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中华危重症医学杂志(电子版)

中华危重症医学杂志(电子版) ›› 2025, Vol. 18 ›› Issue (04) : 290 -296. doi: 10.3877/cma.j.issn.1674-6880.2025.04.004

论著

住院老年患者中医体质特点及其对常见老年综合征发生风险的影响
何彩红1, 李爱萍2, 杨一晨1, 杨云梅1,3,4, 张勤1,3,4,†()   
  1. 1310003　杭州，浙江大学医学院附属第一医院老年医学科
    2311254　杭州，杭州市萧山区所前镇社区卫生服务中心全科
    3310003　杭州，浙江大学医学院附属第一医院全省理化与增龄损伤性疾病诊治研究重点实验室
    4310003　杭州，浙江大学医学院附属第一医院国家中医药管理局科技司-浙江省中医药管理局共建重点实验室-老年衰弱亏虚研究重点实验室
  • 收稿日期:2025-03-07 出版日期:2025-08-31
  • 通信作者: 张勤
  • 基金资助:
    国家中医药管理局科技司-浙江省中医药管理局共建重点实验室建设项目(GZY-ZJ-SY-2404); 国家中医药管理局科技司-浙江省中医药管理局共建科技计划项目(GZY-ZJ-KJ-24027)

Characteristics of traditional Chinese medicine constitutions in hospitalized elderly patients and their influence on the risk of common geriatric syndromes

Caihong He1, Aiping Li2, Yichen Yang1, Yunmei Yang1,3,4, Qin Zhang1,3,4,†()   

  1. 1Department of Geriatrics, the First Affiliated Hospital, Zhejiang University School of Medicine, Co-constructed by the Science and Technology Department of the National Administration of Traditional Chinese Medicine and the Zhejiang Provincial Administration of Traditional Chinese Medicine, Hangzhou 310003, China
    2Department of General Practice, Suoqian Community Healthcare Center, Xiaoshan District, Hangzhou 311254, China
    3Provincial Key Laboratory of Diagnosis and Treatment of Physical, Chemical and Age-Related Injurious Diseases, Co-constructed by the Science and Technology Department of the National Administration of Traditional Chinese Medicine and the Zhejiang Provincial Administration of Traditional Chinese Medicine, Hangzhou 310003, China
    4Key Laboratory of Research on Geriatric Frailty and Deficiency, Co-constructed by the Science and Technology Department of the National Administration of Traditional Chinese Medicine and the Zhejiang Provincial Administration of Traditional Chinese Medicine, Hangzhou 310003, China
  • Received:2025-03-07 Published:2025-08-31
  • Corresponding author: Qin Zhang
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引用本文：

何彩红, 李爱萍, 杨一晨, 杨云梅, 张勤. 住院老年患者中医体质特点及其对常见老年综合征发生风险的影响[J/OL]. 中华危重症医学杂志(电子版), 2025, 18(04): 290-296.

Caihong He, Aiping Li, Yichen Yang, Yunmei Yang, Qin Zhang. Characteristics of traditional Chinese medicine constitutions in hospitalized elderly patients and their influence on the risk of common geriatric syndromes[J/OL]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2025, 18(04): 290-296.

目的

探讨住院老年患者中医体质特点及其对常见老年综合征发生风险的影响。

方法

选取2023年11月到2024年10月入住浙江大学医学院附属第一医院老年医学科的524例老年患者作为研究对象，根据患者中医体质分成阳虚质（69例）、气虚质（244例）、阴虚质（154例）、其他体质（42例）及平和质（15例）。比较不同中医体质老年患者的性别、年龄、教育水平、吸烟、饮酒及常见老年综合征（衰弱、肌少症、失能及睡眠障碍）发生情况。对常见老年综合征患者不同舌质颜色进行比较。采用单因素及多因素logistic回归分析不同中医体质对常见老年综合征发生风险的影响。

