influencing the elderly's attitudes towards death are mainly physiological and psychological factors．
老年人工股骨头置换术后隐性失血是影响手术的重要因素之一,手术后机体生理、病理的变化是一个较为复杂的过程。目前中医对其病因病机尚无系统研究。临床中常存在辨证思维局限,难以客观、全面揭示该病病因病机的特点,进而导致遣方用药难以把握。该文旨在对老年人工股骨头置换术后隐性失血的病因病机进行探讨,认为该病的证候特点为气血亏虚兼瘀,病性为本虚标实,病位肝脾肾,其中气血亏虚贯穿疾病始终,而气为关键。
Hidden blood loss after artificial femoral head replacement in the elderly is one of the important factors affecting the operation,and the change of physiology and pathology after operation is a complicated process．At present,there is no systematic study on its etiology and pathogenesis in traditional Chinese medicine．In clinical practice,there are limitations of dialectical thinking,which make it difficult to Objective ly and comprehensively reveal the characteristics of the etiology and pathogenesis of the disease,and difficult to prescribe．The purpose of this paper is to explore the etiology and pathogenesis of hidden blood loss after artificial femoral head replacement in the elderly．It is considered that the syndrome of the disease is characterized by deficiency of qi and blood and blood stasis,and the disease is based on deficiency of liver,spleen and kidney,in which deficiency of qi and blood runs through the disease all the time,and qi is the key．
本文综述近10年中医传统疗法中通过穴位刺激预防与治疗老年患者骨折术后谵妄的研究概况。术后谵妄是老年患者骨折术后常见的并发症,不仅延长患者住院时间、增加经济负担,同时与骨折术后死亡并发症的发生密切相关。但是本病机制尚未明确,在临床治疗上难以达成共识。针灸等穴位刺激是中医药治疗脑病的独具特色的疗法,近年来有关穴位刺激防治老年骨折术后谵妄的报道越来越多,本文主要探讨不同的穴位刺激方法干预对骨折术后谵妄发生率的影响,包括传统刺激方式如毫针、电针、穴位注射、穴位敷贴和新针疗法如耳针、头针等,认为穴位刺激能够较好预防骨折术后谵妄发生,在治疗上也有较好疗效。以期为进一步临床研究与应用提供参考。
This article summarized the research of acupoint stimulation in preventing delirium after fracture surgery in elderly patients in recent 10 years．Postoperative delirium is a common complication in elderly patients after fracture surgery, which affects life extremely and increases economic burden．However, the mechanism of this disease haven't been revealed, and it is difficult to reach consensus on clinical treatment．Acupoint stimulation, like acupuncture, is a unique treatment of encephalopathy with traditional Chinese medicine．In recent years, there are more and more reports on acupoint stimulation therapy to prevent and treat delirium after fracture surgery in the elderly．This article mainly study the influence of different acupoint stimulation therapy on treatment of delirium after fracture surgery, including electroacupuncture, auriculotherapy, scalp acupuncture, acupoint injection and acupoint application, etc．It is believed that acupoint stimulation can prevent delirium after fracture surgery, so as to provide reference for further clinical research and application．
目的 通过关注追踪中老年人口腔健康问题对生活质量的影响,系统梳理中老年人口腔健康的相关影响因素及其关系,为此类人群的口腔健康及其相关生活质量的活动开展提供调研依据。方法 随机抽取2022年10月—2023年5月之间的266名中老年人参与调查,按照“病因链”收集该类人群的社会学特征、日常口腔保健行为、身体健康状况,分析评价中老年人口腔健康相关生活质量。结果 266名中老年人口腔健康常识和行为得分平均为（30.69±8.98）分,口腔健康评估平均为（8.59±3.68）分,口腔健康相关生活质量GOHAI总分为（25.65±8.10）分。单因素分析显示,人口学特征与一般身体健康状况、口腔健康常识和行为以及口腔健康情况与中老年人的口腔健康相关生活质量的GOHAI得分密切相关（P<0.05）。多因素分析显示,女性、年龄>45岁、患慢性病、日常生活习惯是影响中老年口腔健康和生活质量的独立危险因素（P<0.05或P<0.01）。结论 口腔健康作为全身健康的基础,其影响因素多种多样,通过控制干预主要影响因素来提高社区口腔健康和相关生活质量,以改善社区居民生活幸福值。
