银川回族与汉族绝经后女性骨密度与影响因素及中医证候特点的关系

发布时间：2018-06-19 03:04

本文选题：民族 + 绝经后女性　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的本研究通过收集银川地区回、汉族绝经后女性的一般资料、饮食、运动、临床症状及骨密度等数据,根据民族、诊断进行分组比较,探究回、汉族各类因素对骨密度的影响特点,分析并比较回、汉族的中医证候类型及其骨量水平,为宁夏地区绝经后骨质疏松症的研究、预防和治疗提供前期依据。方法根据本研究的纳入、排除标准,收集2015年10月至2017年1月在宁夏医科大学总医院健康体检中心及骨密度室进行骨密度(BMD)检测的回族与汉族绝经后女性共240名,其中,汉族骨量正常者60名,汉族骨质疏松者60名,回族骨量正常者60名,回族骨质疏松者60名。以MEDIX90 X线双能骨密度仪测定骨密度T值进行诊断分组,身高、体重采用SK-CK超声波体检机进行测量。由1名研究生进行身高、体重测量并对研究内容进行调查登记,包括民族、常居地、既往史、年龄、绝经年龄、饮食情况、户外运动等;由2名中医医师(具有10年诊疗经验者)对受试者进行中医四诊,根据临床症状及舌脉进行中医证候诊断,包括肾阳虚证、肝肾阴虚证、脾肾阳虚证、瘀血阻络证4种类型。以SPSS 22.0软件进行统计分析,率的比较采用χ2检验,计量资料采用独立样本t检验、单因素方差分析,以偏态相关及多因素非条件logistic回归分析研究因素对BMD的影响程度。结果1.骨密度与影响因素回族与汉族绝经后女性的年龄、绝经年龄、绝经年长及BMD无统计学意义(P0.05);不同诊断组的年龄、绝经时长有统计学意义(P0.05),BMD与年龄、绝经年长的变化趋势,回、汉族绝经后女性BMD均在51岁后明显下降,汉族下降水平较回族明显(P0.05)。不同民族、不同诊断组内户外活动者频数差异无统计学意义(χ2=3.270,p0.05),按运动周时、运动年长对运动进行分级后比较显示,bmd与运动周时的长短无关(p0.05),汉族绝经后女性运动1年至5年者可提高骨密度水平(p0.05),回族无此趋势(p0.05)。身高、体重、bmi在回族与汉族之间无统计学意义(p0.05),在不同诊断组间有统计学意义(p0.01),偏态相关分析显示,不论整体身高、体重、bmi还是回、汉族各族的变量均与骨密度呈显著正相关(p0.01)。根据bmi进行肥胖诊断,回、汉族肥胖者的检出率无统计学意义(χ2=3.107,p0.05),骨量正常组中超重者(偏胖+肥胖)较多,回族偏瘦者较汉族bmd水平偏高。整体而言,受试者主要以素食、荤素均衡饮食为主,而荤食者较少,不同民族饮食类型无统计学意义(χ2=0.272,p0.05),不同饮食类型中骨质疏松者的检出率也无统计学意义(χ2=3.785,p0.05)。bmd与饮食类型在民族间的表现为:汉族:素食者荤素均衡者荤食者,回族:素食者荤食者荤素均衡者,但无统计学意义(p0.05)。钙剂、枸杞、八宝茶的食用人数在不同民族、不同诊断组内均无统计学意义(p0.05),并且与bmd无关(p0.05)。将患病与否作为因变量,民族、年龄、绝经年龄、绝经年长、户外运动、身高、体重、饮食类型、是否食用钙剂、枸杞、八宝茶作为自变量进行多因素非条件logistic回归分析显示,绝经年长增加是骨质疏松症的危险因素,户外运动与体重增加是op的保护因素。2.骨密度与中医证候分型在240名受试者中,中医证候分布特点表现为:肾阳虚证(52%)脾肾阳虚证(22%)肝肾阴虚证(16%)瘀血阻络证(10%)。回、汉族绝经后女性中医证候分型无统计学意义(χ2=6.487,p=0.1660.05),在不同骨量水平组中无统计学意义(χ2=3.666,p=0.4530.05)。在整体数据中,肝肾阴虚证的骨密度水平较脾肾阳虚证者偏高(p0.05),在汉族中,除肝肾阴虚证与瘀血阻络证的bmd差异有统计学意义(p0.05)外,其他各组均无意义;回族各类证型的受试者骨密度均无统计学意义(p0.05)。结论1.银川地区汉族较回族绝经后女性的骨密度下降趋势明显,且体重、bmi与bmd的相关性高于回族,绝经年长是银川地区绝经后女性骨质疏松症的危险因素,而户外运动、体重则是该疾病的保护因素,民族之间无差异。2.银川地区回、汉族绝经后女性的饮食、运动无显著区别,汉族可因运动年长对骨密度产生影响。3.银川地区绝经后女性不同民族及骨量水平的中医证候表现均以肾阳虚证为主;汉族表现肝肾阴虚证的受试者骨密度较其他证型偏高;随着绝经年长的增加,除肾阳虚证,回族绝经后女性的其他证候类型表现较为分散,汉族表现较为集中。
[Abstract]:Objective to collect data of general data, diet, exercise, clinical symptoms and bone mineral density of postmenopausal women of Han nationality in Yinchuan, and to compare and compare the characteristics of different factors of Han nationality on bone density according to the nationality and diagnosis, analyze and compare the types of TCM syndrome and bone quantity of Han nationality, for Ningxia land. The study, prevention and treatment of postmenopausal osteoporosis were provided in the early stage. Methods according to the inclusion and exclusion criteria of this study, 240 women from October 2015 to January 2017 in the health check-up center and bone density room of Ningxia Medical University General Hospital were examined by bone density (BMD) in the Hui and Han postmenopausal women, including the bone mass of the Han nationality. There were 60 normal people, 60 Han people with osteoporosis, 60 Hui bone mass and 60 Hui people with osteoporosis. The T value of bone mineral density was measured by MEDIX90 X ray dual energy density meter. The height and weight were measured by SK-CK ultrasonic examination machine. The height, weight measurement and research contents of 1 Postgraduates were investigated and registered. Including ethnic, habitual residence, past history, age, menopause age, diet, outdoor exercise, and so on. 2 doctors of traditional Chinese medicine (with 10 years of experience of diagnosis and treatment) had four diagnosis of traditional Chinese medicine, including kidney yang deficiency syndrome, liver kidney yin deficiency syndrome, spleen kidney yang deficiency syndrome, blood stasis syndrome 4 types, with SPSS 2. 2 the statistical analysis was carried out, the ratio of the rate was compared with the x 2 test, the measurement data were analyzed by independent sample t test, single factor variance analysis, and the influence degree of factors on BMD was analyzed with partial correlation and multi factor unconditional logistic regression. Results 1. bone density and influence factors of the Hui and postmenopausal women of the Hui and Han nationality, menopause age, menopause Age and BMD were not statistically significant (P0.05); the age of different diagnostic groups, menopause length had statistical significance (P0.05), BMD and age, menopause age change trend, Hui, postmenopausal women BMD decreased significantly after 51 years