贺洁, 王拥军, 朱莲, 张伟, 张艳丽, 杨晓峰. 社区综合干预骨质疏松症多元效果评估的初探[J]. 上海预防医学, 2021, 33(4): 306-310. DOI: 10.19428/j.cnki.sjpm.2021.19861
引用本文: 贺洁, 王拥军, 朱莲, 张伟, 张艳丽, 杨晓峰. 社区综合干预骨质疏松症多元效果评估的初探[J]. 上海预防医学, 2021, 33(4): 306-310. DOI: 10.19428/j.cnki.sjpm.2021.19861
HE Jie, WANG Yong-jun, ZHU Lian, ZHANG Wei, ZHANG Yan-li, YANG Xiao-feng. Multi-effect evaluation of community comprehensive intervention against osteoporosis[J]. Shanghai Journal of Preventive Medicine, 2021, 33(4): 306-310. DOI: 10.19428/j.cnki.sjpm.2021.19861
Citation: HE Jie, WANG Yong-jun, ZHU Lian, ZHANG Wei, ZHANG Yan-li, YANG Xiao-feng. Multi-effect evaluation of community comprehensive intervention against osteoporosis[J]. Shanghai Journal of Preventive Medicine, 2021, 33(4): 306-310. DOI: 10.19428/j.cnki.sjpm.2021.19861

社区综合干预骨质疏松症多元效果评估的初探

Multi-effect evaluation of community comprehensive intervention against osteoporosis

  • 摘要:
    目的采用多元效果评估方法评价社区骨质疏松症患者不同干预阶段的综合干预效果,为防治措施提供参考依据。
    方法选择干预骨质疏松症的随访队列社区,将志愿参与研究的原发性骨质疏松症患者随机分为对照组和干预组,对照组采用社区常规防治方法进行管理,干预组采取骨质疏松治疗仪理疗、健腰密骨方联合骨化三醇治疗、健身气功易筋经、健康教育讲座等综合干预。在干预前、干预3个月、干预6个月这3个时间点,应用视觉模拟疼痛评分(VAS)、临床症状总评分、全身情况总评分、骨密度、骨代谢等疗效指标进行评估。
    结果干预组VAS疼痛指标、临床症状总评分、全身情况总评分干预3个月时与干预前比较、与对照组比较都有明显下降,差异有统计学意义(P<0.05)。干预组骨密度在干预6个月时有所上升,与对照组比较,差异有统计学意义(P<0.05)。干预组骨代谢指标中Ⅰ型前胶原氨基端延长肽(PINP)升高,Ⅰ型胶原羧基端肽β特殊序列(β-CTX)下降,与干预前比较、与对照组比较,差异均有统计学意义(P<0.05);25⁃羟⁃维生素D水平升高,甲状旁腺素(PTH)下降,差异有统计学意义(P<0.05),但是与对照组比较,差异没有统计学意义(P>0.05)。
    结论社区综合干预骨质疏松症的效果更优,适合在社区原发性骨质疏松症综合防治方面推广。

     

    Abstract:
    ObjectiveThis study was to evaluate the effects of comprehensive intervention, at different stages, in community osteoporosis patients.
    MethodOsteoporosis intervention was set up for years in a follow-up cohort community, in which patients with primary osteoporosis who volunteered to participate in the research were divided into control and intervention groups. The latter received comprehensive intervention consisting of physical therapy with osteoporosis therapeutic instrument, treatment with the prescription of strengthening waist and keeping bones in combination with calcitriol, health Qigong and changing tendon exercise, and health education lectures. The therapeutic effect was assessed at three different stages: prior to intervention, 3 and 6 months after intervention. The effect indicators included the following: visual anologue scale (VAS) pain score, clinical symptom total score, general condition total score, bone density and bone metabolism.
    ResultsVAS pain index, total clinical symptom score and total systemic condition score in the intervention group were significantly lower than those in the control group (P<0.05). Bone density in the intervention group increased at 6 months and the difference was statistically significant (P<0.05), compared with the control group (P<0.05). All the four bone biochemical indexes in the intervention group changed compared with those before intervention, and the improvement of PINP, β-CTX, 25(OH)D in the intervention group was better than that in the control group.
    ConclusionResult of effect evaluation with multiple indicators demonstrates that comprehensive intervention is suitable for promotion in prevention and treatment of primary osteoporosis in community.

     

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