“三位一体”支气管哮喘教育管理模式对支气管哮喘患者病情控制水平的影响

Impact of “three-in-one” asthma education and management model on asthma control in adult patients

目的评价“三位一体”支气管哮喘教育管理模式对支气管哮喘患者病情控制水平的影响。方法由经过培训的北京市6所大型教学医院的呼吸科医生，以面对面的方式连续不加选择地问卷调查各自医院门诊成年支气管哮喘患者病情控制水平，比较以“三位一体”（哮喘专病门诊、哮喘宣教中心、哮喘患者协会）模式系统教育管理的支气管哮喘患者（教育组）与未进行“三位一体”系统教育管理的支气管哮喘患者（对照组）的问卷调查结果。结果教育组患者100例，对照组患者427例。教育组支气管哮喘控制测试（ACT）评分达20分以上的占85％，显著高于对照组的37％（χ^2=74、345，P〈0．01）；过去1年中教育组因支气管哮喘加重住院、急诊就诊、误工的分别占4％、18％、20％（10／49），显著低于对照组的23％、32％、55％（76／137）（χ^2值分别为19．431、7．515、17．853，P值均小于0．01）。结论“三位一体”支气管哮喘教育管理模式可显著提高患者的病情控制水平。

Objective To evaluate the impact of the asthma education and management model developed by Peking University People＇s Hospital on the level of asthma control Methods Trained respiratory physicians from 6 large teaching hospitals in the urban districts of Beijing conducted a successive questionnaire survey in the form of face-to-face interviews with adult asthma patients attending their respective clinics. The results were used to compare the levels of asthma control between patients who were administered ＂three-in-one＂ asthma education and management （education group） and those who were not （ control group）. Results Among the 100 patients in the education group, 85% showed asthma control test （ACT） values ≥20 points. This was significantly higher than that in the 427 control group patients （37%, χ^2= 74. 345 ,P 〈 0. 01 ）. During the past 1 year, the rate of hospitalization due to exacerbation of asthma, number of emergency treatments, and missed working days were significantly lower in the education group than in the control group （4%, 18%, 20% vs 23%, 32%, 55%, respectively; χ^2 = 19.431,7.515 and 17.853 respectively; and P 〈 0.01 for all）. Conclusion The ＂ three-in-one＂ asthma education and management model can significantly improve asthma control.