社区老年人早期肾小球滤过率功能减退与中医体质辨识的现状调查研究

Investigation on the Status of Early Glomerular Filtration Rate Dysfunction and Traditional Chinese Medicine Constitution Identification in Community Elderly

目的:对老年人体质分布、体质指数(BMI)、早期肾小球滤过率减退患者体质分布进行调查研究,探索社区老年人早期肾小球滤过率功能减退与年龄、中医体质、体质指数的关系。方法:收集五个社区546例老年人体检资料,采用一般资料调查表、老年人中医药健康管理服务记录表进行调查,体质辨识量表、生化检测。检出早期肾小球滤过率功能减退146例并进行统计分析。结果:546例老年人中,男性213人(39%),女性333人(61%)。九种体质情况分布:阴虚体质240人(44%),痰湿体质132人(24.2%),平和体质66人(12.1%),阳虚体质54人(9.9%),湿热体质18人(3.3%),血瘀体质14人(2.6%),气虚体质13人(2.4%),特禀体质8人(1.5%),气郁体质1人(0.2%)。BMI(kg/m^(2))分布特点:<18.5,20人(3.7%),18.5≤BMI≤23.9,279人(51.1%),24≤BMI≤28,197人(36.1%),≥28,50人(9.2%)。社区老年人检出早期肾小球滤过率功能减退146例,检出率为26.74%,其中阴虚体质62人(42.47%),痰湿体质37人(25.34%),平和体质14人(9.59%),阳虚体质18人(12.33%),湿热体质4人(2.7%),血瘀体质5人(3.42%),气虚体质5人(3.42%),特禀体质1人(0.7%)。分析发现年龄与胱抑素C(CysC)间存在正相关关系,差异有统计学意义(χ^(2)=25.849,P<0.05),体质指数、中医体质与胱抑素C(CysC)间存在相关性,差异有统计学意义(χ^(2)=170.548、9.604,P<0.05)。结论:本研究表明社区老年人早期肾小球滤过率功能减退与年龄、中医体质、体质指数间存在相关性,提示从中医体质调理、体重调整方面入手有可能延缓或避免肾小球滤过率功能减退。

Objective:To investigate the physical distribution,body mass index(BMI)and the physical distribution of the elderly patients with early glomerular filtration rate decline,and to explore the relationship between the early glomerular filtration rate decline and age,TCM constitution and body mass index of the elderly in community.Methods:The physical examination data of 546 elderly patients in five communities were collected and investigated by general data questionnaire,TCM health management service record form,physique identification scale and biochemical test.Early glomerular filtration rate dysfunction was detected in 146 cases.Conduct statistical analysis.Results:Among the 546 elderly patients,213(39%)were male and 333(61%)were female.Distribution of nine physical conditions:240 patients with Yin deficiency constitution(44%),132 patients with phlegm-dampness constitution(24.2%),66 patients with peace constitution(12.1%),54 patients with Yang deficiency constitution(9.9%),18 patients with dampness-heat constitution(3.3%),14 patients with blood stasis constitution(2.6%),13 patients with qi deficiency constitution(2.4%),8 patients with special constitution(1.5%),Qi depression constitution 1(0.2%).BMI(kg/m~2)distribution characteristics:<18.5,20(3.7%),18.5≤BMI≤23.9,279(51.1%),24≤BMI≤28,197(36.1%),≥28,50(9.2%).146 cases of early glomerular filtration rate dysfunction were detected among the elderly in community,the detection rate was 26.74%,including 62 cases of Yin deficiency constitution(42.47%),37 cases of phlegm-dampness constitution(25.34%),14 cases of peace constitution(9.59%),18 cases of Yang deficiency constitution(12.33%),4 cases of damp-heat constitution(2.7%).5 patients(3.42%)had blood stasis constitution,5 patients(3.42%)had qi deficiency constitution,and 1 patient(0.7%)had special constitution.There was a positive correlation between age and cystatin C(CysC),the difference was statistically significant(χ^(2)=25.849,P<0.05),there was a significant correlation between body mass index,TCM constitution and cystatin C(CysC)(χ^(2)=170.548,9.604,P<0.05).Conclusion:This study shows that there is a correlation between early glomerular filtration rate decline and age,TCM constitution and body mass index in elderly community,suggesting that TCM constitution conditioning and body weight adjustment may delay or avoid glomerular filtration rate decline.