【作者】 付丰平；

【导师】 黄宏兴；

【作者基本信息】 广州中医药大学 ， 中医骨伤科学， 2012， 硕士

【摘要】 目的本研究主要是通过调查广东省不同城市绝经后女性骨质疏松症患者,来分析广东省绝经后女性原发性骨质疏松症患病率及其各部位骨密度的变化趋势。聚类分析骨质疏松症中医证型和评估不同证型女性人群的生存质量状况。统计分析各危险因素对骨密度的影响程度。探讨不同部位瘦组织含量、脂肪含量、肌力与骨量相关性。方法选取自2010年10月至2011年1月在广东省不同城市筛查符合纳入标准的原发性骨质疏松症患者274例,年龄在50岁～85岁之间。用DXA仪器测量各部位骨密度、脂肪含量,骨量、瘦组织含量,体重指数。电子背力计,前臂握力器测量腰部背伸肌力,前臂最大握力。调查骨质疏松症中医证型及问卷调查患者一般资料情况和生存质量量表评测。运用Epidate软件双核查比对录入患者的调查信息,Excle软件整理数据,最后导入SPSS17.0统计软件分析数据。结果1.广东省各城市绝经后女性原发性骨质疏松症患病率为11.1%～19.2%,总体为15.5%。2.骨质疏松症患者腰椎T-值与休闲活动,健康状况相关性系数(R=-0.218、R=-0.205,P<0.05)；健康状况与家务劳动、日常生活、休闲活动、精神得分相关系数(R=0.444,R=0.405,R=0.578,R=0.664,P<0.01)3.聚类分析得出了中医证型可分为肾阳虚,肝肾阴虚,脾肾阳虚,气滞血瘀。4.腰椎-T值与直系亲属骨折,绝经年限,孕次数,本人驼背史有统计学意义(P<0.05),其估计的OR值分别为5.47,1.21,0.45,0.125；而与既往史,流产次数,无统计学意义。5.体重指数与腰椎骨密度相关系数(R=0.448,P<0.01)与髋部骨密度相关系数(R=0.217,R<0.05),绝经年限与腰椎骨密度,髋部骨密度的相关系数分别为(R=-0.28、R=-0.323),P<0.05.6.躯干骨量与脂肪含量,瘦组织含量,肌力相关系数(R=0.46,R=0.24,R=0.31,P<0.05)回归方程Y=0.2X1+0.4X2+0.2X3,上臂骨量与瘦组织含量,脂肪含量,肌力相关系数(R=0.56,R=0.48,P<0.05)回归方程y=0.66X1+0.44X2结论1.广东省城市女性绝经后原发性骨质疏松症患病率为15.5%。与国内其他省文献所报道的结果基本相符。2.女性50岁以后不同年龄段的腰椎正位L1-4骨密度值随着年龄增加呈逐渐减少,尤其在55～65岁与70～79岁两个阶段间下降速率加快。3.通过聚类分析得出了中医证型可分为肾阳虚,肝肾阴虚,脾肾阳虚,气滞血瘀。4.绝经年限与腰椎、髋部骨密度成负相关；体重指数与腰椎、髋部骨密度成正相关。5.躯干骨量与脂肪含量、瘦组织含量、肌力成正相关；上臂骨量与瘦组织含量、脂肪含量成正相关。更多还原

【Abstract】 ObjectiveThis research is mainly through the investigation of women with postmenopausal osteoporosis among Guangdong Province citys, to analysis the postmenopausal women with osteoporosis prevalence and the trend of bone mineral density. Cluster analysised the different TCM syndromes and evaluated different syndromes of female population status of life quality, using Statistical analysis to make sure of the risk factors on bone mineral density of the influence degree. Discussing the corelation on different parts of thin tissue content, fat content, correlation between muscle force and bone mass.MethodFrom2010October to2011January we had selected274cases which fit for the inclusion criteria for primary osteoporosis patients, at the age of50years old to85years old. By using DXA instrument to measure the bone density, bone mass, fat, thin tissue levels, body mass index. Electron back force meter, forearm grip strength measurements measured lumbar dorsal extensor, maximum grip strength. Meanwhie, we Investigated osteoporosis patients in traditional Chinese medicine syndromes and questionnaired for patients with general information and the quality of life scale evaluation. By using the software of Epidate and the Excle software to dual check and match entry patient survey information and data, finally into SPSS17.0statistical software to analyze data.Result1. postmenopausal women with osteoporosis prevalence rate is11.1%～19.2%, overall15.5%, in each city of the Guangdong province.2. Osteoporosis in patients with lumbar T-value and leisure activities, health status correlation coefficient (R=-0.218, R=-0.205, P<0.05); health and housework, daily life, leisure activities, mental score correlation coefficient (R=0.444, R=0.405, R=0.578, R=0.664, P<0.01)3. Used cluster analysis and based on professional knowledge and our previous studies done, TCM can be divided for kidney yang deficiency, yin deficiency of liver and kidney, spleen kidney yang deficiency, stagnation of Qi and blood stasis.4. Lumbar spine-T value and lineal fracture, menopause, pregnancy times, the hunchback history was statistically significant (P<0.05), the estimation of the OR values were5.47,1.21,0.45,0.125; and the history, times of induced abortion, were not statistical significance.5. There was partially correlation coefficient between Body mass index and bone mineral density of the lumbar spine (R=0.448, P<0.01) and hip bone mineral density (R=0.217, R<0.05), menopause and bone mineral density of the lumbar spine, hip bone mineral density correlation coefficient respectively (R=-0.28, R=-0.323, P<0.05)6. Torso bone mass and fat content, lean tissue content, strength coefficient of correlation (R=0.46, R=0.24, R=0.31, P<0.05) the regression equation is Y=0.2X1+0.4X2+0.2X37. The upper arm bone mass and lean tissue content, fat content, strength was better coefficient of correlation (R=0.56, R=0.48, P<0.05) The regression equation is Y=0.66X1+0.44X2Conclusion1. Guangdong Province city female postmenopausal osteoporosis prevalence and domestic other province of the reported results.2. Women after the age of50different ages of lumbar spine is L1-4bone mineral density values increase with age was gradually reduced, especially in the55to65years old and70to79years old between two phase decreased rate of speed.3. This research through cluster analysis that TCM can be divided for kidney yang deficiency, yin deficiency of liver and kidney, spleen kidney yang deficiency, stagnation of Qi and blood stasis.4. Menopause and lumbar spine, hip bone mineral density were-negatively association; body mass index and lumbar spine, hip BMD was positively association.5. Torso bone mass and fat content, lean tissue content, strength positively correlation.6. The upper arm bone mass and lean tissue content, fat content positively correlation.更多还原