乐维棒营养替餐在超重和肥胖患者综合健康管理中的作用

Effect of Lifeway bar meal replacement on integrated health management in patients with overweight and obesity

目的观察综合健康管理对超重和肥胖成人减重效果和对慢性代谢性疾病控制的影响及乐维棒替餐在管理中的作用。方法 160名超重和肥胖的成人随机平均分为乐维棒替餐组和对照组,均采用饮食运动心理结合的综合健康管理6个月,乐维棒替餐组每日使用一次乐维棒替餐。记录管理前后每个月高血压、糖尿病未达标人数、脂肪肝人数以及管理前及管理后2个月和6个月的体重指数、体脂百分数、腰臀脂肪比、甘油三酯、总胆固醇、高密度脂蛋白胆固醇指标的变化。结果两组高血压未达标率在第4个月时明显低于管理前,差异均有统计学意义（χ^2分别=5.78、7.11,P均〈0.05）。乐维棒替餐组的糖尿病未达标率第2个月时低于管理前,对照组糖尿病未达标率第4个月时低于管理前,差异均有统计学意义（χ^2分别=12.38、4.05,P均〈0.05）。乐维棒替餐组脂肪肝人数在第6个月时低于管理前,差异有统计学意义（χ^2=3.66,P〈0.05）。乐维棒替餐组的糖尿病未达标率与对照组比较下降更明显,两组间COX曲线差异有统计学意义（χ^2=4.35,P〈0.05）。两组管理前后体重指数、腰臀脂肪比、体脂百分数、甘油三酯、总胆固醇和高密度脂蛋白均明显好转,两组间比较差异无统计学意义（t分别=0.26、0.80、1.94、0.34、1.96、1.71,P均〉0.05）。乐维棒替餐组管理后2个月各项指标均较管理前明显好转,差异均有统计学意义（t分别=7.62、6.99、6.18、3.68、5.80、-6.39,P均〈0.05）,管理后6个月与2个月比较差异也有统计学意义（t分别=8.69、14.24、10.75、4.30、7.45、-5.88,P均〈0.05）。对照组管理后2个月体重指数、腰臀脂肪比、甘油三酯、总胆固醇差异均有统计学意义（t分别=4.01、2.27、3.53、2.19,P均〈0.05）,管理后6个月与2个月比较各项指标差异均有统计学意义（t分别=10.60、18.06、2.48、2.48、3.89、-3.71,P均〈0.05）。结论强化综合健康管理对超重和肥胖的成人减轻体重,控制代谢综合征均有明显的效果,加用乐维棒替餐能更快控制超重和肥胖病人中糖尿病病人的血糖水平。

Objective To observe the effects of integrated health management on losing weight of the overweight and obesity adults and controlling of chronic metabolic disease. Methods One hundred and sixty cases with overweight and obesity were randomly divided into lifeway group and control group. Both groups were received integrated health management with diet,exercise and psychology for 6 months. Lifeway group was received one lifeway bar meal replacement per day on the basis of conventional treatment. The numbers with hypertension and diabetes who did not reach the target and fatty livers were recorded before integrated health management and at every month after integrated health management.The body mass index（BMI）,waist hip rate（WHR）, body fat percentage, triglyceride, total cholesterol and high-density lipoprotein cholesterol（HDL-C）were assessed 2 and 6 month after integrated health management were also recorded and compared. Results The numbers of hypertension who did not reach the target in both groups were significantly decreased at 4 months after integrated health management（χ2=5.78, 7.11, P〈0.05）. The numbers of diabetes who did not reach the target in lifeway group and control group were significantly decreased at 2 months and 4 months after health management respectively（χ^2=12.38, 4.05, P〈0.05）. In lifeway group, the numbers of fatty liver were significantly decreased at 6 months after health management（χ^2=3.66,P〈0.05）. With integrated health management, the numbers of diabetes who did not reach the target and the numbers of fatty liver in lifeway groups were gradually decreased.The difference were statistically significant when compared with control group（χ^2=4.35, P〈0.05）. The levels of BMI,WHR, body fat percentage, triglyceride, total cholesterol and HDL-C in both groups were significant improved after the health man agement. There were no significant difference between the two groups（t =0.26,0.80,1.94,0.34,1.96,1.71,P〉0.05）. In lifeway group, there were significant difference in BMI, WHR, body fat percentage, triglyceride,total cholesterol and HDL-C between 2 months after health management and before management（t=7.62, 6.99, 6.18, 3.68,5.80,-6.39, P〈0.05） as well as compared with 6 months after health management（t=8.69, 14.24, 10.75, 4.30, 7.45,-5.88,P〈0.05）. In control group, there were significant difference in BMI, WHR, triglyceride and total cholesterol between 2months after health management and before management（t=4.01, 2.27, 3.53, 2.19, P〈0.05）. The BMI,WHR, body fat percentage, triglyceride, total cholesterol and HDL-C between 2 months and 6 months after health management were significantly different（t =10.60,18.06,2.48,2.48,3.89,-3.71,P〈0.05）. Conclusion Integrated health management has obvious effect on losing weight and controlling of the metabolic syndrome in patients with overweight and obesity. Lifeway bar meal replacement is more efficacious in controlling blood glucose level in diabetic patients.