本文選題：骨質(zhì)疏松 + 人體成分　； 參考：《中國(guó)科學(xué)技術(shù)大學(xué)》2017年博士論文

【摘要】：骨質(zhì)疏松癥是一種典型的慢性退行性疾病,是人類共同面臨的五大老年病(高血壓,心血管,糠尿病,腫瘤和骨質(zhì)疏松癥)之一。我國(guó)是世界上老年人口最多的國(guó)家之一,老齡化進(jìn)程快速加劇,隨著骨質(zhì)疏松人群的急劇增加,將給國(guó)家和社會(huì)醫(yī)療資源帶來(lái)巨大的挑戰(zhàn)。中老年人一旦患有骨質(zhì)疏松,由于影響成骨細(xì)胞前體細(xì)胞分化的促性激素減少,破骨細(xì)胞活性增強(qiáng),且骨骼所處的內(nèi)外部環(huán)境不易改變,導(dǎo)致其治療難度非常大。目前雖然部分藥物可以通過(guò)促進(jìn)成骨細(xì)胞成骨或抑制破骨細(xì)胞活性達(dá)到干預(yù)骨質(zhì)疏松進(jìn)程的目的,但藥物干預(yù)的長(zhǎng)期安全性并不確定,現(xiàn)在已知的一些藥物已被證明會(huì)增加心血管等疾病的風(fēng)險(xiǎn),因此,美國(guó)食品藥品管理局(FDA)建議骨質(zhì)疏松的藥物干預(yù)需十分謹(jǐn)慎。應(yīng)對(duì)骨質(zhì)疏松的最佳策略是預(yù)防,通過(guò)提高成年早期獲得的骨量峰值以及降低隨增齡引起的骨質(zhì)下降速率,從而達(dá)到防控骨質(zhì)疏松的目的。在人體骨質(zhì)的調(diào)控方面,一些學(xué)者已提出骨應(yīng)力調(diào)控理論(Mechanostat)用來(lái)分析骨骼在應(yīng)力環(huán)境下的應(yīng)變,并探究防治骨質(zhì)疏松的有效方法。但針對(duì)不同種族、性別、不同年齡段的人群,作用于骨骼的人體靜態(tài)負(fù)荷,包括瘦體重和脂肪,以及不同運(yùn)動(dòng)產(chǎn)生的運(yùn)動(dòng)應(yīng)力對(duì)骨質(zhì)的影響尚存在諸多爭(zhēng)議。本研究基于骨應(yīng)力調(diào)控理論構(gòu)建系統(tǒng)性的骨質(zhì)健康促進(jìn)方法,并以一定樣本人群為研究對(duì)象跟蹤研究,研究運(yùn)動(dòng)對(duì)骨質(zhì)促進(jìn)的作用。本研究將從以下幾個(gè)方面開(kāi)展:1.骨靜態(tài)負(fù)荷對(duì)人體骨質(zhì)的影響鑒于作用于骨骼的人體瘦體重、肌肉、脂肪等靜態(tài)負(fù)荷與骨強(qiáng)度的關(guān)系在不同種族、性別、年齡段人群中的差異性,獲得在我國(guó)人群中人體成分與骨質(zhì)關(guān)系有利于為下一步制定科學(xué)的干預(yù)指導(dǎo)方法提供數(shù)據(jù)支撐。本研究分別以441名中年男性和女性以及568名老年男性和女性為研究對(duì)象,獲取研究對(duì)象的人體成分?jǐn)?shù)據(jù)、骨質(zhì)數(shù)據(jù),分析不同年齡段、不同性別人群的人體成分參數(shù)與骨質(zhì)的關(guān)系。研究發(fā)現(xiàn):隨著年齡的增加,男性和女性的骨質(zhì)都呈下降趨勢(shì),老年女性的骨質(zhì)疏松比率要大于老年男性的骨質(zhì)疏松比率(P0.05),此外,在男性和女性中,瘦體重與骨質(zhì)呈顯著正相關(guān)(R=0.271-0.406,P0.001),脂肪與骨質(zhì)的關(guān)系存在性別差異,脂肪與女性的骨質(zhì)存在弱相關(guān),但在男性中未發(fā)現(xiàn)這種關(guān)系。2.運(yùn)動(dòng)能力與骨質(zhì)的關(guān)系研究為了研究人體運(yùn)動(dòng)能力與骨質(zhì)的關(guān)系,本研究分析了 937名20-40歲的青年男性和女性的縱跳水平、下肢肌肉量、握力與跟骨骨質(zhì)的關(guān)系,結(jié)果顯示人體局部的肌肉量和肌肉力量與局部的骨質(zhì)顯著相關(guān)(P0.05),而在男性中更為顯著,并且這種關(guān)系具有部位特異性。結(jié)果也表明了通過(guò)提高特定部位的肌肉量和肌肉力量有助于促進(jìn)該部位的骨質(zhì)。此外,本研究分析了 945名20-40歲男性的心肺耐力和肺活量與骨質(zhì)的關(guān)系,結(jié)果顯示人體的運(yùn)動(dòng)心肺耐力和肺活量均與骨質(zhì)呈顯著正相關(guān)(P0.05),這表明了提高個(gè)體的心肺耐力水平有助于促進(jìn)骨質(zhì)健康。以上研究為骨質(zhì)健康促進(jìn)策略的制定提供了數(shù)據(jù)支撐。3.骨質(zhì)健康促進(jìn)方案推理量表和個(gè)性化骨質(zhì)健康促進(jìn)服務(wù)系統(tǒng)的構(gòu)建基于骨應(yīng)力調(diào)控理論,本研究建立了骨應(yīng)力調(diào)控模型,提出了骨質(zhì)健康促進(jìn)方案推理量表,構(gòu)建了基于個(gè)體體質(zhì)機(jī)能數(shù)據(jù)的骨質(zhì)健康促進(jìn)服務(wù)系統(tǒng)。系統(tǒng)對(duì)個(gè)體骨質(zhì)狀況和影響骨質(zhì)的風(fēng)險(xiǎn)因素進(jìn)行分析,并綜合個(gè)體健康數(shù)據(jù)推理出針對(duì)性的骨質(zhì)健康促進(jìn)方案,相關(guān)運(yùn)動(dòng)處方可推送至個(gè)人的手機(jī)終端,系統(tǒng)會(huì)監(jiān)測(cè)用戶運(yùn)動(dòng)過(guò)程的生理指標(biāo)變化,監(jiān)測(cè)數(shù)據(jù)也會(huì)傳送到健康云數(shù)據(jù)中心,通過(guò)動(dòng)態(tài)監(jiān)測(cè)個(gè)體的骨質(zhì)變化和影響骨質(zhì)的風(fēng)險(xiǎn)因素的變化,從而實(shí)現(xiàn)對(duì)骨質(zhì)健康促進(jìn)的閉環(huán)干預(yù)管理系統(tǒng)。此外,本研究設(shè)計(jì)了一種智能化骨質(zhì)健康促進(jìn)干預(yù)器械,該器械可執(zhí)行骨質(zhì)健康促進(jìn)服務(wù)系統(tǒng)生成的骨質(zhì)促進(jìn)方案,該器械可針對(duì)身體各個(gè)部位進(jìn)行鍛煉,提高身體各部位的肌肉量、肌肉力量和肌肉質(zhì)量,達(dá)到促進(jìn)骨質(zhì)健康的目的。4.運(yùn)動(dòng)對(duì)骨質(zhì)健康促進(jìn)作用的人群樣本跟蹤研究為了研究運(yùn)動(dòng)干預(yù)對(duì)于骨質(zhì)健康促進(jìn)的量效關(guān)系,驗(yàn)證提出的骨質(zhì)健康促進(jìn)方案推理量表的有效性,本研究在普通人群中隨機(jī)選取了較易發(fā)生骨質(zhì)疏松的中老年人群,最終選取了 81名中老年人,進(jìn)行了為期6個(gè)月的有氧跑和低強(qiáng)度器械鍛煉相結(jié)合的運(yùn)動(dòng)干預(yù),研究結(jié)果發(fā)現(xiàn)在老年男性和女性中,運(yùn)動(dòng)都對(duì)其骨質(zhì)健康具有顯著的促進(jìn)作用(P0.05),研究結(jié)果證實(shí)了所提出的骨質(zhì)健康促進(jìn)推理量表的有效性。同時(shí),本研究也選取了 106名的毒品依賴女性進(jìn)行骨質(zhì)評(píng)價(jià)和干預(yù)研究。首先,研究了毒品依賴女性與健康女性之間的骨質(zhì)差異,并分析了研究組和對(duì)照組的骨質(zhì)影響因素,發(fā)現(xiàn)了長(zhǎng)期的毒品依賴將導(dǎo)致骨質(zhì)低下。然后,本研究將毒品依賴女性分為低骨質(zhì)組和正常骨質(zhì)組,測(cè)定了她們的骨質(zhì)、人體成分?jǐn)?shù)據(jù),調(diào)查了運(yùn)動(dòng)和飲食情況,針對(duì)這兩組人群進(jìn)行了為期7個(gè)月的有氧體操鍛煉,結(jié)果發(fā)現(xiàn)低骨質(zhì)組的骨質(zhì)得到了明顯改善(P0.05),但正常骨質(zhì)組骨質(zhì)并沒(méi)有顯著改善。本研究首次在戒毒人群中進(jìn)行骨質(zhì)評(píng)價(jià)和跟蹤研究,國(guó)內(nèi)外類似的研究較為罕見(jiàn)。研究結(jié)果證實(shí)了運(yùn)動(dòng)干預(yù)可以促進(jìn)低骨質(zhì)女性戒毒人員的骨質(zhì)健康,但針對(duì)不同骨質(zhì)狀況的人群需采取差異化的干預(yù)方案。
