【目的】 探讨老年糖尿病足（DF）患者的社会隔离、中医证型要素与多维度衰弱（简称多维衰弱）的相关性。【方法】 选取 2024年10月至2025年6月期间在广州中医药大学第八临床医学院（即佛山市中医院）住院治疗的171例老年DF患者，分析患 者的社会隔离、中医证型与多维衰弱的相关性。【结果】（1）在老年 DF 患者中，衰弱的发生率较高，其中衰弱发生率为 66.67%（114/171），多维衰弱发生率为 53.22%（91/171）。（2）在衰弱及各维度衰弱患者中，气血两虚证占比最多（分别为 46.49%、42.86% ~ 46.88%），其次是瘀血阻络证（分别为19.30%、15.96% ~ 23.08%）和热毒伤阴证（分别为19.30%、15.96% ~ 25.00%）。（3）多因素Logistic回归分析发现，年龄越大是衰弱的危险因素（OR = 1.066，P = 0.030）；夜间睡眠时间 ≥ 8 h是衰弱 （OR = 0.149，P = 0.002）和多维衰弱（OR = 0.214，P = 0.003）、身体衰弱（OR = 0.139，P＜0.01）、心理衰弱（OR = 0.230，P = 0.004）的保护因素；糖尿病足病程 1 ~ 3个月是多维衰弱（OR = 2.765，P = 0.029）、社会衰弱（OR = 3.511，P = 0.016）、心理 衰弱（OR = 3.917，P = 0.017）的危险因素；家庭人均月收入 ≥ 5 000 元是衰弱（OR = 0.138，P = 0.019）、心理衰弱（OR = 0.246，P = 0.044）的保护因素，而 3 001 ~ 5 000 元是社会衰弱（OR = 4.847，P = 0.017）的危险因素；气血两虚是衰弱（OR = 0.287，P = 0.038）和心理衰弱（OR = 0.364， P = 0.037）的危险因素；Wanger分级是衰弱（OR = 1.767，P = 0.038）的危险因素。 （4）限制性立方样条（RCS）曲线分析发现，社会隔离与衰弱和多维衰弱的发生风险均存在正向线性关系；进一步亚组分析及 交互作用检验发现，不同人群中，非社会隔离对衰弱的保护效应在不同特征人群中具有一致性。【结论】 中医证型、社会隔 离与衰弱和各维度衰弱均有一定相关性。

Objective To explore the correlations among social isolation，elements of traditional Chinese medicine （TCM） syndrome types，and multidimensional frailty in elderly patients with diabetic foot（DF）. Methods A total of 171 elderly DF patients hospitalized at the Eighth School of Clinical Medicine of Guangzhou University of Chinese Medicine （i.e.，Foshan Hospital of Traditional Chinese Medicine） from October 2024 to June 2025 were selected to analyze the correlations between their social isolation，TCM syndrome types，and multidimensional frailty. Results （1） The incidence of frailty was high among elderly DF patients， with a frailty prevalence of 66.67% （114/171） and a multidimensional frailty prevalence of 53.22% （91/171）.（2） Among patients with frailty and various dimensions of frailty，the qi and blood deficiency syndrome was the most prevalent （accounting for 46.49% and 42.86%-46.88%，respectively），followed by the blood stasis obstructing the collaterals syndrome （19.30% and 15.96%-23.08%， respectively） and the heat toxin damaging yin syndrome （19.30% and 15.96%-25.00%， respectively）.（3） Multivariate logistic regression analysis revealed that older age was a risk factor for frailty （OR = 1.066，P = 0.030）；nighttime sleep duration ≥ 8 h was a protective factor against frailty （OR = 0.149，P = 0.002），multidimensional frailty （OR = 0.214，P = 0.003），physical frailty （OR = 0.139， P＜0.01），and psychological frailty （OR = 0.230，P = 0.004）；a DF disease course of 1-3 month（s） was a risk factor for multidimensional frailty （OR = 2.765， P = 0.029）， social frailty （OR = 3.511， P = 0.016）， and psychological frailty （OR = 3.917， P = 0.017）； a monthly household income per capita ＞5 000 yuan was a protective factor against frailty （OR = 0.138，P = 0.019） and psychological frailty （OR = 0.246，P = 0.044）， while an income of 3 001-5 000 yuan was a risk factor for social frailty （OR = 4.847，P = 0.017）；the qi and blood deficiency syndrome was a risk factor for frailty （OR = 0.287，P = 0.038） and psychological frailty （OR = 0.364，P = 0.037）；and a higher Wagner grade was a risk factor for frailty （OR = 1.767，P = 0.038）.（4）Restricted cubic spline （RCS） curve analysis indicated a positive linear relationship between social isolation and the risk of both frailty and multidimensional frailty. Further subgroup analysis and interaction tests revealed that the protective effect of the absence of social isolation against frailty was consistent across populations with different characteristics. Conclusion TCM syndrome types and social isolation are correlated to some extent with frailty and its various dimensions.

R259.872

广东省医学科学技术研究基金资助项目（编号：B2021340）；佛山市科学技术局科技计划项目（编号：2420001004362）