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| 综合方法预防COPD合并骨质疏松症（OP）患者发生OCVF的初步观察 |
| A preliminary approach to prevent OCVF in patients with COPD complicated with osteoporosis |
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| DOI：10.3969/j.issn.1006.7108.2018.04.012 |
| 中文关键词: 慢性阻塞性肺疾病﹔骨质疏松症﹔骨质疏松性胸腰椎骨折﹔ 预防 |
| 英文关键词:COPD Osteoporosis OCVF prevention |
| 基金项目:广西壮族自治区卫生和计划生育委员会科研课题（ Z2015486） |
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| 中文摘要: |
| 目的 确定单纯西药、太极拳结合药物改善饮食结构等不同干预措施在预防慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)合并骨质疏松症（osteoporosis，OP）患者发生骨质疏松性胸腰椎骨折（OCVF）中的作用，寻找一种适合COPD合并OP患者预防OCVF的预防方法。方法 将90例COPD合并骨质疏松症（OP）患者，分为对照组、西药组、综合组（太极拳结合西药及改善饮食结构），每组30例，随机分组后予以不同的干预方法。对照组：告知患者病情，嘱患者平常行动小心，减少负重。西药组：在对照组基础上加用四联抗骨质疏松药物抗骨质疏松。综合组：在西药组基础上加上太极拳练习，指导研究对象有规律地打太极拳，同时指导其改善饮食结构。观测并比较各组椎体骨折发生率、腰椎椎体QCT值变化及跌倒发生次数。结果 随访1 年内各组胸腰椎椎体骨折发生率组间比较对照组与其他两组间差异比较有统计学意义（P< 0. 01)，西药组与综合组比较差异有统计学意义(P<0.05)。治疗前患者腰椎QCT比较显示对照组与其他两组间差异比较无统计学意义(P>0.05)，治疗后腰椎QCT比较显示对照组与其他两组间比较有统计学意义(P<0.05)，西药组与综合组比较无统计学意义(P>0.05)。3组1 年内跌倒发生次数对比，对照组发生次数明显较其它2组多(P<0.05)，西药与综合组跌倒发生次数无明显差异(P>0.05)。结论 采用太极拳结合西药及药膳饮食对COPD合并骨质疏松症（OP）患者进行干预能够有效减少骨折发生率、减少跌倒次数及控制骨质疏松进展。但随访中不能配合的患者最多，有待进一步增大样本量研究及优化。 |
| 英文摘要: |
| Objective To determine the effects of different interventions such as western medicine, and Tai Chi combined with medication and improvement of dietary structure on the prevention of osteoporotic thoracolumbar fractures (OCVF) in patients with chronic obstructive pulmonary disease (COPD) complicated with osteoporosis (OP), with the aim of finding a suitable prevention method to prevent OCVF in COPD patients with OP. Methods 90 patients with COPD complicated with OP were divided into three groups: control group, western medicine group, and comprehensive group (Tai Chi combined with western medicine and improvement of dietary structure). Patients in the control group were informed of the disease condition, and were instructed to perform usual activities carefully and to reduce weight-bearing. Patients in the western medicine group received the instructions given to the control group and were given quadruple anti-osteoporosis drugs. Patients in the comprehensive group received the intervention given to the western medicine group and were guided to play Tai Chi regularly and to improve their diet. The incidence of vertebral fracture, the change of QCT measures at lumbar vertebrae and the number of falls occurred were observed and compared. Results For the incidence of vertebral fracture, there were significant differences between the control group and the other two groups ( P < 0.01), and there was significant difference between the western medicine group and the comprehensive group ( P < 0.05). There were no significant differences between the control group and the other two groups for baseline QCT measures ( P > 0.05). Compared with the other two groups, the QCT measures of lumbar vertebrae of the control group was statistically significant after intervention ( P < 0.01) ( P < 0.05), but there were no significant differences between the western medicine group and the comprehensive group ( P > 0.05). The incidence of falls in the control group was significantly higher than the other two groups, but there was no significant difference in the number of falls between the western medicine group and the comprehensive group ( P > 0.05). Conclusion Intervention of Tai chi combined with western medicine and improved diet on COPD complicated with OP can effectively reduce the incidence of fracture, reduce the number of falls and control the progress of osteoporosis. However, large number of patients could not cooperate with the follow-ups, therefore further research with increased sample size and optimization of method is needed. |
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