CAJ | 학술논문

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。
목적：비교태겁권결합약선음식、태겁권결합약선음식급서약、서약、건강교육등불동간예방안예방사구골질소송고위인군발생흉요추골절적효과，탐색괄합사구골질소송성흉요추골절적예방책략。방법사선100례사구골질소송고위인군，분위전통조（태겁권＋선식）、종합조（태겁권＋선식＋서약）、서약조급공백대조조공4조，매조25례，분별급여불동적간예방안，기중전통조지도약선음식급태겁권운동，종합조지도약선음식급태겁권운동병구복개이기D3편급아법골화순연효낭、서약조구복개이기D3편급아법골화순연효낭，공백대조조급여건강교육지도，관측병비교각조추체골절발생정황、VAS골통평분개변급질도발생등정황。결과간예후종합조신발추체골절수교소、대조조신발추체골절수교다，단조간비교무통계학차이（P＞0.05）。대조조간예후VAS골통평분여간예전비교무통계학차이（P＞0.05），기타삼조간예후VAS골통평분균강저，여간예전비교균유통계학차이（P＜0.05）；전통조、종합조급서약조간예전후VAS골통평분차치여공백대조조비교균유통계학차이（P＜0.05），단전통조여서약조조간비교무통계학차이（P＞0.05），종합조여전통조급서약조조간비교균유통계학차이（P＜0.05）。간예기간종합조적질도차수최소、공백대조조적질도차수최다，단사조조간질도차수비교무통계학차이（P＞0.05）。결론채용태겁권결합약선음식급서약간예사구골질소송고위인군능구유효강저VAS골통평분、감소질도차수급신발골절。단재고위인군질도차수급신발골절방면여태겁권결합약선음식간예、서약간예급건강교육등비교미견현저차별，유대확대양본량진일보연구。
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 D 3 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 VASpain score in the other 3 groups decreased after the intervention , showing significant difference comparing with that before theintervention (P <0.05).The VAS pain score in traditional group, comprehensive group, and western medicine group before and afterintervention all had significant difference comparing with that in the control group (P <0.05), but there was no significant differencebetween 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 least incomprehensive 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 theVAS pain score and the number of falls and new fractures in the intervention of osteoporosis in high -risk 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 .