健康教育与乳清蛋白联合抗阻运动干预中老年肌少症的效果研究

Effect of health education and whey protein supplementation combined with resistance exercise on the intervention of middle-aged and elderly people with sarcopenia

目的比较健康教育、健康教育+乳清蛋白补充、健康教育+乳清蛋白补充+抗阻运动3种方法对中老年肌少症人群的干预效果。方法前瞻性选取2018年3~10月在南京大学医学院附属盐城第一医院体检及就诊的骨骼肌指数(SMI)低标准的中老年人60例,使用SPSS 22.0统计软件进行区组随机化分为3组,分别为健康教育组(E组)、健康教育+乳清蛋白补充组(N组)、健康教育+乳清蛋白补充+抗阻运动组(NS组),每组各20例。进行12周的干预,并采集3组研究对象的肌肉、生化和膳食相关数据。结果与干预前比较,干预12周后NS组和N组SMI显著增加,NS组和E组握力有显著增加,NS组、N组和E组的步速均有显著增加,差异均有统计学意义(P <0.05),E组干预前后SMI、N组干预前后握力差异均无统计学意义(P> 0.05)。组间差异结果显示:NS组SMI变化率相较于E组、N组增加显著(P <0.05),而N组与E组之间差异无统计学意义(P> 0.05)。3组间握力和步速的变化量的差异无统计学意义(P> 0.05);3组间生化参数、膳食参数的差异均无统计学意义(P> 0.05)。结论健康教育、乳清蛋白补充及抗阻运动均可改善肌肉丢失严重人群的状况,其中健康教育+乳清蛋白补充+抗阻运动SMI变化率显著高于健康教育+乳清蛋白补充和单纯的健康教育,能更有效地改善中老年肌少症人群的肌肉含量、肌力和肌肉功能。

Objective To compare the intervention effects of three methods: health education,health education + whey protein supplementation,health education + whey protein supplementation + resistance exercise on middle-aged and elderly people with sarcopenia. Methods Sixty middle-aged and elderly patients with low skeletal muscle index( SMI) standards in the physical examination and treatment at the First People’s Hospital of Yancheng,Affiliated Hospital of Nanjing University Medical Schooll were prospectively selected from March to October 2018,and randomly divided into three groups by SPSS 22. 0,20 in each group. Health education( E),health education + whey protein( WP) supplementation( N) and health education + WP supplementation + resistance exercise( NS) were respectively adopted by the three groups with 12 weeks of intervention. Muscle,biochemical and dietary data of all the subjects were collected. Results Compared with before the intervention,after 12 weeks of intervention,the SMI of the NS group and the N group increased significantly,the grip strength of the NS group and the E group increased significantly,and the gait speed of the NS group,the N group and the E group increased significantly,and the differences were statistically significant( P < 0. 05);there was no significant difference in the comparison of SMI before and after intervention in group E and the comparison of grip strength before and after intervention in group N( P > 0. 05). The results of difference among groups showed that the change rate of SMI in the NS group increased significantly compared to the E group and the N group( P < 0. 05),while there was no statistical significance between N group and E group( P > 0. 05). There was no significant difference in the change of grip strength and walking speed among the three groups( P >0. 05). There was no significant difference in biochemical parameters and dietary parameters among the three groups( P > 0. 05). Conclusion Health education + WP supplementation + resistance exercise intervention can effectively improve muscle content,muscle strength and muscle function in middle-aged and elderly people with severe muscle loss.