社区家庭医生签约的老年2型糖尿病患者合并慢性便秘现况及临床特征分析

朱雪梅; 陶洁; 谭娟

doi:10.16766/j.cnki.issn.1674-4152.004419

社区家庭医生签约的老年2型糖尿病患者合并慢性便秘现况及临床特征分析

doi: 10.16766/j.cnki.issn.1674-4152.004419

朱雪梅¹,
陶洁²,
谭娟^2, ,

1.
淮安市淮海社区卫生服务中心全科医学科，江苏淮安 223300
2.
南京医科大学附属淮安第一医院全科医学科，江苏淮安 223300

基金项目:

江苏省干部保健科研面上项目 BJ24045

江苏省老年健康科研面上项目 LKM2022069

详细信息

通讯作者:
谭娟，E-mail：hayytan664@sina.com

中图分类号: R587.1 R442.2
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- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2025-02-19
- 网络出版日期: 2026-06-02

Prevalence and clinical characteristics of chronic constipation in elderly patients with type 2 diabetes mellitus under family doctor contract management

ZHU Xuemei¹,
TAO Jie²,
TAN Juan^{2
, ,}

1.
Department of General Practice, Huaihai Community Health Center, Huaian, Jiangsu 223300, China

摘要

摘要: 目的了解社区签约老年2型糖尿病(type 2 diabetes mellitus, T2DM)患者慢性便秘的患病现况，深入分析其在代谢指标、生活方式及心理状态等方面的临床特征，旨在为社区老年糖尿病患者的综合干预提供科学依据。方法选取2022年6月—2024年6月于淮安市淮海社区签约的293例老年T2DM患者进行横断面调查。采集患者人口学特征、生活方式、便秘症状、心理评分及生化指标，比较便秘组与非便秘组差异。结果慢性便秘患病率为37.5%(110/293)。与非便秘组相比，便秘组年龄更大[(74.26±7.69)岁vs.(70.66±6.25)岁，P < 0.001]及糖尿病病程更长[15.00(5.00, 20.00)年vs. 10.00(5.00, 18.50)年，P=0.016]；粗粮摄入(47.71% vs. 61.67%，P=0.020)、每日饮水(72.22% vs. 84.83%, P=0.010)、睡眠时长(38.89% vs. 52.51%, P=0.025)及运动量(72.48% vs. 83.71%, P=0.022)达标率均降低。此外，便秘组糖化血红蛋白水平更高[(7.82±1.70)% vs.(7.24±1.08)%, P=0.019]、焦虑抑郁评分更高(P < 0.001)，而估算肾小球滤过率更低[(79.97±21.81)mL/(min·1.73 m²) vs.(86.69±24.99)mL/(min·1.73 m²)，P=0.023]。结论社区老年T2DM合并便秘患者具有高龄、长病程、血糖控制欠佳、肾功能相对减退、焦虑抑郁严重及生活方式不良的临床特征。
- 2型糖尿病 /
- 慢性便秘 /
- 老年人 /
- 家庭医生签约
Abstract: Objective To investigate the prevalence of chronic constipation among community-dwelling elderly patients with type 2 diabetes mellitus (T2DM) and to analyze their clinical characteristics regarding metabolic profiles, lifestyle factors, and psychological status, aiming to provide scientific evidence for comprehensive interventions in this population. Methods A cross-sectional survey was conducted from June 2022 to June 2024 involving 293 elderly T2DM patients under contract management in Huaihai Community, Huaian City. Demographic characteristics, lifestyle, constipation symptoms, psychological scores, and biochemical indicators were collected and compared between the constipation and non-constipation groups. Results The prevalence of chronic constipation was 37.5% (110/293). Compared with the non-constipation group, the constipation group was older [(74.26±7.69) years vs. (70.66±6.25) years, P < 0.001] and had a longer diabetes duration [15.00(5.00, 20.00)years vs. 10.00(5.00, 18.50)years, P=0.016]. The rates of adequate coarse grain intake (47.71% vs. 61.67%, P=0.020), daily water intake (72.22% vs. 84.83%, P=0.010), sleep duration (38.89% vs. 52.51%, P=0.025), and physical activity (72.48% vs. 83.71%, P=0.022) were significantly lower in the constipation group. Additionally, the constipation group exhibited higher HbA1c levels [(7.82±1.70)% vs. (7.24±1.08)%, P=0.019] and anxiety/depression scores (P < 0.001), while estimated glomerular filtration rate was significantly lower [(79.97±21.81) mL/(min·1.73 m²) vs. (86.69±24.99) mL/(min·1.73 m²), P=0.023]. Conclusion Community-dwelling elderly T2DM patients with chronic constipation are characterized by advanced age, longer diabetes duration, poor glycemic control, reduced renal function, significant anxiety and depression, and unhealthy lifestyle habits.
- Type 2 diabetes mellitus /
- Chronic constipation /
- Elderly /
- Family doctor contract