[Abstract]:Osteoporosis is a typical chronic degenerative disease. It is one of the five major geriatric diseases (hypertension, cardiovascular, furfuronuria, tumor and osteoporosis) common to mankind. China is one of the countries with the largest population in the world. The process of aging is rapidly increasing. With the rapid increase of osteoporosis, it will be given to the state and society. Medical resources are a great challenge. Once the elderly are suffering from osteoporosis, it is difficult to treat the osteoblast as a result of the reduction of the stimulating hormone that affects the differentiation of the osteoblast precursor cells, the enhancement of the osteoclast activity and the internal and external environment in the bone, which can lead to the osteogenesis of osteoblasts. Or inhibition of osteoclast activity to interfere with the process of osteoporosis, but the long-term safety of the drug intervention is not determined. Now some known drugs have been proven to increase the risk of cardiovascular diseases. Therefore, the US Food and Drug Administration (FDA) recommends that the drug intervention for osteoporosis should be very cautious. The best strategy is to prevent and control osteoporosis by increasing the peak bone mass obtained in early adulthood and reducing the rate of osteopenia caused by aging. In the regulation of human bone, some scholars have proposed the theory of bone stress regulation (Mechanostat) to analyze the strain of bone in the stress environment and explore the strain of bone in the stress environment. Effective methods to prevent and cure osteoporosis. However, there are many controversies on the effect of human body static load on bone, including lean body weight and fat, and the effect of exercise stress produced by different movements on bone. This study builds a systematic bone health promotion based on the theory of bone stress regulation. This study will be carried out in the following aspects: 1. the effect of static load on bone in human body in view of the relationship between the body weight, muscle, fat and other static load and bone strength in different races, sex, age The relationship between human body composition and bone in the population of the population in our country is beneficial to provide data support for the next step of formulating scientific intervention guidance. This study took 441 middle-aged men and women and 568 elderly men and women as research subjects to obtain human body composition data, bone data, and bone data. The study found that the bone of men and women decreased with age, and the ratio of osteoporosis in older women was greater than that of older men (P0.05), and in males and females, thin body weight and bone were significantly positive. R=0.271-0.406 (P0.001), there was a gender difference in the relationship between fat and bone. Fat was weakly related to the existence of bone in women, but the relationship between.2. exercise and bone was not found in men. In order to study the relationship between human exercise ability and bone, this study analyzed 937 young male and female 20-40 year old men and women. The relationship between jumping level, lower limb muscle volume, grip strength and calcaneus bone, results show that local muscle volume and muscle strength are significantly associated with local bone (P0.05), but more significant in men, and the relationship is specific. In addition, the study analyzed the relationship between cardiopulmonary endurance