本文選題：民族 + 絕經后女性��； 參考：《寧夏醫(yī)科大學》2017年碩士論文

【摘要】：目的本研究通過收集銀川地區(qū)回、漢族絕經后女性的一般資料、飲食、運動、臨床癥狀及骨密度等數(shù)據(jù),根據(jù)民族、診斷進行分組比較,探究回、漢族各類因素對骨密度的影響特點,分析并比較回、漢族的中醫(yī)證候類型及其骨量水平,為寧夏地區(qū)絕經后骨質疏松癥的研究、預防和治療提供前期依據(jù)。方法根據(jù)本研究的納入、排除標準,收集2015年10月至2017年1月在寧夏醫(yī)科大學總醫(yī)院健康體檢中心及骨密度室進行骨密度(BMD)檢測的回族與漢族絕經后女性共240名,其中,漢族骨量正常者60名,漢族骨質疏松者60名,回族骨量正常者60名,回族骨質疏松者60名。以MEDIX90 X線雙能骨密度儀測定骨密度T值進行診斷分組,身高、體重采用SK-CK超聲波體檢機進行測量。由1名研究生進行身高、體重測量并對研究內容進行調查登記,包括民族、常居地、既往史、年齡、絕經年齡、飲食情況、戶外運動等;由2名中醫(yī)醫(yī)師(具有10年診療經驗者)對受試者進行中醫(yī)四診,根據(jù)臨床癥狀及舌脈進行中醫(yī)證候診斷,包括腎陽虛證、肝腎陰虛證、脾腎陽虛證、瘀血阻絡證4種類型。以SPSS 22.0軟件進行統(tǒng)計分析,率的比較采用χ2檢驗,計量資料采用獨立樣本t檢驗、單因素方差分析,以偏態(tài)相關及多因素非條件logistic回歸分析研究因素對BMD的影響程度。結果1.骨密度與影響因素回族與漢族絕經后女性的年齡、絕經年齡、絕經年長及BMD無統(tǒng)計學意義(P0.05);不同診斷組的年齡、絕經時長有統(tǒng)計學意義(P0.05),BMD與年齡、絕經年長的變化趨勢,回、漢族絕經后女性BMD均在51歲后明顯下降,漢族下降水平較回族明顯(P0.05)。不同民族、不同診斷組內戶外活動者頻數(shù)差異無統(tǒng)計學意義(χ2=3.270,p0.05),按運動周時、運動年長對運動進行分級后比較顯示,bmd與運動周時的長短無關(p0.05),漢族絕經后女性運動1年至5年者可提高骨密度水平(p0.05),回族無此趨勢(p0.05)。身高、體重、bmi在回族與漢族之間無統(tǒng)計學意義(p0.05),在不同診斷組間有統(tǒng)計學意義(p0.01),偏態(tài)相關分析顯示,不論整體身高、體重、bmi還是回、漢族各族的變量均與骨密度呈顯著正相關(p0.01)。根據(jù)bmi進行肥胖診斷,回、漢族肥胖者的檢出率無統(tǒng)計學意義(χ2=3.107,p0.05),骨量正常組中超重者(偏胖+肥胖)較多,回族偏瘦者較漢族bmd水平偏高。整體而言,受試者主要以素食、葷素均衡飲食為主,而葷食者較少,不同民族飲食類型無統(tǒng)計學意義(χ2=0.272,p0.05),不同飲食類型中骨質疏松者的檢出率也無統(tǒng)計學意義(χ2=3.785,p0.05)。bmd與飲食類型在民族間的表現(xiàn)為:漢族:素食者葷素均衡者葷食者,回族:素食者葷食者葷素均衡者,但無統(tǒng)計學意義(p0.05)。鈣劑、枸杞、八寶茶的食用人數(shù)在不同民族、不同診斷組內均無統(tǒng)計學意義(p0.05),并且與bmd無關(p0.05)。將患病與否作為因變量,民族、年齡、絕經年齡、絕經年長、戶外運動、身高、體重、飲食類型、是否食用鈣劑、枸杞、八寶茶作為自變量進行多因素非條件logistic回歸分析顯示,絕經年長增加是骨質疏松癥的危險因素,戶外運動與體重增加是op的保護因素。2.骨密度與中醫(yī)證候分型在240名受試者中,中醫(yī)證候分布特點表現(xiàn)為:腎陽虛證(52%)脾腎陽虛證(22%)肝腎陰虛證(16%)瘀血阻絡證(10%)�；�、漢族絕經后女性中醫(yī)證候分型無統(tǒng)計學意義(χ2=6.487,p=0.1660.05),在不同骨量水平組中無統(tǒng)計學意義(χ2=3.666,p=0.4530.05)。在整體數(shù)據(jù)中,肝腎陰虛證的骨密度水平較脾腎陽虛證者偏高(p0.05),在漢族中,除肝腎陰虛證與瘀血阻絡證的bmd差異有統(tǒng)計學意義(p0.05)外,其他各組均無意義;回族各類證型的受試者骨密度均無統(tǒng)計學意義(p0.05)。結論1.銀川地區(qū)漢族較回族絕經后女性的骨密度下降趨勢明顯,且體重、bmi與bmd的相關性高于回族,絕經年長是銀川地區(qū)絕經后女性骨質疏松癥的危險因素,而戶外運動、體重則是該疾病的保護因素,民族之間無差異。2.銀川地區(qū)回、漢族絕經后女性的飲食、運動無顯著區(qū)別,漢族可因運動年長對骨密度產生影響。3.銀川地區(qū)絕經后女性不同民族及骨量水平的中醫(yī)證候表現(xiàn)均以腎陽虛證為主;漢族表現(xiàn)肝腎陰虛證的受試者骨密度較其他證型偏高;隨著絕經年長的增加,除腎陽虛證,回族絕經后女性的其他證候類型表現(xiàn)較為分散,漢族表現(xiàn)較為集中。
[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.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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