宁波市城区中老年居民中医体质评估及干预效果评价

Evaluation on the TCM constitution and intervention effect among middle-aged and elderly residents in Ningbo

目的通过对宁波市城区中老年人群中医体质辨识,采取针对性干预措施并对干预效果进行评估,为城市社区居民的中医养生保健提供科学依据。方法对3 101名干预组对象进行中医体质辨识和中医干预(饮食药膳建议、运动处方等),对2 879名对照组对象进行问卷调查及常规健康宣教,采用问卷调查方法收集对象健康状况,采用χ2检验和t检验进行比较分析,P<0.05为差异有统计学意义。结果本调查中平和质占干预组调查总数34.57%,8种偏颇体质占65.43%,女性偏颇体质占67.80%,显著高于男性的58.74%(χ2=21.75,P<0.01)。女性气虚、阴虚、阳虚体质比例(分别为15.38%、12.49%、5.29%)显著高于男性(8.00%、8.25%、2.71%),男性痰湿体质比例(27.46%)显著高于女性(19.22%)。干预组干预后健康得分4.05显著高于干预前3.51(配对t检验,t=182.92,P<0.01),对照组终期调查得分3.98显著高于基线调查得分3.72(配对t检验,t=122.43,P<0.01)。干预组在干预后健康得分平均增加0.55,显著高于对照组0.37(t=15.78,P<0.01),其中以体力状态和睡眠情况改善最为明显,体力状态得分增加干预组与对照组分别为0.67和0.34(t=20.00,P<0.01),睡眠情况分别为0.67和0.29(t=25.40,P<0.01)。总体健康情况和体力状态在气虚、湿热和阳虚体质对象中改善最为明显,血瘀、气郁和特禀体质中改善情况相对较差。睡眠情况在湿热、气虚和阴虚体质中改善最为明显。结论根据中医体质采取有针对性的中医干预对辖区中老年居民健康状况改善取得较好的效果,尤其是在体力状态和睡眠情况方面效果更为明显。

Objective To evaluate the TCM constitution and intervention effect among middle-aged and elderly urban residents in Ningbo. Methods TCM constitution of 3 101 residents was performed and identified,specific intervention was given accordingly based on their constitution types.Meanwhile,aquestionnaire survey and health education was conducted among 2 879 residents as controls.Chi-square and t tests were used for data analysis. Results Less than half（34.57%）of residents in intervention group were found to be constitution of yin-yang harmony,65.43% had biased constitution,which was higher in females（67.80%）than in males（58.74%）（χ2=21.75,P〈0.01）.The percentage of constitution of qi asthenia,yin asthenia and yang asthenia among females（15.38%,12.49%,5.29%）were all significantly higher than that in males（8.00%,8.25%,2.71%）,while,more males than females had constitution of phlegm-dampness（27.46%vs 19.22%）.The overall health score increased from 3.51 to 4.05 after the intervention.The added value of0.55 to health score was significantly higher among residents in intervention group compared to that of 0.37 added in control group（t=15.78,P〈0.01）.Physical strength and sleep quality were improved dramatically.Residents with constitutional types of qi asthenia,damp-heat or yang asthenia gained the most improvement in overall health as well as in physical strength,while those with constitutional types of blood stasis,qi stagnation or allergic constitution achieved the least. Conclusions The percentage of biased constitution among urban middle-aged and elderly residents is relatively high,and specific intervention on TCM constitution can help to improve the overall health status of residents,especially in physical strength and sleep quality.