| Objective1.To investigate the frailty status and the characteristics of physical,psychological and cognitive among elderly in Guangzhou area,then further explore its influencing factors,in order to provide effective evidence for intervention and prevention to frailty.2.Evaluation of Jianpi Yangwei formula in the treatment of frailty elderly is effective and safety.Methods1.The Investigation of frailty among 254 elderly residents in Guangzhou:254 elderly 60 years or older living in Guangzhou were enrolled at baseline.The diagnosis of frailty was based on the original Fried frailty phenotype and the other investigative tools included demography,socioeconomic information,Pittsburgh sleep quality index,Patient Health Questionnare-9,Generalized Anxiety Disorder-7,Mini-mental State Examination.In addition,120 elderly people were randomly selected in the next morning after enrollment,to draw fasting blood sample for determination of Tumor necrosis factor alpha,C-reactive protein,IL-6,IgG,IgA,IgM,testosterone and vitamin D to observe immunologic function,inflammatory cytokines and nutrition.2.Clinical Intervention Study of Jianpi Yangwei formula on Elderly:We selected 63 frailty elderly people from April 2018 to March 2019 through Guangdong Province Traditional Chinese Medical Hospital recruitment advertising or recruited in Guangzhou community.It was a non-randomized controlled study and patients were divided into two groups.Participants in experimental group were treated by Jianpi Yangwei formula.Patients in the control group were given Chinese medicine formula placebo.The treatment period was 8 weeks.Subjective evaluation was performed using the FI,PSQI,PHQ-9,GAD-7,and clinical efficacy evaluation.The objective criteria,included physical activity function and serum tests,including grip strength of upper limbs,six-minute pace,TNF-α,CRP,IgG,IgA,IgM,IL-6,testosterone,vitamin D were analyzed before and after treatment.SPSS19.0 statistical software was used to establish data base for data collection and analysis.More data comparison with analysis of variance between groups,two two compared with t test,the percentage of comparison with χ2 test.Results1.The prevalence of frailty of the 254 elderly residents in Guangzhou is 27.9%.Univariate analysis indicated that age,education,satisfaction with economic income,BMI,comorbidity,polypharmacy,sleep disorders,depression,MMSE score affect the incidence of frailty elderly in Guangzhou.With age increasing,frailty prevalence increases,there is a positive correlation between the two(OR=1.195,p<0.001).Frailty was negatively correlated with Body mass index(BMI)(OR=0.797,p=0.001).Sleep disorders are a risk factor for frailty,and elderly with sleep disorders would have a higher frailty prevalence(OR=2.819,p=0.035).Depression(OR=6.1151,p=0.001)and lower MMSE score were independent risk factors for the frailty occurrence.2.The serum tests results of 120 elderly residents showed that there were statistically significant differences in the levels of CRP,TNF-α,IL-6,IgA,testosterone,IGF-1,and vitamin D among different frailty status elderly(p<0.05)The levels of CRP,IL-6 and IgA increased with the frailty deterioration,and the levels of testosterone,IGF-1 and vitamin D decreased with the frailty deterioration.3.The Clinical Intervention Study of Jianpi Yangwei formula on Elderly actually completed 63 cases.The gender,age,education,Smoking history,drinking history,comorbidity,polypharmacy,MMSE score comparison before treatment.There was no statistical difference(p>0.05),which was comparable.3.1 The Frailty Index score comparison:experimental group,before and after treatment of frailty index score difference was statistically significant(p<0.05);The difference between the experimental group and the control group was statistically significant(p<0.05),experimental group fruit better than control group.3.2 Physical activity function(grip strength,pace)comparison:experimental group,before and after treatment of grip strength and pace difference was statistically significant(p<0.05);The difference between the experimental group and the control group showed no statistically significant(p<0.05).3.3 Sleep quality and psychological status comparison:The difference between the scores of the depression and anxiety scale before and after treatment in the experimental group was statistically significant(p<0.05);the difference between the experimental group and the control group showed no statistically significant(p>0.05).3.4 Vitamin D changes:The difference between vitamin D before and after treatment in the experimental group was statistically significant(p<0.05);the difference between the experimental group and the control group was statistically significant(p<0.05).3.5 Immunoglobulin-A changes:The difference between Immunoglobulin-A before and after treatment in the experimental group was statistically significant(p<0.05);the difference between the experimental group and the control group showed no statistically significant(p>0.05).3.6 Other laboratory indexs:CRP and TNF-α in the experimental group showed downward trend after the formula treatment,and testosterone showed upward trend after the formula treatment.3.7 There were no abnormalities in safety indicators before and after treatment in the two groups.Conclusion1.The prevalence of frailty elderly residents in Guangzhou is relatively high,which was affected by age,education,satisfaction with economic income,BMI,comorbidity,polypharmacy,sleep disorders,depression,MMSE score.In addition,Age,BMI,depression,and MMSE scores were the independent factors of the frailty.In addition,the detection of CRP,TNF-α,IL-6,IgA,testosterone,IGF-1,and vitamin D levels may indicate frailty status in the elderly.2.Jianpi Yangwei formula in the treatment of frailty in elderly,can better improvement the frailty status,strengthen physical activity function,improve the patient’s depression and anxiety symptoms,increases serum IgA and vitamin D,and has a potential anti-inflammatory property and trend of increasing blood testosterone.And it is safe for clinical application. |
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