行为干预对2型糖尿病患者生命质量心理状况和代谢性指标控制的影响

The effects of behavioral intervention on the life quantity, mental state and metabolic indices control in patients with type 2 diabetes

目的 探讨行为干预对 2型糖尿病患者生命质量、心理状况和病情控制的影响。方法 对2型糖尿病患者按登记顺序随机分为观察组 (A组 )、对照组 (B组 ),进行糖尿病知识问卷、糖尿病生命质量问卷调查和症状自评量表评分,并对其血糖、血脂、体重等代谢指标的控制情况进行比较,两组均给以降糖药物治疗,A组并给予行为干预, 6个月后两组重复上述量表测评及代谢指标检测,最后进行统计学分析。问卷采用自拟糖尿病知识问卷、丁元林修订的糖尿病生命质量量表 (A DQOL)和症状自评量表 (SCL 90)。结果 两组治疗后比较,生命质量问卷总分:A组 100. 3±28. 6、B组 138. 9±10. 7;生命质量满意度:A组 33. 3±8. 4、B组 42. 8±9. 2;影响程度:A组 46. 4±3. 4、B组 57. 2±4. 2;忧郁程度Ⅰ:A组 12. 6±2. 1、B组 18. 8±2. 4;忧郁程度Ⅱ:A组 8. 8±2. 6、B组13. 9±1. 1,均有显著性差异(P<0. 01);A组治疗后症状自评量表中躯体化症状、忧郁、焦虑评分均较治疗前降低显著 (P<0. 05),而B组治疗前后无显著性差异(P>0. 05);两组治疗前后强迫症状均有显著差异 (P<0. 05);空腹血糖、餐后 2h血糖、糖化血红蛋白、血清总胆固醇、甘油三酯、低密度脂蛋白、体重指数等,A组较B组均有显著性改善 (P<0. 01)。结论

Objective To study the effects of behavioral intervention on life quantity, mental state and metabolic indices in patients with type 2 diabetes. Methods 300 patients with type 2 diabetes mellitus were randomly divided into observation group (group A, including 200 cases) and control group (group B, including 100 cases). Both groups were investigated with diabetes life quantity the questionnaire (A-DQOL) and SCL-90, and the body weight, the concentrations of blood sugar, blood lipoids were measured. Both groups were treated normally, besides, group A were given the treatment of behavioral intervention. 6 months later, all the indices above were remeasured and compared.Results After treatments for 6 months, the total score of A-DQOL in group A and group B were 100.3 28.6 vs 138.9±10.7 respectively; the score of the satisfactory degree of life quantity , influence degree, suppressionⅠand suppressionⅡ in group A and group B were 33.3±8.4 vs 42.8±9.2, 46.4± 3.4 vs 57.2±4.2, 12.6±2.1 vs 18.8±2.4,8.8±2.6 vs 13.9±1.1. All the difference between group A and group B is very obvious(P<0.01),The concentrations of blood sugar,blood lipoids and BMI in group A improved more obviously than that in group B (P<0.01). After treatments for 6 months in group A, the score of somatic symptom, suppression and anxiety of SCL-90 decreased significantly than that before treatments (P<0.01).Conclusions The treatment of behavioral intervention on the patients with type 2 diabetes had positive effects, which could improve the life quantity, mental state and metabolic indices of the patients.