电容电阻式靶向疗法结合β-羟基β-甲基丁酸盐营养补充剂对老年肌少性肥胖患者的疗效观察

王任杰; 梁玉祥; 王丽琼; 杨茗; 蒋佼佼

doi:10.12182/20250760601

电容电阻式靶向疗法结合β-羟基β-甲基丁酸盐营养补充剂对老年肌少性肥胖患者的疗效观察

Efficacy of Transfer Energy Capacitive and Resistive Therapy Combined With β-Hydroxy-β-Methylbutyrate Nutritional Supplementation in Older Adults With Sarcopenic Obesity

摘要

摘要:
目的探讨电容电阻式靶向疗法（Transcutaneous Capacitive and Resistive Electric Transfer, TECAR）联合β-羟基β-甲基丁酸盐（β-hydroxy-β-methylbutyrate, HMB）营养补充对老年肌少性肥胖（sarcopenic obesity, SO）患者的综合干预效果。
方法采用随机对照试验设计，纳入140例符合亚洲肌少性肥胖诊断标准的老年患者，随机分为四组：A组（双安慰组）、B组（TECAR+安慰剂）、C组（假TECAR+HMB）、D组（TECAR+HMB），每组35例。干预周期为12周，主要结局指标为简易体能状况量表（SPPB）总分，次要指标包括改良的Barthel指数（modified Barthel index, MBI）、微型营养评估简表（MNA-SF）评分、握力、体质量及体质量指数（BMI）。采用双因素方差分析评估TECAR与HMB的交互效应。
结果干预后，D组（TECAR+HMB）各项指标较干预前差异均有统计学意义：SPPB总分从（6.29±1.34）分提高至（8.06±1.51）分（P<0.001），其中步行速度〔（2.71±0.86）分 vs. （1.97±0.82）分〕、椅子站立测试〔（2.60±0.55）分 vs. （2.11±0.47）分〕和平衡能力〔（2.74±0.74）分 vs.（2.20±0.76）分〕三个子项均有明显提高；MBI从（71.74±14.41）提高至（79.91±10.52）（P<0.001）；握力从（13.65±5.05） kg提升至（15.72±4.89） kg（P=0.001）；体质量从（81.78±9.02） kg 下降至（76.95±9.89） kg（P<0.001），BMI从（30.14±1.68） kg/m² 下降至（28.34±2.33） kg/m²（P<0.001）。交互效应分析显示，TECAR和HMB在改善SPPB总分（F=16.374，P<0.001, η²=0.107）、降低BMI（F=14.328，P<0.001, η²=0.095）等方面具有显著协同作用。
结论 TECAR联合HMB能显著改善老年肌少性肥胖患者的躯体功能、生活能力和BMI，且两者具有协同增效作用。

Abstract:
Objective To investigate the comprehensive intervention effects of transfer energy capacitive and resistive (TECAR) therapy combined with β-hydroxy-β-methylbutyrate (HMB) nutritional supplementation in older patients with sarcopenic obesity (SO).
Methods We conducted a randomized controlled trial, enrolling 140 older patients who met the Asian diagnostic criteria for SO. Participants were randomly assigned to 4 groups, including a double-placebo group (Group A), TECAR + placebo group (Group B), sham TECAR + HMB group (Group C), and TECAR + HMB group (Group D), with 35 patients in each group. The intervention lasted 12 weeks. The primary outcome measure was the total score of the Short Physical Performance Battery (SPPB). Secondary outcome indicators included the modified Barthel Index (MBI), scores of the Mini Nutritional Assessment–Short Form (MNA-SF), handgrip strength, body mass, and body mass index (BMI). A two-way analysis of variance (ANOVA) was used to assess the interaction effects between TECAR and HMB.
Results After the intervention, Group D (TECAR + HMB) demonstrated significant improvements across all metrics. The SPPB total score increased from 6.29 ± 1.34 to 8.06 ± 1.51 (P < 0.001), with notable enhancements in walking speed (2.71 ± 0.86 vs. 1.97 ± 0.82), chair stand (2.60 ± 0.55 vs. 2.11 ± 0.47), and balance (2.74 ± 0.74 vs. 2.20 ± 0.76). MBI improved from 71.74 ± 14.41 to 79.91 ± 10.52 (P < 0.001). Handgrip strength increased from (13.65 ± 5.05) kg to (15.72 ± 4.89) kg (P = 0.001). Body mass decreased from (81.78 ± 9.02) kg to (76.95 ± 9.89) kg (P < 0.001), and BMI reduced from (30.14 ± 1.68) kg/m² to (28.34 ± 2.33) kg/m²(P < 0.001). Interaction analysis revealed significant synergistic effects between TECAR and HMB in improving the SPPB total scores (F = 16.374, P < 0.001, η² = 0.107) and reducing BMI (F = 14.328, P < 0.001, η² = 0.095).
Conclusion TECAR therapy combined with HMB supplementation significantly enhances physical function, activities of daily living, and body composition in elderly patients with sarcopenic obesity, demonstrating a synergistic effect.

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