健康教育与生活方式干预在骨质疏松阿仑膦酸钠治疗中的作用

目的探讨健康教育和生活方式干预在临床骨质疏松患者阿仑膦酸钠治疗中的作用。方法120例绝经后骨质疏松妇女经知情同意为观察对象，随机分为两组，阿仑膦酸钠治疗＋健康管理组（A组）和阿仑膦酸钠治疗组（B组），每组60例。为期1年的随机对照研究，A组干预内容包括阿仑膦酸钠70mg，每周1次，每季度进行1次的健康知识讲座、健康问题咨询和健康教育资料发放，内容主要为健康知识知晓率、健康信念持有率、健康行为形成率（健康知信行）指导，以及骨质疏松治疗中的注意事项；生活方式调整包括平衡饮食，日晒（每天30min-2h，每周8h以上），有氧运动（每天30min～1h，每周3～5次），每天补充元素钙600mg和维生素D125IU。B组为单纯阿仑膦酸钠治疗，70mg，每周1次，每天补充元素钙600mg和维生素D125IU，饮食、运动及生活方式无特殊要求。监测分别于研究时和12个月时测量腰椎和髋部骨密度，以及患者依从性的随访情况比较。结果干预1年后A组5l例，B组38例得到随访，A组患者治疗依从性显著高于B组。骨量变化：两组患者腰椎和髋部骨量与研究干预前自身比较均明显增加，差异均有统计学意义，组间比较差异未见统计学意义。但骨密度变化值比较中发现腰椎（0．042±0．067／0．026±0．070，P=0．029）和髋部Words区（0．029±0．129／0．023±0．143，P=0．041）差异有统计学意义。结论骨质疏松阿仑膦酸钠治疗，健康管理在保持临床治疗有效性的同时，明显提高骨质疏松患者治疗的依从性，是临床骨质疏松长期治疗疗效得以保证的重要手段。

The effects of health education and comprehensive lifestyle modification on postmenopausal osteoporosis women treatment with alendronate sodium

Objective To evaluate the effects of an intervention programme of health education and life style modification on postmenopausal osteoporosis women. Methods A total of 120 postmenopausal osteoporosis women were enrolled in this one-year randomized controlled follow-up study and assigned to the intervention group （ Group A, n = 60 ） or the control group （ Group B, n = 60 ）. Both groups were treated with alendronate sodium. In Group A, education program was performed once a season in the form of face-to-face consultation or group session. In Group B, no additional intervention was used. The primary outcome was patients＇ compliance in follow-up. The secondary outcomes were change in bone mineral density （ BMD ）. BMD was measured by dual-X-ray absorptiometry （DXA） on lumbar spine and hip at baseline and 12 months after the intervention. Results After one-year intervention,51 subjects in Group A and 38 in Group B completed the follow-up. Groups A showed better compliance. BMD on lumbar spine and hip was significantly increased in both groups when compared with baseline. The changes of BMD on lumbar （0. 042 ± 0. 067 vs 0. 026 ± 0. 070, P = 0. 029 ） or Words region （ 0. 029 ±0. 129 vs 0. 023 ± 0. 143, P = 0. 041） showed statistical significance between the two groups. Conclusion For alendronate sodium treatment, health management ensures the effectiveness of the therapy and improves the compliance of the patients.