我国老年慢性病患者中医药治疗现状及影响因素分析*

作者：和晓珺1，智 恺2，徐欢欢1，于亚南1，刘 骏1，肖 静3，党海霞1,2

单位：1.中国中医科学院中医临床基础医学研究所，北京 100700； 2.中国中医科学院中医药发展研究中心，北京 100700； 3.南通大学公共卫生学院，江苏 南通 226019

引用：引用：和晓珺，智恺，徐欢欢，于亚南，刘骏，肖静，党海霞.我国老年慢性病患者中医药治疗现状及影响因素分析[J].中医药导报,2025,31(12):273-278.

DOI：10.13862/j.cn43-1446/r.2025.12.043

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摘要：

目的：分析我国老年慢性病患者选择中医药治疗的情况及影响因素。方法：以中国健康与养老追踪调查（CHARLS）数据库2018年随访数据中7 372名60岁及以上的老年慢性病患者为研究对象，采用χ2检验、秩和检验比较中医药治疗与其他治疗方式各指标的组间差异，并采用logistic回归分析中医药参与治疗的影响因素。结果：纳入7 372名老年慢性病患者中，2 142名使用中医药治疗，中医药整体参与率为29.06%。中医药参与治疗率最高为中风208人（26.40%），最低为糖尿病134人（9.83%）。老年慢性病患者中医药治疗与地区（OR中部=1.211，P=0.007；OR西部=2.135，P＜0.001）、居住地（OR城镇=1.163，P=0.036）、民族（OR少数民族=1.256，P=0.025）、自评健康状况（OR一般=1.255，P=0.010；OR不好=1.726，P＜0.001）、慢性病数量（OR2种=1.689，P＜0.001；OR3种=2.223，P＜0.001；OR≥4种=3.519，P＜0.001）、月门诊次数（OR1~2次=1.306，P=0.001；OR≥3次=1.897，P＜0.001）、年住院次数（OR1~2次 =1.164，P=0.023）、医疗服务满意度（OR不满意=1.146，P=0.016）、个人年收入（OR＞72 000=0.530，P=0.037）显著相关。在医疗成本上，中医药参与治疗组每月门诊医疗费用高于其他治疗组（P=0.012）。结论：老年慢性病患者选择中医药治疗与患者个体特征、自身疾病状况及医疗行为等因素密切相关。

关键词：慢性病；老年人；中医药治疗；影响因素；CHARLS

Abstract：

Objective: To analyze the status quo of traditional Chinese medicine (TCM) treatment selection and its influencing factors among elderly patients with chronic diseases in China. Methods: A total of 7,372 elderly patients aged 60 years and above with chronic diseases from the 2018 follow-up data of the China Health and Retirement Longitudinal Study (CHARLS) database were selected as the research objects. The χ2 test and rank-sum test were used to compare the differences in various indicators between the TCM treatment group and other treatment groups, and logistic regression was applied to analyze the influencing factors of TCM participation in treatment. Results: Among the 7,372 included elderly patients with chronic diseases, 2,142 received TCM treatment, with an overall TCM participation rate of 29.06%. The highest TCM participation rate was observed in stroke patients (208 cases, 26.40%), while the lowest was in diabetic patients (134 cases, 9.83%). TCM treatment in elderly patients with chronic diseases was significantly correlated with the following factors: region (ORcentral=1.211, P=0.007; ORwestern=2.135, P＜0.001), place of residence (ORurban=1.163, P=0.036), ethnicity (ORethnic minorities=1.256, P=0.025), self-rated health status (ORfair=1.255, P=0.010; ORpoor=1.726, P＜0.001), number of chronic diseases (OR2 types=1.689, P＜0.001; OR3 types=2.223, P＜0.001; OR≥4 types=3.519, P＜0.001), monthly outpatient visits (OR1-2 visits=1.306, P=0.001; OR≥3 visits=1.897, P＜0.001), annual hospitalization times (OR1-2 times=1.164, P=0.023), medical service satisfaction (ORdissatisfied=1.146, P=0.016), and personal annual income (OR＞72,000 yuan=0.530, P=0.037). In terms of medical costs, the monthly outpatient medical expenses of the TCM treatment group were higher than those of the other treatment groups (P=0.012). Conclusion: The choice of TCM treatment among elderly patients with chronic diseases is closely related to individual characteristics, disease status, and medical behaviors of the patients.

Key words：chronic diseases; elderly; traditional Chinese medicine treatment; influencing factors; CHARLS

发布时间：2025-12-31

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