of age, and the Han descent level was significantly higher than that of the Hui nationality (P0.05). There was no difference in frequency of outdoor activities among different ethnic groups and different diagnosis groups. Statistical significance (x 2=3.270, P0.05), according to the exercise week, the exercise year length of the movement was compared to show that BMD was not related to the length of the exercise week (P0.05), the Han postmenopausal women movement for 1 to 5 years can improve the bone density level (P0.05), the Hui people have no this trend (P0.05), height, weight, BMI between the Hui and Han people has no statistical significance (P) 0.05) there was statistical significance between different diagnostic groups (P0.01). Partial correlation analysis showed that no matter the overall height, weight, BMI or back, the Han nationality had a significant positive correlation with bone density (P0.01). The diagnosis of obesity was based on BMI, and the detection rate of Han obese people was not statistically significant (2=3.107, P0.05), and overweight in the normal bone mass group was overweight. People (fat + obesity) were more than the Han BMD level. As a whole, the subjects were mainly vegetarian, meat and vegetarian balanced diet, and meat eaters were less, there was no statistical significance (x 2=0.272, P0.05) in different ethnic groups (x, P0.05), and there was no statistical significance (x 2=3.785, P0.05).Bmd in different diet types. And the type of diet in the ethnic groups: the Han: vegetarian meat and vegetarian eaters, Hui: vegetarian meat and vegetarian meat and vegetarian balance, but no statistical significance (P0.05). The consumption of calcium, wolfberry, eight treasure tea in different ethnic groups, different diagnostic groups have no statistical significance (P0.05), and BMD (P0.05). Will be ill or not as a Variables, nationalities, age, menopause age, menopause age, outdoor exercise, height, weight, diet type, dietary calcium, wolfberry, eight treasure tea as independent variables unconditional logistic regression analysis showed that the increase of menopause age is a risk factor for osteoporosis, outdoor exercise and weight gain are the protective factors of OP.2. bone density. Among the 240 subjects, the characteristics of TCM syndrome distribution were as follows: kidney yang deficiency syndrome (52%) spleen kidney yang deficiency syndrome (22%) liver kidney yin deficiency syndrome (16%) stagnation of blood stasis syndrome (10%). There was no statistical significance (x 2=6.487, p=0.1660.05) in the Han Chinese postmenopausal women (chi square, x, 2=3.666). P=0.4530.05). In the whole data, the bone density level of the liver kidney yin deficiency syndrome is higher than that of the spleen and kidney yang deficiency syndrome (P0.05). In the Han nationality, there is no significant difference in the BMD difference between the liver kidney yin deficiency syndrome and the blood stasis obstruction syndrome (P0.05), and the bone density of all the various types of the Hui nationality of the Hui nationality has no statistical significance (P0.05). Conclusion 1. Yinchuan The bone mineral density of the Han nationality in the region of the Han nationality is obviously lower than that of the postmenopausal women, and the weight, the correlation of BMI and BMD is higher than that of the Hui. The menopause age is the risk factor for postmenopausal women with osteoporosis in Yinchuan, and the outdoor exercise and weight are the protective factors of the disease. There is no difference between the ethnic groups in the Yinchuan region and the postmenopausal women of the Han nationality. There is no significant difference in diet and exercise. The Han nationality can affect the bone density in.3. in Yinchuan area. The TCM Syndromes of different ethnic and bone mass levels of postmenopausal women in Yinchuan area are mainly kidney yang deficiency syndrome, and the bone density of the Han people showing liver kidney yin deficiency syndrome is higher than that of the other syndrome types; with the increase of menopause age, the kidney yang deficiency syndrome, The other syndromes of Hui women in postmenopausal women are more dispersed and the Han nationality is more concentrated.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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