改善膳食模式对北京市房山区张坊村中老年超重或肥胖高血压患者血压和人体成分及血脂谱的影响研究

摘要

Objective To improve the dietary patterns of overweight or obese middle ―aged and aged people with hypertension in Zhangfang Village of Fangshan District of Beijing by adding a fixed formula of whole grains, nuts, beans, ginseng,jujube and other food ( referred to as the food powder of anti ― atherosclerosis ), and to observe its effects on the patients'blood pressure,body composition and blood lipid. Methods From 27th June 2015 to 11th October 2015,from the original villagers databases of 245 middle ―aged and aged people(aged between 45 and 75)in Zhangfang Village Fangshan District of Beijing,30 overweight or obese patients with grade one hypertension were selected as the research objects according to the inclusion criteria. The patients were divided into group one and group two by random number table method and each group had 15 cases. Cross―intervention study was made. Group one first entered the intervention stage and used the food powder of anti―atherosclerosis for supplement. At the same time group two entered the control stage and maintained the original dietary pattern. The above stage lasted for six weeks. Then in the following two―week wash―out period,group one recovered the original dietary pattern, but group two kept the original dietary pattern. At the beginning of the ninth week, group two entered the intervention phase,while group one was in the control stage for six weeks. Finally,24 patients(11 patients in group one,13 patients in group two)completed the test. Blood pressure,body composition level,blood lipid profile level,and dietary energy intake level were measured before the test(T0),at the end of the sixth week(T1)and at the end of the fourteenth week(T2) respectively. Results In group one,the systolic pressure at T1 was lower than that at T2,the diastolic pressure at T0 was lower than that at T2(p〈0. 05);in group two,the diastolic pressure at T0 was lower than that at T2(p 〈0. 05);the systolic pressure in group two at T1 was higher than that in group one(p〈0. 05). In group two,WHR and VF at T0 were greater than those at T1,and BF,WHR and VF were less than those at T2(p〈0. 05). The TG level in group two at T2 was lower than that in group one(p〈0. 05). In group one,the intake of protein,dietary fiber(DF),vitamin B1,mono unsaturated fatty acid (MUFA),poly unsaturated fatty acid(PUFA)at T0 was lower than that at T1,and the intake of total energy,protein,DF, vitamin B1 and PUFA at T1 was lower than that at T2,and the intake of vitamin B1 at T0 was greater than that at T2(p 〈0. 05). In group two,the intake of total energy,protein,fat at T0 was greater than that at T1,and the intake of total energy, protein,fat,DF,Zn,PUFA was less than that at T2,and the intake of DF and PUFA was lower than that at T2(p〈0. 05);the intake of total energy,carbohydrate,protein,fat,DF,Se,Zn,vitamin B1 ,MUFA and PUFA in group two at T1 was less than that in group one(p〈0. 05);the intake of PUFA in group two at T2 was greater than that in group one(p〈0. 05). Conclusion For overweight or obese middle―aged and aged patients with grade one hypertension after supplementation of food powder of anti―atherosclerosis,the dietary pattern is improved when the intake of energy properly increases. It can improve the body composition,lower the level of TG and has the tendency to decrease the blood pressure. When the intake of energy increases significantly,the dietary structure cannot be improved,and this means the body composition will not be improved,the level of TG will not be lowered and blood pressure will significantly increase.%目的：通过补充固定配方的全谷类、坚果类、豆类、西洋参、大枣等食物（简称抗动脉粥样硬化食疗粉），改善北京市房山区张坊村超重或肥胖高血压患者的膳食模式，观察其对患者血压、人体成分、血脂谱的影响。方法2015―06―27至2015―10―11，从北京市房山区张坊村245例中老年（45~75岁）村民数据库中，选取符合纳入标准的超重或肥胖的1级高血压患者30例作为研究对象，采用随机数字表法将患者分为一组和二组，各15例。进行交叉干预研究，一组先进入干预阶段（补充抗动脉粥样硬化食疗粉），二组为对照阶段（保持原膳食模式），共6周；之后为2周的洗脱期，一组恢复原膳食模式，二组仍保持原膳食模式；第9周开始二组进入干预阶段，一组为对照阶段，共6周。最终有24例患者（一组11例，二组13例）完成试验。分别于试验前（ T0）、6周末（ T1）及14周末（ T2）测量患者血压、人体成分、血脂谱、膳食能量摄入量。结果一组T1时收缩压低于T2时， T0时舒张压低于T2时（p〈0.05）；二组T0时舒张压低于T2时（p〈0.05）；T1时，二组收缩压高于一组（p〈0.05）。二组T0时腰臀比（WHR）、内脏脂肪（VF）大于T1时，T1时体脂肪（BF）、WHR、VF小于T2时（p〈0.05）。二组T2时三酰甘油（TG）水平低于一组（p〈0.05）。一组T0时蛋白质、膳食纤维、维生素B1、单不饱和脂肪酸、多不饱和脂肪酸摄入量小于T1时，T1时总能量、蛋白质、膳食纤维、维生素B1、多不饱和脂肪酸摄入量大于T2时，T0时维生素B1摄入量大于T2时（p〈0.05）；二组T0时总能量、蛋白质、脂肪摄入量大于T1时，T1时总能量、蛋白质、脂肪、膳食纤维、锌、多不饱和脂肪酸摄入量小于T2时，T0时膳食纤维、多不饱和脂肪酸摄入量小于T2时（p〈0.05）；T1时，二组总能量、碳水化合物、蛋白质、脂肪、膳食纤维、硒、锌、维生素B1、单不饱和脂肪酸、多不饱和脂肪酸摄入量小于一组（p〈0.05）；T2时，二组多不饱和脂肪酸摄入量大于一组（p〈0.05）。结论对中老年超重或肥胖1级高血压患者，补充抗动脉粥样硬化食疗粉后，当总能量摄入量适度增加时，膳食模式得以改善，进而可以改善人体成分，降低TG水平，有降低血压的趋势；但当总能量摄入量显著增加时，膳食模式未能改善，不能改善人体成分、降低TG水平，且血压显著升高。