先后天论结合中医辨证治疗老年衰弱症的价值研究

Study on Value of Treatment of Senile Asthenia with Congenital and Acquired Constitution Theory and Syndrome Differentiation of Traditional Chinese Medicine

目的肌少症是老年衰弱症的主要表现,旨在探讨先后天论结合中医辨证法对老年衰弱症患者的肌肉减弱和相应功能下降的影响。方法随机选取2019年2月—2020年2月在医院体检资料完整的老年人,依据美国Fried五项标准判断,进行衰弱综合征的评判,筛选出48例衰弱前期患者,48例衰弱患者。分别对衰弱前期患者和衰弱患者进行先后天论结合中医辨证法进行治疗,治疗2个月后,依据美国Fried五项标准判断重新对患者进行衰弱评定。随后进行早期肌少症测定、肌功能(日常步行速度测定)、起立-行走测试、5次起坐测试以及平衡试验进行评估,比较组间的治疗效果,评定先后天论结合中医辨证治疗老年衰弱症的价值。结果两组患者在治疗2个月后,生活活动能力下降、平衡和步态显著性下降、跌倒风险增加、营养不良现象降低、精神心理得分显著升高、睡眠障碍降低、听力下降减缓、尿失禁状况得到缓解,同时各组患者的衰弱评分得到改善(P<0.05),但各组患者缺牙数目未见显著性改变、压疮出现的次数组间未见显著性的改变(P>0.05)。两组老年人握力和步速得到显著改善,四肢骨骼肌质量显著增加,5次起坐测试验、平衡试验以及起立行走试验组间有显著性改变(P<0.05)。结论肌少症是衰弱发生的重要原因,肌肉相关指标的变化可能是衰弱综合征发展的重要指征,先后天论结合中医辨证治疗老年衰弱症具有显著的临床价值。

Objective Sarcopenia is the main manifestation of senile asthenia. The purpose of this study was to explore the effect of congenital and acquired constitution theory theory combined with TCM syndrome differentiation on muscle weakening and corresponding functional decline in patients with senile asthenia. Methods The elderly with complete physical examination data in our hospital from February 2019 to February 2020 were randomly selected and judged according to the five criteria of Fried in the United States. Forty-eight patients with pre-asthenia and 48 patients with asthenia were selected. The patients in the early stage of asthenia and those with asthenia were treated with the congenital and acquired constitution theory combined with TCM syndrome differentiation. After 2 months of treatment, the patients were re-evaluated according to the five criteria of Fried in the United States. Then the early sarcopenia test, muscle function(daily walking speed measurement), stand-up-walk test, 5 sit-up test and balance test were evaluated, and the therapeutic effects between the two groups were compared. to evaluate the value of successive days theory combined with TCM syndrome differentiation in the treatment of senile asthenia. Results After 2 months treatment, the living ability of the two groups was decreased, the balance and gait decreased significantly, the risk of fall increased, the phenomenon of malnutrition decreased, the mental and psychological score increased significantly, the sleep disorder decreased, the hearing loss slowed down, and the urinary incontinence was relieved. At the same time, the weakness score of patients in each group was improved(P<0.05). However, there was no significant change in the number of missing teeth or the number of pressure sores in each group(P>0.05). The grip strength and walking speed of the elderly in the two groups were significantly improved, and the skeletal muscle mass of the extremities was significantly increased. There were significant changes among the five sit-up test, balance test and stand-up walking test groups(P<0.05). Conclusion Sarcopenia is an important cause of asthenia, and the changes of muscle-related indexes may be an important indication for the development of asthenia. The congenital and acquired constitution theory combined with TCM syndrome differentiation has significant clinical value in the treatment of senile asthenia.