结果

住院老年患者中气虚质的比例最高[46.56%（244 / 524）]，其次为阴虚质[29.39%（154 / 524）]、阳虚质[13.17%（69 / 524）]。不同中医体质老年患者在性别（ χ2 = 13.795，P = 0.008）、年龄（F = 4.806，P < 0.001）、衰弱（ χ2 = 10.640，P = 0.031）、肌少症（ χ2 = 11.530，P = 0.021）、失能（ χ2 = 13.083，P = 0.011）及睡眠障碍（ χ2 = 9.870，P = 0.043）比较，差异均有统计学意义。且与阴虚质比较，阳虚质男性比例更高（P < 0.005）、年龄更大（P < 0.05）、肌少症和失能患者的比例更高（P均< 0.005），气虚质失能患者的比例更高（P < 0.005）；与平和质比较，阳虚质睡眠障碍患者的比例更高（P < 0.005）。肌少症（ χ2 = 11.318，P = 0.010）及失能（ χ2 = 19.561，P < 0.001）老年患者的不同舌质颜色占比比较，差异均有统计学意义，且肌少症及失能老年患者的舌质红占比较舌质淡红更高（P均< 0.008）。单因素及多因素logistic回归分析发现，与阳虚质比较，平和质老年患者肌少症的发生风险明显下降[比值比（OR） = 0.260，95%置信区间（CI）（0.071，0.958），P = 0.043]，气虚质[OR = 0.418，95%CI（0.187，0.936），P = 0.034]和平和质[OR = 0.147，95%CI（0.041，0.521），P = 0.003]老年患者睡眠障碍的发生风险均显著下降。

结论

住院老年患者多气虚质、阳虚质及阴虚质，偏颇体质（尤其是阳虚质）老年综合征的比例更高，阳虚质患者肌少症、睡眠障碍的发生风险相对较高。

关键词: 老年综合征, 中医体质, 老年住院患者
Objective

To explore the characteristics of traditional Chinese medicine constitutions in hospitalized elderly patients and their influence on the risk of common geriatric syndromes.

Methods

A total of 524 elderly patients admitted to the Department of Geriatrics of the First Affiliated Hospital, Zhejiang University School of Medicine from November 2023 to October 2024 were selected as the study subjects. According to their traditional Chinese medicine constitutions, patients were divided into the yang-deficient constitution (69 cases), qi-deficient constitution (244 cases), yin-deficient constitution (154 cases), gentleness constitution (15 cases), and other constitution (42 cases). The gender, age, educational level, smoking and drinking habits, and occurrence of common geriatric syndromes (frailty, sarcopenia, disability, and sleep disorders) of these elderly patients with different traditional Chinese medicine constitutions were compared. The different tongue colors of patients with common geriatric syndromes were detected and compared. Univariate and multivariate logistic regression analyses were used to investigate the influence of different traditional Chinese medicine constitutions on the risk of common geriatric syndromes.

Results

The proportion of qi-deficient constitution was the highest [46.56% (244 / 524)] among hospitalized elderly patients, followed by the yin-deficient constitution [29.39% (154 / 524)] and yang-deficient constitution [13.17% (69 / 524)]. The gender ( χ2 = 13.795, P = 0.008), age (F = 4.806, P < 0.001), frailty ( χ2 = 10.640, P = 0.031), sarcopenia ( χ2 = 11.530, P = 0.021), disability ( χ2 = 13.083, P = 0.011), and sleep disorders ( χ2 = 9.870, P = 0.043) among elderly patients with different traditional Chinese medicine constitutions all showed significant differences. Moreover, compared with the yin-deficient constitution, the proportions of males, sarcopenia, and disability were higher in patients with yang-deficient constitution (all P < 0.005), with an older age (P < 0.05), and the proportion of disability was also higher in patients with qi-deficient constitution (P < 0.005). Compared with the gentleness constitution, the proportion of sleep disorders was higher in patients with yang-deficient constitution (P < 0.005). There were statistically significant differences in the proportions of different tongue colors among elderly patients with sarcopenia ( χ2 = 11.318, P = 0.010) and disability ( χ2 = 19.561, P < 0.001), and the proportion of red tongue in elderly patients with sarcopenia and disability was higher than that of pale red tongue (both P < 0.008). Univariate and multivariate logistic regression analyses revealed that compared with the yang-deficient constitution, the risk of sarcopenia in elderly patients with gentleness constitution was significantly reduced [odds ratio (OR) = 0.260, 95% confidence interval (CI) (0.071, 0.958), P = 0.043], and the risk of sleep disorders in elderly patients with qi-deficient constitution [OR = 0.418, 95%CI (0.187, 0.936), P = 0.034] and gentleness constitution [OR = 0.147, 95%CI (0.041, 0.521), P = 0.003] was also remarkedly decreased.

