全身震动治疗用于绝经后妇女骨质疏松治疗和跌倒预防的有效性分析

发布时间：2018-12-14 01:35

【摘要】：背景：现代研究表明,绝经后妇女骨质疏松发病率呈明显上升,因该病的广泛性、骨质疏松相关骨折的处理复杂性而弓I起广泛关注。临床的治疗手段以药物治疗为主。近几年来,国外出现了一种全新的非药物治疗手段,即全身震动治疗(whole body vibration, WBV),但文献报道治疗效果不一。本研究通过荟萃分析(meta-analysis)方法,综合多篇随机对照临床研究的结果,来探讨全身震动治疗用于绝经后妇女骨质疏松治疗和跌倒预防的有效性。方法：电子检索PubMed、EMBASE、Cochrane图书馆、Web of Science数据库,收集研究全身震动治疗用于减少股骨颈与腰椎骨密度(BMD)损失和跌倒预防的随机对照研究(RCT)。对纳入的文献进行质量分析和资料提取后使用RevMan5.3软件进行数据处理。结果：纳入RCT研究8篇,患者1014例,WBV组477例,对照组537例。并以震动强度分层进行亚组分析,数据分析显示,低震动强度的WBV能有效减少绝经后妇女腰椎椎体的BMD降低(N=838,WMD:0.01(0.00,0.01,);p=0.007),但对股骨颈部位的BMD降低没有明显改进(N=838,WMD:0.00(-0.00,0.00);p=0.92).高振动强度的WBV对腰椎(N=176,WMD:0.00(-0.01,0.02);p=0.47)和股骨颈(N=98,WMD:0.02(-0.00,0.05);p=0.06)的BMD变化都没有明显作用。所有纳入研究提供的跌倒相关因素的统计学数据都表明了WBV在预防跌倒方面的有效性。此外,所有的纳入研究中都未出现治疗并发症。结论：根据本研究结果,低强度的全身振动治疗能改善绝经后妇女腰椎的骨密度(BMD)下降趋势,并且能有效降低患者的跌倒风险。
[Abstract]:Background: modern studies have shown that the incidence of osteoporosis in postmenopausal women has increased significantly. Drug therapy is the main method of clinical treatment. In recent years, there has been a new non-drug therapy in foreign countries, that is, whole body vibration therapy (whole body vibration, WBV),). In this study, meta-analysis (meta-analysis) was used to evaluate the efficacy of systemic vibration therapy in the treatment of postmenopausal women with osteoporosis and fall prevention. Methods: PubMed,EMBASE,Cochrane library, Web of Science database was searched electronically, and a randomized controlled study, (RCT)., was conducted to study the effects of systemic shock therapy on the reduction of bone mineral density of femoral neck and lumbar vertebrae and the prevention of falls. The quality analysis and data extraction of the included documents were carried out using RevMan5.3 software for data processing. Results: 1014 patients, 477 patients in WBV group and 537 patients in control group were included in 8 RCT studies. The subgroup analysis of vibration intensity stratification showed that WBV with low vibration intensity could effectively reduce the decrease of BMD in postmenopausal women's lumbar vertebrae (NN838) WMD: 0.01 (0.000. 01,); However, the decrease of BMD in femoral neck was not improved significantly (NN838 WMD: 0.00 (-0.000. 00); p0. 92). WBV with high vibration intensity had no significant effect on the changes of BMD in lumbar vertebrae (NV 176) WMD: 0.00 (-0.01 0. 02), p0. 47) and femoral neck (NV 98) WMD: 0. 02 (- 0. 000. 05), p0. 06). All statistical data included in the study showed the effectiveness of WBV in the prevention of falls. In addition, no treatment complications were found in all of the included studies. Conclusion: according to the results of this study, low intensity whole body vibration therapy can improve the decline trend of bone mineral density (BMD) of postmenopausal women's lumbar vertebrae, and can effectively reduce the risk of falling down in postmenopausal women.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R580

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