健脾益肾药膳雌鸡粥对社区老年衰弱患者衰弱状态及营养状况的干预效果研究

Effectiveness Evaluation of Jianpiyishenyaoshancijizhou for the Improvement of Frailty and Nutritional Status in Community-dwelling Frail Elderly Patients

目的评价健脾益肾药膳雌鸡粥干预社区老年衰弱患者衰弱状态及营养状况的效果。方法于2017年3—10月,采用随机数字表法将成都市华川社区72例老年衰弱患者随机分为对照组和试验组,每组各36例。对照组由经过规范培训的研究者采用集体讲座和个体化指导相结合的方式实施健康教育,1次/2周,共4次;试验组在健康教育基础上食用健脾益肾药膳雌鸡粥,每次300～400 ml,于早饭前空腹服用,隔日1次,4周为1个疗程,共2个疗程。于干预前、干预后第8周末采用Fried衰弱表型(FP)、微型营养评估(MNA)量表分别评价两组社区老年衰弱患者的衰弱状态及营养状况。结果最终共64例患者完成研究,其中对照组32例(脱落4例),试验组32例(脱落3例、剔除1例)。干预后,除无意识体质量下降指标外,试验组患者自述疲劳感、步速缓慢、握力下降、低体力活动指标及FP总分低于对照组,差异均有统计学意义(P<0.05);除整体情况维度外,试验组患者人体测量、膳食评定、主观评定维度评分及MNA总分均高于对照组,差异有统计学意义(P<0.05)。结论健脾益肾药膳雌鸡粥可有效改善社区老年衰弱患者的衰弱状态及营养状况,从而有效提高社区老年人的生活质量。

Objective To evaluate the effects of Jianpiyishenyaoshancijizhou(a type of congee with herbs,shredded female chicken breast and rice for invigorating the spleen and nourishing the kidney)on the frailty and nutritious status in community-dwelling frail elderly patients.Methods From March to October 2017,a total of 72 community-dwelling frail elderly patients were sampled from Huachuan Community in Chengdu and equally divided into the experimental and control groups by the random number table.Both groups received four times of public combined with personalized health education at fortnightly intervals,the experimental group additionally ate 300-400 ml Jianpiyishenyaoshancijizhou on an empty stomach before breakfast,one time every other day,for 8 weeks(two courses of treatment).Before the intervention and at the end of intervention,the frailty and nutritional status of both groups were evaluated by Fried's Frailty Phenotype(FP)and Mini-Nutritional Assessment(MNA),respectively.Results Except for 4 dropouts in the control group and 3 dropouts and 1 exclusion case in the experimental group,the other 64 cases who completed the intervention were included in the final analysis.After intervention,the experimental group demonstrated lower mean scores of FP and its each item except for the unintentional weight loss compared with the control group(P<0.05).Moreover,the experimental group demonstrated much higher mean scores of the MNA,and anthropometric measurements,dietary questionnaire,and subjective assessment except for the score of the global assessment(P<0.05).Conclusion Jianpiyishenyaoshancijizhou could significantly improve the frailty and nutritional status of community-dwelling frail elderly people,thus the quality of life of them was enhanced effectively.