and lung capacity and bone mass in 945 20-40 year old men. The results showed a significant positive correlation between exercise cardiopulmonary endurance and vital capacity (P0.05). This showed that improving the individual's cardiopulmonary endurance was helpful to promote bone health. The formulation of health promotion strategy provides data support.3. bone health promotion scheme reasoning scale and personalized bone health promotion service system construction based on bone stress regulation theory. This study established bone stress regulation model, proposed a bone health promotion scheme reasoning scale, and constructed bone based on individual physical function data. The health promotion service system. The system analyzes the individual bone status and the risk factors affecting the bone, and combines the individual health data to deduce the targeted bone health promotion program. The related exercise prescriptions can be pushed to the individual mobile terminal. The system will monitor the changes in the physiological indexes of the user's movement process and the monitoring data will be transmitted. To the health cloud data center, a closed loop intervention management system for bone health promotion is achieved by dynamically monitoring the changes in the bone and the risk factors affecting the bone. In addition, this study designed an intelligent bone health promotion intervention device that can perform bone health promotion service system generated bone. To promote the program, the apparatus can be exercised at various parts of the body to improve the muscle volume, muscle strength and quality of all parts of the body, to achieve the purpose of promoting bone health to promote bone health. The sample tracking study on the effect of.4. exercise on bone health is designed to study the quantitative relationship between exercise intervention and bone health promotion. The effectiveness of the bone health promotion program reasoning scale was selected in this study. In this study, 81 middle-aged and elderly people were selected randomly in the general population. Finally, 81 middle-aged and elderly people were selected for a 6 month combination of aerobic and low intensity exercise. The results were found in old men and women. Exercise has a significant promoting effect on bone health (P0.05). The results confirmed the effectiveness of the proposed bone health promotion scale. At the same time, 106 drug dependent women were selected to conduct bone evaluation and intervention study. First, the bone differences between drug dependent women and healthy women were studied. In the study group and the control group, the bone influence factors were analyzed, and the long-term drug dependence was found to lead to bone loss. Then, this study divided drug dependent women into low bone groups and normal bone groups, measured their bone, body composition data, investigated exercise and diet, and lasted for 7 months for these two groups. It was found that bone in the low bone group improved significantly (P0.05), but the bone in the normal bone group did not improve significantly. This study was the first to conduct bone evaluation and follow up research in the detoxification population. Similar studies were rare both at home and abroad. The study confirmed that exercise intervention could promote low bone female ring. The bone health of the drug users is different, but different groups of people need to adopt a differentiated intervention plan.
【學(xué)位授予單位】：中國(guó)科學(xué)技術(shù)大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2017
【分類號(hào)】：R580

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本文編號(hào)：2006205