【作者】 张誉文；

【导师】 王建华；

【作者基本信息】 天津医科大学 ， 流行病与卫生统计学， 2010， 硕士

【摘要】 目的：通过对社区超重肥胖人群进行健康教育结合有氧运动的综合干预,评价干预措施对超重和肥胖人群关于超重肥胖的知识、态度、行为,心理状况,以及体质指数、腰围、血压、血糖、血脂等指标的影响,探索适合我国社区超重、肥胖人群的干预模式。方法：随机抽取天津市南开区王顶堤社区的三个小区,纳入研究对象共130人,随机分为干预组和对照组,干预组65人采取规律的有氧运动及健康教育干预,每周3次；对照组65人不采取任何干预措施。干预前后调查两组研究对象的人口学资料、超重／肥胖KAB问卷、焦虑自评量表、人体测量指标、血压、血清生化指标(包括血糖、甘油三酯、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)。比较两组各项变化情况采用重复测量的方差分析方法,P<0.05为差异有统计学意义。结果：两组年龄、性别等特征差异无统计学意义,均衡可比。基线时两组超重／肥胖KAB评分、SAS评分、BMI、腰围、血压、血糖、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇差异无统计学意义。干预组中96.4%的人完成了六个月的有氧运动和健康教育干预。本研究显示,综合干预有效地降低了干预组的SAS评分(-9.85[95%CI：-11.07,-8.64]分)、BMI(-0.47[95%CI：-0.58,-0.36]kg/m2)、腰围(-4.00[95%CI：-5.01,-2.99]cm)、收缩压(-11.69[95%CI:-13.84,-9.55]mmHg)、空腹血糖(-1.21[95%CI:-1.55,-0.88]mmol/L)、甘油三酯(-0.06[95%CI：-0.25,0.13]mmol/L)、低密度脂蛋白胆固醇水平(-0.48[95%CI:-0.62,-0.34]mmol/L),提高了超重／肥胖KAB评分(13.82[95%CI：12.42,15.23]分)和高密度脂蛋白胆固醇水平(0.22[95%CI:0.17,0.28]mmol/L)。两组组间比较,干预前后BMI构成比及SAS评分构成比差异有统计学意义。干预组超重／肥胖人群比例分别由66.1%、33.9%降至62.9%、30.6%,并且有6.5%的人BMI降至正常范围内,而对照组人群肥胖比例由41.3%增加至42.9%,超重比例由58.7%降至57.1%；干预组SAS得分大于40分的由17.7%降至3.2%,对照组仅由27.0%降至20.6%。结论：规律的有氧运动和健康教育,能有效改善超重肥胖人群的心理状况、BMI、腰围、血糖、血压、血脂等水平,在社区超重肥胖人群中进行这种干预是增强身体机能、提高心理健康水平、降低肥胖各类相关疾病发生的重要手段。更多还原

【Abstract】 Objective:To evaluate the effects of intervention of regular aerobic exercise and health education on KAB, SAS scores, BMI, waist circumferences, blood pressure, serum glucose and blood lipids in middle-aged and elderly people with overweight and obesity.Methods:3 smaller resident communities were choosen randomly from wangdingdi community in nankai district in Tianjin. Totally 130 overweight people were involved in this study.65 and 65 people were randomly assigned to intervention group and control group respectively. The members of intervention group were asked to participate in aerobic exercise and health education program 3 times per week. And control group members received no intervention. The demographic, anthropometric data and medical examination, including serum glucose, blood pressure and blood lipids were collected at the beginning of the study and at the end of the study after six months. Then to evaluate the effects of intervention of regular aerobic exercise and health education on BMI, waist circumferences,blood pressure, serum glucose and blood lipids in middle-aged and elderly people with overweight and obesity by using a repeated-measures ANCOVA. In all cases, a P＜0.05 was considered as statistically significant level.Results:No significant differences were found between the intervention group and the control group in gender and age distribution. KAB scores, SAS scores, BMI, waist circumference, serum glucose, blood pressure, total cholesterol, HDL cholesterol, LDL cholesterol were not significantly different between the intervention group and the control group at baseline.96.4% patients in the intervention group completed the six-month aerobic exercise and health education program. The results showed that the comprehensive intervention resulted in significant reductions in intervention group in SAS scores(-9.85 [95%CI:-11.07 to-8.64]), BMI(-0.47 [95%CI:-0.58,-0.36]kg/m2), waist circumference (-4.00 [95%CI:-5.01,-2.99]cm), SBP(-11.69 [95%CI:-13.84,-9.55]mmHg), FPG (-1.21 [95%CI:-1.55,-0.88] mmol/L), triglyceride (-0.06 [95%CI:-0.25,0.13] mol/L), LDL cholesterol (-0.48 [95%CI:-0.62,-0.34] mmol/L), and improvement of the KAB scores (13.82 [95%CI:12.42, 15.23]) and HDL cholesterol (0.22 [95%CI:0.17,0.28] mmol/L). And between-groups comparisons showed a significant difference in proportion of BMI and SAS score. The proportions of overweight and obesity were decreased from 66.1% and 33.9% to 62.9% and 30.6% respectively; and BMI of 6.5% people changed to normal in intervention group, while the proportion of obesity was increased from 41.3% to 42.9%,the proportion of overweight was decreased from 58.7% to 57.1% in control group. The proportion of people with SAS score above 40 was decreased from 17.7% to 3.2% in intervention group. In comparison to intervention group there was only a smaller decrease from 27.0% to 20.6% in control group.Conclusion:Six-month period of regularly aerobic exercise and health education program in community can successfully reduce BMI, waist circumference and some other risk factors related to overweight and obesity. It is effective to improve awareness, physical fitness, psychological state for middle-aged and elderly people.更多还原