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目的研究群组看病模式对老年骨质疏松高危人群的疗效。方法收集年龄65岁以上、OSTA指数小于-4的骨质疏松高危人群86例,随机分为群组干预组和对照组,每组43例。应用双能X线吸收仪(DXA)测定左股骨颈骨密度值(LFN BMD),同时测定血生化指标及骨生化、代谢指标。应用骨质疏松知识问卷(OKT)及骨质疏松自我效能量表(OSES)进行评分。群组干预包括:健康教育及个体化的技能指导,病情监测,小组活动及处方开药等4项内容。干预1年后,两组再次进行上述项目评估。结果干预后,两组除血Ca~(2+)、P~(3+)、LFN BMD的差异无统计学意义(P>0.05)外,干预组的OKT、OSES得分,血清25羟维生素D3[25(OH)Vit D3]水平均高于对照组及组内干预前(P<0.05);干预组的血甲状旁腺激素(PTH)、I型前胶原氨基末端前肽(PINP),I型胶原交联羧基末端肽(β-CTX)水平均低于对照组及组内干预前(P<0.05)。结论群组看病是一种适合骨质疏松高危人群的有效的社区管理干预模式
Objective To study the curative effect of group medical treatment on high-risk population of elderly osteoporosis. Methods Eighty-six patients with high risk of osteoporosis who were over 65 years of age with OSTA less than -4 were randomly divided into group intervention group and control group, with 43 cases in each group. Left femur neck bone mineral density (LFN BMD) was measured by dual energy X-ray absorptiometry (DXA), and blood biochemical markers, bone biochemical and metabolic indices were also determined. The scores of osteoporosis knowledge questionnaire (OKT) and osteoporosis self-efficacy scale (OSES) were scored. Group intervention includes: health education and individualized skills guidance, condition monitoring, group activities and prescribe prescribing four elements. After one year of intervention, both groups reevaluated the above project. Results After intervention, the levels of OKT and OSES in the intervention group were significantly lower than those in the control group (P> 0.05) except for the levels of Ca ~ (2 +), P ~ (3 +) and LFN BMD in the two groups, [25 (OH) Vit D3] were significantly higher than those in control group and before intervention (P <0.05). The levels of PTH, PINP, The level of β-CTX in collagen was lower than those in control group and before intervention (P <0.05). Conclusions Group therapy is an effective model of community management intervention suitable for high-risk groups of osteoporosis