中医体质辨识在社区老年高血压患者健康管理中的应用分析

Analysis on the Application of Traditional Chinese Medicine Constitution to Elderly Hypertensive in Community

目的了解社区老年高血压患者中医体质分布情况,探讨中医体质辨识在社区高血压病管理中应用的可行性。方法通过对福州市鼓楼区洪山和水部社区卫生服务中心所管辖范围内的65岁及以上的高血压患者进行问卷调查,结合电话随访、面对面访谈、观察法了解社区卫生服务中心老年人的健康服务进展,运用描述性分析说明社区老年高血压患者的中医体质分布情况及中医体质辨识的时间成本。结果老年高血压患者中偏颇体质占68.58%,前4位为痰湿质(23.37%)、阳虚质(21.07%)、气虚质(9.20%)、阴虚质(8.05%)。鉴于老年人的理解和应答能力以及社区卫生服务的条件,社区医务人员为每位患者做中医体质辨识调摄指导,总共约需95分钟/人年。结论老年高血压患者中医体质不一,以中医体质为依据进行高血压患者健康指导,有利于实现个性化服务。加强对中医体质辨识的投入力度和人才队伍的建设,规范体质辨识的流程和制度,有利于促进中医体质辨识调摄理论在社区高血压病健康管理中的应用及推广。

OBJECTIVE To understand the physical distribution of traditional Chinese medicine(TCM) constitution among hyperten-sive in community and explore the feasibility of TCM constitution in community elderly hypertension management. METHODS Datawas collected by questionnaire investigation with telephone interview, face-to-face interview and observation among hypertensive aged65 years old and above in community. Data analysis was conducted by SPSS 16.0 with descriptive statistic. RESULTS The distribu-tion of TCM constitution of elderly hypertensive was as following: Phlegm-dampness Constitution(23.37%), Yang-deficiency Constitu-tion(21.07%), Qi-deficiency Constitution(9.20%), Yin-deficiency Constitution(8.05%). It needed about 95minutes/person every year toidentify TCM constitution and recuperate according to patients' constitution. Human resource, related instruments and basic knowl-edge of TCM were challenging factors for primary health care institutions to promote the application of constitution theory of TCM.CONCLUSION TCM constitution of elderly people was different even if they have the same disease of hypertension. The applicationof constitution theory of TCM could promote the individual service in hypertension management. Some barriers should be overcomefor promoting the application of constitution theory of TCM: convenient software for identification of TCM, human resources in commu-nity health services centers and the sharing platform of patients' information.