Objective By focusing on and tracking the impact of oral health problems of middle-aged and elderly people on the quality of life,the relevant influencing factors and relationships of oral health were systematically sorted out to provide a research basis for the development of oral health and related quality of life of such people．Methods A total of 266 middle-aged and elderly people were randomly selected from October 2022 to May 2023 to participate in the survey,and the sociological characteristics,daily oral health care behaviors and physical health status of this population were collected according to the “etiological chain”,so as to analyze and evaluate the quality of life related to the oral health of middle-aged and elderly people．Results The 266 middle-aged and elderly people had a mean score of（30.69±8.98）for general knowledge and behavioral scores of oral health,a mean score of（8.59±3.68）for oral health assessment,a total score of（25.65±8.10）for oral health-related quality of life GOHAI．The univariate analysis showed that demographic characteristics,general body health state,oral health cognition and behavior and oral health state were closely associated with the GOHAI score related to the oral health associated quality of life in the middle-aged and elderly people（P<0.05）．The multivariate analysis indicated that female,age >45 years old,presence of chronic diseases and daily living habits were indepdent risk factors of the oral health and quality of life of the middle-aged and elderly（P<0.05）．Conclusions Oral health,as the basis of systemic health,has various influencing factors,by controlling the main influencing factors can improve the community oral health and related quality of life,and improve the happiness of community residents．
目的 探讨弹力带抗阻训练对老年人骨骼肌功能的影响。方法 在我院筛选60例老年人随机分为两组,对照组30例患者采用常规康复训练,观察组30例患者采用弹力带抗阻训练;分别于干预前及干预3月后评价骨骼肌功能,分析跌倒风险指数。结果 对照组干预前后骨骼肌质量指数、握力、歩速以及平衡量表BBS评分比较无差异(P>0.05);观察组干预后骨骼肌质量指数、6 m步速、握力均高于对照组,平衡量表BBS评分低于对照组(P<0.05)。结论 弹力带抗阻训练能够提高老年人骨骼肌质量、改善老年人握力计和歩速,提高平衡能力。
Objective To investigate the effect of elastic band resistance training on skeletal muscle function in the elderly. Methods 60 elderly patients in our hospital were selected and randomly divided into two groups. 30 patients in the control group received conventional rehabilitation training, while 30 patients in the observation group received elastic band resistance training. Skeletal muscle function was evaluated before intervention and 3 months after intervention, and the fall risk index was analyzed. Results There were no significant differences in skeletal muscle mass index, grip strength, pacing and BBS scores of balance scale before and after intervention in the control group (P>0.05). After intervention, the skeletal muscle mass index, 6 m step speed and grip strength of the observation group were all higher than those of the control group, and the BBS score of balance scale was lower than that of the control group (P<0.05). Conclusion The elastic band resistance training can improve the skeletal muscle quality, improve grip strength and pacing, and improve the balance ability in the elderly.
