The Study Of The Quality Of Life And Distribution Characteristics Of Traditional Chinese Medicine Syndromes In Elderly Patients With Functional Gastrointestinal Disorders

PurposeThis study uses the gastrointestinal diseases PRO scale (Patient reported outcomes scale), the health status scale of traditional Chinese medicine (TCM), ANOVA analysis and t-test to analyze and assess the mean quality of life/health status scores of elderly patients with functional gastrointestinal disorders. In order to evaluate the quality of life/health status in elderly patients with functional gastrointestinal disorders, a comparison of the mean quality of life/health status score between elderly and young patients with functional gastrointestinal disorders and the healthy elderly persons were made. At the same time, a study uses the elderly patients with functional gastrointestinal disease information collection table, clustering analysis method, frequency analysis and χ2test on distribution characteristics of TCM syndromes in elderly patients with functional gastrointestinal disorders is conducted to help prevent and treat of functional gastrointestinal disease and improve the quality of life of the elderly people.MethodsThe study was implemented in The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine Clinic, Gastroenterology Department and Medical Centers based on the gastrointestinal disease PRO scale, the health status scale of traditional Chinese medicine (TCM) and the elderly patients with functional gastrointestinal disease information collection table to select657cases, divided into two parts:the fist part is analyze and assess the mean quality of life/health status scores of elderly patients with functional gastrointestinal disorders, the second part is conducted the distribution characteristics of TCM syndromes in elderly patients with functional gastrointestinal disorders. The fist part to select360case, divided into three groups:elderly patient group (110cases), young patient group (148cases) and elderly healthy group (102cases). The second part to select555case, divided into four groups:elderly patients with field data group (110cases), elderly patients with historical data group (101cases), young patients with field data group (148cases), young patients with historical data group (196cases).Using ANOVA analysis and t-test to analyze the mean quality of life/health status scores of elderly patients with functional gastrointestinal disorders, the mean quality of life/health status score between elderly and young patients with functional gastrointestinal disorders were compared as well as between elderly patients with functional gastrointestinal disorders and elderly healthy persons. In the gastrointestinal diseases PRO scale, the higher the score, the better the quality of life. In the health status of traditional Chinese medicine, the lower the score, the better the health status.The clustering analysis method, frequency analysis and χ2test for statistics on distribution characteristics of TCM syndromes in elderly patients with functional gastrointestinal disorders was used.Result1The quality of life of elderly patients with functional gastrointestinal disorders1.1Analysis of the mean score for the gastrointestinal diseases PRO scalePhysiology:t-test results showed mean quality of life score in elderly patient group were lower than the elderly healthy group (t=15.064; P-value=0.000), mean quality of life score in elderly patient group were higher than the young patient group (t=4.477; P-value=0.000).Psychology:t-test results showed mean quality of life score in elderly patient group were lower than the elderly healthy group (t=-5.548; P-value=0.000), mean quality of life score in elderly patient group were higher than the young patient group (t=7.956; P-value=0.000).Sociology:t-test results showed mean quality of life score in elderly patient group were lower than the elderly healthy group (t=-5.657; P-value=0.000), mean quality of life score in elderly patient group were higher than the young patient group (t=10.950; P-value=0.000).The overall mean score for gastrointestinal diseases PRO scale:t-test results showed mean quality of life score in elderly patient group were lower than the elderly healthy group (t=-8.945; P-value=0.000), mean quality of life score in elderly patient group were higher than the young patient group (t=2.242; P-value=0.026)1.2Health status scale of traditional Chinese medicine.Energy:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=5.463; P-value=0.000), mean health status score in elderly patient group were lower than the young patient group (t=-2.923; P-value=0.004).Pain:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=7.135; P-value=0.000), mean health status score in elderly patient group were higher than the young patient group (t=3.607; P-value=0.000).Diet:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=8.931; P-value=0.000), there was no statistical significant difference in the mean health status score between elderly patient group and young patient group (t=-1.621、P-value=0.106).Defecation:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=9.453; P-value=0.000), there was no statistical significant difference in the mean health status score between elderly patient group and young patient group (t=-0.708; P-value=0.480).Urination:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=11.417; P-value=0.000), mean health status score in elderly patient group were higher than the young patient group (t=7.524; P-value=0.000). Sleep:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=4.142; P-value=0.000), there was no statistical significant difference in the mean health status score between elderly patient group and young patient group (t=-0.141; P-value=0.888).Physique:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=11.310; P-value=0.000), there was no statistical significant difference in the mean health status score between elderly patient group and young patient group (t=0.298; P-value=0.320).Mood:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=5.553; P-value=0.000), mean health status score in elderly patient group were lower than the young patient group (t=6.788; P-value=0.000).The overall health status:t-test results showed mean health status score in elderly patient group were higher than the elderly healthy group (t=8.327; P-value=0.000), there was no statistical significant difference in the mean health status score between elderly patient group and young patient group (t=0.788; P-value=0.431)In various fields, t-test results showed no significant difference in the mean quality of life/heathl status scores between elderly patient group at age stages except energy issue (P>0.05).2Distribution characteristics of syndromes in elderly patients with functional gastrointestinal disorders.2.1Distribution characteristics of Rome Ⅲ classification in elderly patients with functional gastrointestinal disorders.According to the subtypes of Rome Ⅲ classification, the results of elderly functional gastrointestinal disorders were as follows:In field data of elderly patients group no see globus (A4), unspecified excessive belching (B2b), chronic idiopathic nausea (B3a), functional vomiting (B3b), functional gallbladder and sphincter of oddi disorders (E), functional anorectal disorders (F)In a historical data of elderly patients group no see functional heartburn (Al), functional chest pain of presumed esophageal origin (A2), functional dysphagia (A3), unspecified excessive belching (B2b), chronic idiopathic nausea (B3a), functional vomiting (B3b), functional anorectal disorders (F).2.2Distribution characteristics of TCM syndromes in elderly patients with functional gastrointestinal disorders.In field data of elderly patients group, the characteristics of TCM syndromes in elderly functional gastrointestinal disorders are as follows: spleen-stomach damp retention, liver-stagnation and spleen deficiency, spleen and stomach damp heat, liver-stomach disharmony.In field data of young patients group, the characteristics of TCM syndromes in young functional gastrointestinal disorders are as follows: spleen-stomach damp retention, liver-stomach disharmony, spleen and stomach damp heat, liver-stagnation and spleen deficiency, spleen stomach deficiency.In historical data of elderly patients group, the characteristics of TCM syndromes in elderly functional gastrointestinal disorders are as follows:spleen and stomach damp heat, Qi deficiency and wet stagnation, liver-stomach disharmony, cold and heat mixed, spleen-stomach deficiency, Qi Yin deficiency, spleen-stomach damp retention, liver stagnation and spleen deficiency.In historical data of young patients group, the characteristics of TCM syndromes in elderly functional gastrointestinal disorders are as follows:dampness-resistance, spleen-stomach deficiency, qi stagnation and dampness retention, cold dampness resistance, liver-stomach disharmony, liver-stagnation and spleen deficiency, spleen and stomach damp heat, spleen-stomach damp retention.Conclusion1. Quality of life of elderly patients with functional gastrointestinal disordersThe analyzed results of the gastrointestinal diseases PRO scale showed that:amongst the physiology, psychology, sociology categories and the overall mean score, the quality of life of elderly patients with functional gastrointestinal disorders decreased, but there was higher than young patients with functional gastrointestinal disorders.The analyzed results of the health status scale of traditional Chinese medicine showed that:in terms of categories and the overall health status score, the health status of elderly patients with functional gastrointestinal disorders decreased. But in energy and psychology, the health status in elderly patient group were higher than young patient group; in pain and urination, the health status in elderly patient group were lower than young patient group. In terms of diet, defecation, sleep, physique and the overall health status, there was no difference in the health status between elderly patient group and young patient group.Although the elderly patients with functional gastrointestinal disorders were satisfied or dissatisfied with some fields in their life, overall they are satisfied. In general, quality of life assessment in the elderly patients with functional gastrointestinal disorders was acceptable.Treatment should be followed the principles of traditional Chinese medicine such as pay attention to regulate the functions of the zang-fu, balance of Yin and Yang. Preventive treatment should be followed different times, regions and persons in order to raise the spirit, adjust the diet, moderate temperature and physical exercise.2. Distribution characteristics of TCM syndromes in elderly patients with functional gastrointestinal disorders.The results of the clustering analysis for distribution characteristics of TCM syndromes in elderly patients with functional gastrointestinal disorders are as follows:spleen-stomach damp retention, liver-stagnation and spleen deficiency, spleen and stomach damp heat, liver-stomach disharmony, spleen-stomach deficiency, Qi deficiency and wet stagnation, cold and heat mixed, Qi yin deficiency.The traditional Chinese medicine pathogenesis of elderly patients with functional gastrointestinal disorders is due to Zang-Fu deficiency, a weak body allowing the opportunity for xieqi to attack the body which ultimately is the cause of diseases.Although the elderly with functional gastrointestinal disordes is one of the most common diseases, but it is not a serious illness, so that most it do not need to treatment in the hospital. Therefore, prevention of disease through raising the spirit, adjusting the diet, moderating temperature, physical exercise and avoiding fatigue in order to maintain the normal functions and activities of the body. At the same time, it is very important to guide to the implementation of primary health care and preventive treatment for gastrointestinal disease of the elderly in the community.