醫(yī)教結合實施運動處方對3~6歲超重及肥胖幼兒的干預效果研究

劉琳 王惠琴

摘? 要：目的? 驗證通過醫(yī)教結合在幼兒園中實施運動處方的干預效果。方法? 選擇來自上海市虹口區(qū)星貝幼兒園，2018年5～9月體檢診斷為單純性肥胖幼兒（輕度肥胖幼兒10例，中重度肥胖幼兒0例）及超重幼兒（20例），分為實驗組幼兒15例和對照組幼兒15例，聘請復旦大學附屬兒科醫(yī)院康復中心醫(yī)師使用Peabody表測評超重、肥胖幼兒，并根據(jù)幼兒體重、身高、心率制定運動處方，帶班教師采用由醫(yī)師及保健教師“量身制定”的運動處方治療方案，期間均按照幼兒園幼兒營養(yǎng)分析合格標準制定菜譜飲食。結果? 1學年后實驗組實超重、輕度肥胖幼兒實驗組BMI指數(shù)好轉(zhuǎn)率明顯高于對照組BMI指數(shù)好轉(zhuǎn)率（P<0.05），1學年后根據(jù)Peabody表評測后制定的治療目標達成值實驗組評分均到達2。而對照組評分均未到達2（P<0.05）。結論? 該研究設計的兒童減肥運動處方科學有效，參與實驗的肥胖兒童在無任何飲食控制情況下獲得了較好的減肥效果。

關鍵詞：運動處方? 超重? 肥胖? 幼兒園

中圖分類號：G4 ? ?文獻標識碼：A 文章編號：1672-3791（2020）06（a）-0197-05

Abstract： Objective? To verify the intervention effect of combining medical education with exercise prescription in kindergartens. Methods：The research objects are from Shanghai Honghou Xingbei kindergarten. From May 2018 to September 2018， children diagnosed with simple obesity （10 cases of mild obese children， 0 cases of moderate to severe obese children） and overweight children （20 cases） were selected as the research objects and these children were divided into 15 children in the experimental group and 15 children in the control group. The study employed physicians from the rehabilitation center of the affiliated pediatric hospital of Fudan University to use the Peabody scale to evaluate overweight and obese children， and to formulate exercise prescriptions according to children's weight， height and heart rate. In addition， the teachers in charge must follow the exercise prescription treatment program tailored by doctors and health care teachers. During the study period， all diets must be formulated in accordance with the kindergarten's qualified standards for child nutrition analysis. Research results：After 1 school year， the BMI improvement rate of overweight and mildly obese children in the experimental group was significantly higher than that in the control group（P< 0.05）.After 1 school year， the scores of the treatment target scores reached according to the Peabody table? evaluation reached 2， while the control group scores did not reach 2 （P<0.05）. Conclusion：The exercise prescription for weight loss for children designed in this study is scientifically effective， and the obese children participating in the experiment also achieved a good weight loss effect without any diet control.

Key Words： Exercise prescription; Overweight; Obesity; Kindergarten

我國超重、肥胖幼兒的流行形勢日益嚴峻，學校、家庭的不重視及兒童自身對超重、肥胖危害知識的缺乏使得超重、肥胖兒童的增勢在大城市已接近甚至超過發(fā)達國家水平[1-2]。預計到2020年，全世界超重肥胖幼兒將增長至9.1%，大約有將近6000萬超重和肥胖兒童[3]。肥胖曾被發(fā)達國家列為兒童成長發(fā)育的影響因素，它能引起危害兒童健康的并發(fā)癥，甚至危及到成年期，據(jù)研究表明，兒童期超重、肥胖相對于非超重肥胖兒童而言，會導致成年后更多慢性疾病，他們可能會較早罹患哮喘[4]、阻塞性睡眠呼吸暫停[5]、

糖尿病[6]、高血壓、心血管[7]等疾病，從而加劇過早死亡和殘疾的風險，甚至在成長發(fā)育期間會影響兒童智力發(fā)展、學習成績下降，產(chǎn)生自卑感等[8-10]，據(jù)研究表明，運動訓練可以有益于血管內(nèi)皮功能、增強肌肉力量、改善體質(zhì)[11-12]。……