目的 应用FRAX®工具评估广州社区中老年人发生骨质疏松性骨折的风险。方法 回顾性研究1 140例广州社区中老年人的临床资料,应用FRAX®工具计算未来10年发生主要骨质疏松性骨折及髋部骨折的风险,分析不同危险因素与骨折风险的关系。结果 广州社区中老年人群10年内发生主要骨质疏松性骨折概率为(4.2±3.6)%,髋部骨折概率为(1.3±2.4)%。主要骨质疏松性骨折风险及髋部骨折风险、OSTA值均随着年龄增长而增加。多因素回归分析结果显示: 年龄、性别、既往骨折、继发性骨质疏松、股骨颈T值、跌倒对主要部位骨折及髋部骨折风险具有独立性预测意义。结论 FRAX®工具可用于评估广州社区中老年人骨质疏松性骨折风险,建议在社区中老年人健康体检时应用FRAX®工具进行骨折风险评估。
Objective To predict the osteoporotic fracture risk in senile people in Guangzhou communities by FRAX,the fracture risk assessment tool published by WHO. Methods Clinical data of 1140 cases were collected for the retrospective analysis. The FRAX tool was uesed to calculate the 10-year probability of a major osteoporotic and hip fracture.The relationship between different risk factors and the fracture risk predicted by FRAX was analyzed. Results The 10-year probability of major osteoporotic fractures was (4.2±3.6)%, and the 10-year probability of hip fractures was (1.3±2.4)%.The 10-year probability of the major osteoporotic and hip fracture increased with age.Multivariate regression analysis showed that age,gender,previous fracture,secondary osteoporosis,T-score of femoral neck BMD and fall were independent predictors of the 10-year probability of major osteoporotic fracture and hip fracture. Conclusion The FRAX tool may be effectively applied to assess the fracture risk of senile population in Guangzhou communities.We recommedated that FRAX-tool should be included in routine health check-up.
目的 探讨广州地区老年人维生素D水平及其与骨密度、甲状旁腺激素的相关性。方法 收集2016年6月—12月在广州市第一人民医院老年病科就诊的患者。检测25-羟维生素D、甲状旁腺激素、Ⅰ型前胶原氨基端前肽、β-Ⅰ型胶原C端肽、腰椎和髋部骨密度。将患者分为维生素D缺乏组(≤20 ng/mL)、维生素D不足组(20～30 ng/mL)、维生素D充足组(≥30 ng/mL)。结果 ①426例研究对象的平均年龄是(79.77±7.69)岁,25羟维生素D平均值是(20.38±8.20)ng/mL。维生素D缺乏、不足、充足者比例分别是53%(226/426)、34.3%(146/426)、12.7%(54/426)。②25羟维生素D水平随年龄增加而降低。25羟维生素D与股骨颈和全髋骨密度呈正相关(r=0.18,P＜0.001),与甲状旁腺激素呈负相关(r=-2.05,P＜0.001)。结论 广州地区老年人维生素D不足及缺乏十分普遍。维生素D与股骨颈、髋部骨密度呈正相关,与甲状旁腺激素呈负相关。
Objective To investigate the vitamin D level of elder people in Guangzhou and the relationship in vitamin D, bone mineral density and parathyroid hormone. Methods To screening elderly patients in the geriatric department of Guangzhou First peoples Hospital from June to December 2016.Serum 25-hydroxy vitamin D,parathyroid hormone,procollagen typeⅠN-terminal propeptide,β-crosslaps of C-telopeptide of typeⅠcollagen,bone mineral density were measured.Three groups were divided according to the serum 25(OH)D level,including deficiency group(≤20 ng/mL),insufficiency group(20-30 ng/mL) and sufficiency group(≥30 ng/mL). Results The mean age of the 426 subjects was 79.77±7.69 years old. The average level of 25(OH)D was 20.38±8.20 ng/mL. The proportion of vitamin D deficiency, insufficient and sufficient persons were 53% (226/426), 34.3% (146/426), and 12.7% (54/426). The level of 25 hydroxy vitamin D was decreased with age.Correlation analysis showed that 25 hydroxy vitamin D level was positive correlated with the femoral neck and total hip bone density(r=0.18,P＜0.001),was negatively correlated with parathyroid hormone(r=-2.05,P＜0.001). Conclusion Vitamin D deficiency or insufficiency is highly prevalent in elderly men in Guangzhou.25 hydroxy vitamin D level was positive correlated with the femoral neck and total hip bone density, negatively correlated with parathyroid hormone.