Conclusions

Hospitalized elderly patients predominantly exhibit qi-deficient, yang-deficient, and yin-deficient constitutions. The proportion of geriatric syndromes is high in patients with biased constitutions (especially the yang-deficient constitution), and the risk of sarcopenia and sleep disorders is relatively high in patients with yang-deficient constitution.

Key words: Geriatric syndrome, Traditional Chinese medicine constitution, Elderly inpatient
表1 不同中医体质老年住院患者的一般资料比较
组别 例数 男/女（例） 年龄（岁， ± s） 教育水平（例） 吸烟（例）
小学及以下 初中及高中 大学及以上 从不吸烟 已戒烟 仍在吸烟
阳虚质 69 50 / 19 77.0 ± 8.8 35 21 13 52 13 4
气虚质 244 136 / 108 74.4 ± 8.6 104 91 49 179 46 19
阴虚质 154 76 / 78a 72.1 ± 7.4b 69 58 27 114 25 15
其他体质 42 28 / 14 73.4 ± 8.5 20 11 11 29 9 4
平和质 15 11 / 4 76.7 ± 8.8 7 5 3 9 3 3
χ2 / F值   13.795 4.806 4.164 4.537
P值   0.008 < 0.001 0.842 0.806
组别 例数 饮酒（例） 衰弱（例，是/否） 肌少症（例，是/否） 失能（例，是/否） 睡眠障碍（例，是/否）
从不饮酒 已戒酒 仍在饮酒
阳虚质 69 48 12 9 51 / 18 38 / 31 25 / 44 61 / 8
气虚质 244 180 30 34 176 / 68 107 / 137 74 / 170 188 / 56
阴虚质 154 131 10 13 93 / 61 52 / 102a 26 / 128ac 120 / 34
其他体质 42 32 2 8 23 / 19 15 / 27 13 / 29 33 / 9
平和质 15 10 2 3 9 / 6 4 / 11 3 / 12 8 / 7a
χ2 / F值   14.269 10.640 11.530 13.083 9.870
P值   0.075 0.031 0.021 0.011 0.043
图1 衰弱、肌少症、失能及睡眠障碍住院老年患者不同舌质颜色分布的比较注：与舌质淡红比较，aP < 0.008
表2 影响住院老年患者常见老年综合征发生的单因素logistic回归分析
因变量 自变量 OR值 95%CI P值
衰弱 阳虚质 1.000 1.000 -
  气虚质 0.913 0.498 ~ 1.674 0.770
  阴虚质 0.538 0.287 ~ 1.007 0.053
  其他体质 0.427 0.190 ~ 0.961 0.040
  平和质 0.529 0.165 ~ 1.696 0.284
肌少症 阳虚质 1.000 1.000 -
  气虚质 0.637 0.372 ~ 1.091 0.100
  阴虚质 0.416 0.233 ~ 0.743 0.003
  其他体质 0.453 0.206 ~ 0.998 0.049
  平和质 0.297 0.086 ~ 1.024 0.055
失能 阳虚质 1.000 1.000 -
  气虚质 0.766 0.437 ~ 1.343 0.353
  阴虚质 0.357 0.187 ~ 0.683 0.002
  其他体质 0.789 0.348 ~ 1.788 0.570
  平和质 0.440 0.113 ~ 1.709 0.236
睡眠障碍 阳虚质 1.000 1.000 -
  气虚质 0.440 0.199 ~ 0.975 0.043
  阴虚质 0.463 0.202 ~ 1.061 0.069
  其他体质 0.481 0.170 ~ 1.364 0.169
  平和质 0.150 0.043 ~ 0.525 0.003
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