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| 社区骨质疏松高危人群预防胸腰椎骨折的干预研究 |
| Interventional study of the prevention of thoracic and lumbar fractures in high risk population with osteoporosis in the community |
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| DOI：10.3969/j.issn.1006.7108.2013.11.016 |
| 中文关键词: 骨质疏松 胸腰椎骨折 社区预防 中西医干预 |
| 英文关键词:Osteoporosis Thoracic and lumbar fractures Community prevention Chinese medicine and western medicine intervenfion |
| 基金项目:广西科学研究与技术开发计划课题(桂科攻10124001B-38) |
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| 中文摘要: |
| 目的 比较太极拳结合药膳饮食、太极拳结合药膳饮食及西药、西药、健康教育等不同干预方案预防社区骨质疏松高危人群发生胸腰椎骨折的效果，探索适合社区骨质疏松性胸腰椎骨折的预防策略。方法 筛选100例社区骨质疏松高危人群，分为传统组(太极拳+膳食)、综合组(太极拳+膳食+西药)、西药组及空白对照组共4组，每组25例，分别给予不同的干预方案，其中传统组指导药膳饮食及太极拳运动，综合组指导药膳饮食及太极拳运动并口服钙尔奇D3片及阿法骨化醇软胶囊、西药组口服钙尔奇D3片及阿法骨化醇软胶囊，空白对照组给予健康教育指导，观测并比较各组椎体骨折发生情况、VAS骨痛评分改变及跌倒发生等情况。结果 干预后综合组新发椎体骨折数较少、对照组新发椎体骨折数较多，但组间比较无统计学差异(P>0.05)。对照组干预后VAS骨痛评分与干预前比较无统计学差异(P>0.05)，其他三组干预后VAS骨痛评分均降低，与干预前比较均有统计学差异(P < 0. 05 );传统组、综合组及西药组干预前后VAS骨痛评分差值与空白对照组比较均有统计学差异(P<0.05)，但传统组与西药组组间比较无统计学差异(P>0.05)，综合组与传统组及西药组组间比较均有统计学差异(P<0.05)。干预期间综合组的跌倒次数最少、空白对照组的跌倒次数最多，但四组组间跌倒次数比较无统计学差异(P>0.05)。结论 采用太极拳结合药膳饮食及西药干预社区骨质疏松高危人群能够有效降低VAS骨痛评分、减少跌倒次数及新发骨折。但在高危人群跌倒次数及新发骨折方面与太极拳结合药膳饮食干预、西药干预及健康教育等比较未见显著差别，有待扩大样本量进一步研究。 |
| 英文摘要: |
| Objective To compare the efficacy of different intervention methods，including Tai Chi combined with medicated diet，Tai Chi combined with medicated diet and western medicine，western medicine，and health education，on the prevention of thoracic and lumbar fractures in high-risk population with osteoporosis in the community，and to explore the suitable prevention strategies .Methods A total of 100 subjects in high-risk population with osteoporosis in the community were selected .All the subjects were divided into traditional group (Tai Chi combined with medicated diet),comprehensive group(Tai Chi combined with medicated diet and western medicine)，western medicine group，and control group. There are 25 subjects in each group. Different interventions were given to patients in different groups .Patients in traditional group received the guidance of Tai Chi and medicated diet . Patients in comprehensive group received guidance of Tai Chi，medicated diet，and oral medication of caltrate D3 and alfacalcidol soft capsules. Patients in western medicine group were treated with caltrate D 3 and alfacalcidol soft capsules，while patients in the control group just received health education .The occurrence of vertebral fractures，the changes of VAS pain score and the occurrence of fall were observed and compared among groups .Results After the intervention，new vertebral fractures were less in comprehensive group ,while new vertebral fractures were more in the control group，but no significant difference was observed among the groups(P>0.05).The VAS pain score in control group showed no significant difference before and after the intervention ( P>0.05). Whereas，the VAS pain score in the other 3 groups decreased after the intervention, showing significant difference comparing with that before the ntervention(P < 0.05).The VAS pain score in traditional group，comprehensive group，and western medicine group before and after intervention all had significant difference comparing with that in the control group(P<0. 05),but there was no significant difference between traditional group and western medicine group( P>0. 05).Significant difference was observed among comprehensive group，traditional group，and western medicine group(P<0. 05).During the intervention period，the times of fall were the Ieast in comprehensive group，while the times were the most in the control group . But no significant difference was observed among the 4 groups (P>0.05).Conclusion The intervention of Tai Chi combined with medicated diet and western medicine can effectively reduce the VAS pain score and the number of falls and new fractures in the intervention of osteoporosis in high -nsk population in the community.But in the aspects of falls and new fractures in high -risk population，the interventions such as Tai Chi combined with medicated diet,western medicine，and health education show no significant difference，which needs further studies with larger amount of samples. |
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