住院老年患者共病现状及中医证型分析
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R592

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广东省医学科研基金指令性课题项目(C2014040)


Analysis on Present Situation of Comorbidity in Hospitalized Senile Patien ts and Chinese Medicine Syndrome Type
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    摘要:

    目的:研究老年患者共病现状及中医证型与共病的关系。方法:将722例符合纳入要求的患者进行住院数据的回顾性分析,探讨老年患者共病发生率、高发疾病患病率、中医证型相互间的关系及以上指标与年龄、性别的关系。结果:(1)患病率排前10位的为动脉硬化性疾病(641例)、高血压病(502例)、糖尿病(268例)、脊椎退行性变(399例)、血脂异常(329例)、前列腺病变(323例)、冠心病(244例)、脑血管病(255例)、感染性疾患(177例)、骨质疏松(107例)。动脉硬化、高血压病、冠心病、脑血管病、感染性疾患及骨质疏松等疾患患病率随年龄增大而增长(P<0.01),血脂异常患者发病率随年龄增长下降(P<0.01),动脉硬化、冠心病、脑血管病、感染性疾患等4种疾患男性患病率高于女性(P<0.01),脊椎退行性病变及骨质疏松女性患病率高于男性(P<0.01)。老年问题的诊断率比实际发生率要少。(2)将患者分为7个单一证型,血瘀型(646例)、气虚型(526例)、痰浊型(509例)、阴虚型(126例)、肾虚型(119例)、湿邪型(116例)、实热型(71例)。单一证型中血瘀型、气虚型、痰浊型占的比例最高。气虚证发生比例随年龄增加而递减,合并阴虚、肾虚、湿邪3个证型的患者中,71~80岁年龄段人数比例最大,差异有统计学意义(P<0.05)。气虚性患者中女性比例较男性高,其余单一证型均是男性比例比女性高,其中阴虚证与实热证差异有统计学意义(P<0.05)。(3)各证型间常见病患病率并无统计学差异。结论:老年患者最常见的疾病是动脉硬化性疾患,老年问题的诊断率远不如实际高。住院老年患者中单一证型气虚、痰浊和血瘀证型占多数,血瘀证患病率最高,说明气虚痰浊瘀血是老年患者各种疾病的发病基础。

    Abstract:

    Objective: To study the present situation of comorbidity in senile patients and the relationship between Chinese medicine syndrome type the present situation and comorbidity.Methods:Retrospectively analyzed the hospitalization data of 722 cases of patients who met the inclusion criteria,discussed the incidence of comorbidity,prevalence of diseases with high incidence,relationship among Chinese medicine syndrome types and relationship of each index above with age and gender of senile patients.Results: (1)Diseases with top 10 prevalence were arteriosclerotic disease(641 cases),hypertension(502 cases),diabetes(268 cases), degenerative spinal disease(399 cases), dyslipidemia(329 cases),prostate lesions(323 cases),coronary heart disease(244 cases),cerebrovascular disease(255 cases), infectious disease(177 cases)and osteoporosis(107 cases).The prevalence of arteriosclerosis, hypertension, coronary heart disease, cerebrovascular disease infectious disease and osteoporosis was higher as age increased(P < 0.01),the prevalence of dyslipidemia was lower as age increased(P < 0.01), the prevalence of 4 types of disease including arteriosclerosis, coronary heart disease,cerebrovascular disease and infectious disease in male was higher than that in female(P < 0.01),and the prevalence of degenerative spinal disease and osteoporosis in female was higher than that in male( P <0.01).The diagnostic rate of senile problems was lower than the actual incidence.(2)Divided patients into 7 simple syndrome types,including blood-stasis type(646 cases), qi-deficiency type(526 cases), phlegm-turbidity type(509 cases), yin-deficiency type(126 cases),kidney-deficiency type(119 cases),dampness-evil type(116 cases)and excessive-heat type(71 cases).Among the simp le syndrome types,the blood-stasis type,qi-deficiency type and phlegm-turbidity type made up the highest proportion.The incidence proportion of qi-deficiency syndrome was lower as age increased,and among the comorbidity of 3 syndrome types of yin deficiency,kidney deficiency and dampness evil,the proportion of patients at age from71 to 80 years old was the largest,differences being significant(P < 0.05).Among patients of qi-deficiency type,the proportion in female was higher than that in male,among the other single syndrome types,the proportion in male was higher than that in female,and there was significant difference being found in the yin-deficiency syndrome and the excessive-heat syndrome( P <0.05).(3)There were no significant differences being found in the prevalence of common diseases among various syndrome types.Conclusion:The most common disease of hospitalized senile patients is arteriosclerotic disease,and the diagnostic rate of senile problems is far lower than the actual incidence.Among the hospitalized senile patients,the single syndrome types of qi deficiency, turbid phlegmand blood stasis make up the majority, and the prevalence of blood-stasis syndrome is the highest,indicating that qi deficiency,turbid phlegmand blood stasis are the pathogenic basis of various diseases of senile patients.

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吴瑜,李新梅,张熹煜.住院老年患者共病现状及中医证型分析[J].新中医,2018,50(7):53-56

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  • 在线发布日期: 2018-07-09
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