神经药理学报 ›› 2025, Vol. 15 ›› Issue (1): 7-.DOI: 10.3969/j.issn.2095-1396.2025.01.002

• 研究论文 • 上一篇    下一篇

老年肌少症患者实施不同干预方式的效果评价

李玉双,蒋欢欢,陈冬,谷秀林   

  1. 1. 华北理工大学附属医院药学部,唐山,063000,中国 

    2. 华北理工大学药学院,唐山,063210,中国 

    3. 华北理工大学附属医院临床营养科,唐山,063000,中国 

    4. 河北北方学院附属第二医院药剂科,张家口,075100,中国

  • 出版日期:2025-02-26 发布日期:2025-06-20
  • 通讯作者: 蒋欢欢,副主任药师;研究方向:老年慢病管理;E-mail:jianghuan1001@163.com
  • 作者简介:李玉双,华北理工大学药学院研究生
  • 基金资助:
    河北省卫健委重点科技研究计划项目(No.20220027)

Effect Evaluation of Different Intervention Methods in Elderly Patients with Sarcopenia

LI Yu-shuang, JIANG Huan-huan, CHEN Dong, GU Xiu-lin   

  1. 1. Department of Pharmacy, Affiliated Hospital of North China University of Science and Technology, Tangshan, 063000, China 

    2. School of Pharmacy, North China University of Technology, Tangshan, 063210, China 

    3. Department of Clinical Nutrition, Affiliated Hospital of North China University of Science and Technology, Tangshan, 063000, China 

    4. Department of Pharmacy, The Second Affiliated Hospital of Hebei North University, Zhangjiakou, 075100, China

  • Online:2025-02-26 Published:2025-06-20

摘要:

目的:探讨老年肌少症(sarcopenia, SP)患者实施不同干预方式的有效性和安全性。方法:156 例老年 肌少症患者随机分为对照组、营养组和营养运动组,各52 例,对照组给予常规诊疗服务,营养组在对照组基础上 增加营养干预,营养运动组在营养组基础上增加营养联合运动干预,3 个月后比较三组骨骼肌质量指数(muscle mass index,SMI)、握力、6 m 步速、肌少症干预有效率及不良事件发生率。结果:三组均完成了随访,干预前,三组 SMI、握力和6 m 步速比较,差异无统计学意义(P>0.05)。协方差分析结果显示:干预后三组SMI、握力和6 m 步 速,差异有统计学意义(P<0.01)。与对照组相比较,营养组SMI 增加0.601 kg·m-2 (P< 0.001,95%Cl:0.477~0.724)、 握力增加1.167(P< 0.001,95%Cl:0.887~1.448)、6 m 步速增加0.148 m·s-1(P< 0.001,95%Cl:0.108~0.187);营养 运动组SMI 增加0.677 kg·m-2(P< 0.001,95%Cl:0.554~0.800)、握力增加1.1986(P< 0.001,95%Cl:1.706~2.265)、 6 m 步速增加0.239 m·s-1 (P< 0.001,95%Cl:0.200~0.278)。与营养组相比较,营养运动组SMI 增加0.077 kg·m-2 (P= 0.221,95%Cl:-0.046~0.200)、握力增加0.818 (P< 0.001,95%Cl:0.541~1.095)、6 m 步速增加0.091 m·s-1(P< 0.001,95%Cl:0.052~0.130)。营养组和营养运动组肌少症干预有效率均显著高于对照组(P< 0.01);营养运动组 肌少症干预有效率高于营养组(RR = 1.260,95%Cl:0.858~1.850),差异无统计学意义(P= 0.163)。三组骨折和一 般不良反应发生率差异无统计学意义(骨折P= 0.128 ;不良反应P= 0.773);营养组和营养运动组跌倒发生率显著 低于对照组,差异有统计学意义(P= 0.049)。结论:对老年肌少症患者实施营养干预、营养运动干预可提高肌肉 质量和肌肉功能、降低跌倒等不良事件的发生率,具有较高的安全性和有效性,对老年肌少症患者具有重要意义。

关键词: 老年, 肌少症, 营养运动, 营养干预

Abstract:

Objective: To explore the effectiveness and safety of different interventions in elderly patients with sarcopenia. Methods: A total of 156 elderly patients with sarcopenia randomly divided into control group, nutrition group and nutrition exercise group and each group had 52 cases. The control group was given diagnosis and treatment service, the nutrition group was added nutrition intervention, and the nutrition exercise group was added nutrition combined exercise intervention on the basis of routine health guidance. After 3 months, skeletal muscle mass index (SMI), grip strength, 6 m stride speed, the intervention effectiveness of sarcopenia and the incidence of adverse events were compared among the three groups. Results: Follow-up was completed in all three groups. Before intervention, there were no significant differences in SMI, grip strength and 6 m stride speed among the three groups (P>0.05). The results of covariance analysis showed that there were significant differences in SMI, grip strength and 6 m stride speed among the three groups after intervention (P<0.01). Compared with the control group, SMI in nutrition group increased by 0.601 kg·m-2 (P<0.001,95%Cl:0.477~0.724), grip strength increased by 1.167 kg (P<0.001,95%Cl: 0.887~1.448), 6 m stride speed increased by 0.148 m·s-1( P<0.001,95%Cl: 0.108~0.187); In the nutrition exercise group, SMI increased by 0.677 kg·m-2 (P<0.001, 95%Cl: 0.554~0.800), grip strength increased by 1.1986 (P<0.001, 95%Cl: 1.706~2.265), 6 m stride speed increased by 0.239 m·s-1 (P<0.001, 95%Cl: 0.200~0.278). Compared with nutrition group, SMI in nutrition exercise group increased by 0.077 kg·m-2 (P=0.221, 95%Cl: -0.046~0.200), grip strength increased by 0.818 (P<0.001, 95%Cl: 0.541~1.095), 6 m stride speed increased by 0.091 m·s-1 (P<0.001, 95%Cl: 0.052~0.130). The effective rate of sarcopenia intervention in nutrition group and nutrition exercise group was significantly higher than that in control group (P<0.01); The effective rate of intervention in nutrition exercise group was higher than that in nutrition group (RR=1.260, 95%Cl: 0.858~1.850), with no statistical significance (P=0.163). The incidence of fracture and general adverse reactions in the three groups was not statistically significant (Fracture P=0.128; Adverse reaction P=0.773); The incidence of fall in nutrition group and nutrition exercise group was significantly lower than that in control group, with statistical significance (P=0.049). Conclusion: Nutritional intervention and nutritional exercise intervention for elderly patients with sarcopenia can improve muscle mass and muscle function, reduce the incidence of adverse events of fall, and have high safety and effectiveness, which is of great significance for elderly patients with sarcopenia.

Key words: early, sarcopenia, nutrition exercise, nutritional intervention

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