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表 1 2组2型糖尿病患者临床资料比较

Table 1. Comparison of baseline characteristics between the two groups of patients with type 2 diabetes mellitus

项目	非便秘组(n=183)	便秘组(n=110)	统计量	P值
年龄(x±s, 岁)	70.66±6.25	74.26±7.69	-4.164^a	< 0.001
体重指数(x±s)	25.34±3.20	24.77±2.90	1.512^a	0.132
糖尿病病程[M(P₂₅, P₇₅), 年]	10.00 (5.00, 18.50)	15.00 (5.00, 20.00)	-2.402^b	0.016
腰围(x±s, cm)	88.54±9.00	89.42±9.00	-0.765^a	0.445
糖尿病药物使用[例(%)]			0.007^c	0.934
否	16(8.90)	10(9.17)
是	164(91.10)	99(90.83)
拜糖平[例(%)]			0.016^c	0.901
否	141(77.90)	85(77.27)
是	40(22.10)	25(22.73)
二甲双胍[例(%)]			0.043^c	0.835
否	76(41.99)	44(40.74)
是	105(58.01)	64(59.26)
教育情况[例(%)]			1.408^c	0.495
小学及以下	25(14.97)	21(19.81)
中学和高中	78(46.71)	50(47.17)
大专及以上	64(38.32)	35(33.02)
性别[例(%)]			1.670^c	0.196
男性	99(54.10)	68(61.82)
女性	84(45.90)	42(38.18)
高血压[例(%)]			3.364^c	0.067
否	51(27.87)	20(18.35)
是	132(72.13)	89(81.65)
注：^a为t值，^b为Z值，^c为χ²值。

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表 2 2组2型糖尿病患者生活方式比较[例(%)]

Table 2. Comparison of lifestyle between patients with type 2 diabetes [n (%)]

项目	非便秘组(n=183)	便秘组(n=110)	χ²值	P值
水果摄入充足			0.119	0.731
否	56 (31.28)	32 (29.36)
是	123 (68.72)	77 (70.64)
蔬菜摄入充足			0.196	0.658
否	97 (54.49)	57 (51.82)
是	81 (45.51)	53 (48.18)
粗粮摄入充足			5.381	0.020
否	69 (38.33)	57 (52.29)
是	111 (61.67)	52 (47.71)
饮水充足			6.697	0.010
否	27 (15.17)	30 (27.78)
是	151(84.83)	78(72.22)
运动充足			5.221	0.022
否	29(16.29)	30(27.52)
是	149(83.71)	79(72.48)
饮酒			0.000	0.991
否	121(67.22)	72(67.29)
是	59(32.78)	35(32.71)
吸烟			0.184	0.668
否	141(77.90)	81(75.70)
是	40(22.10)	26(24.30)
睡眠充足			5.016	0.025
否	85(47.49)	66(61.11)
是	94(52.51)	42(38.89)

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表 3 2型糖尿病合并慢性便秘及未合并便秘患者的精神心理评估状态比较

Table 3. Comparison of psychological assessment results between patients with type 2 diabetes mellitus complicated by chronic constipation and those without constipation

组别	例数	SAS(x±s, 分)	GDS15 [M(P₂₅, P₇₅), 分]
非便秘组	183	36.11±6.26	1.00 (1.00, 2.00)
便秘组	110	42.69±8.50	2.00 (1.00, 4.25)
统计量		-6.971^a	-5.336^b
P值		< 0.001	< 0.001
注：^a为t值，^b为Z值。

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表 4 2型糖尿病合并慢性便秘与未合并便秘患者血生化指标比较

Table 4. Comparison of blood biochemical indicators between patients with type 2 diabetes complicated by chronic constipation and those without constipation

组别	例数	糖化血红蛋白(x±s，%)	空腹C肽[M(P₂₅, P₇₅), pmol/L]	总胆固醇(x±s，mmol/L)	甘油三酯[M(P₂₅, P₇₅), mmol/L]	HDL-C (x±s，mmol/L)	LDL-C (x±s，mmol/L)	尿酸(x±s，μmol/L)	eGFR[x±s，mL/(min·1.73m²)]	血钙(x±s, mmol/L)	血钾(x±s, mmol/L)
非便秘组	183	7.24±1.08	740.50(534.50, 969.25)	4.54±1.29	1.27 (0.97, 2.03)	1.31±0.38	2.50±0.90	308.01±91.52	86.69±24.99	2.35±0.16	4.05±0.40
便秘组	110	7.82±1.70	712.00(577.50, 968.50)	4.36±1.42	1.24 (0.91, 1.92)	1.25±0.32	2.37±1.00	316.98±106.52	79.97±21.81	2.34±0.16	4.02±0.36
统计量		-2.385^a	-0.112^b	1.081^a	0.694^b	1.420^a	1.139^a	0.557^a	2.289^a	0.241^a	0.336^a
P值		0.019	0.911	0.281	0.488	0.157	0.256	0.578	0.023	0.810	0.737
注：^a为t值，^b为Z值。

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