社区超重和肥胖居民健康管理及效果评价

The Evaluation of the Effectiveness of the Community-based Health Management among Residents with Overweight and Obesity

目的评价对社区超重和肥胖居民实施健康管理的效果。方法选取于2008年10-12月在北京市朝阳区八里庄和劲松2个社区中参加卫生部"慢性病社区综合干预项目"的居民为研究对象,按照自愿原则分为管理组(n=427)和对照组(n=427)。对管理组实施为期1年的健康管理,于干预前后进行体格检查、生化指标检测,并比较食物达标率以及身体活动量。结果干预前后,管理组体质指数(BMI)、腰围和体重的差异均无统计学意义(P>0.05)。管理组和对照组干预前后BMI、腰围和体重的差值差异有统计学意义(P<0.05)。与干预前比较,干预后管理组收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平降低,差异有统计学意义(P<0.05),而对照组血压、血脂、血糖指标干预前后差异无统计学意义(P>0.05)。与干预前比较,干预后管理组谷类、豆类、食盐和烹调油的摄入达标率上升,差异有统计学意义(P<0.05)。干预前后管理组和对照组身体活动量的差异均无统计学意义(P>0.05)。结论在社区对研究对象实施健康管理是长期、渐进的过程,可以控制体重的增加趋势,减少慢性病发生的危险因素。

Objective To evaluate the effects of the community-based health management on overweight and obesity. Methods 854 residents with overweight and obesity were selected from two communities of Balizhuang and Jinsong district during October to December of 2008 among residents who participated in the ＂Chronic Disease Community Intervention Project＂ funded by the Ministry of Health, and the participants were divided into the management group（n=427） and the control group （n= 427） according to their voluntary, and the management group received health management for one year. Then the physical examination, biochemical index inspection, the food intake compliance rate and physical activities before and after intervention were compared. Results It showed that after intervention, the differences of the BMI, waistline and mean body weight were not significant between two groups（P〉0.05 ）, but the differences of D-values of the indexes above between two groups was significant （P〈0.05）; After intervention, levels of SBP, DBP, LC and LDL-C were decreased in the management group （P〈0.05）, but the levels of blood pressure, blood lipids and blood glucose were not significant compared with those before the intervention （P〉0.05）; Intake compliance rates of grains, beans, salt and cooking oil was significantly increased after the intervention in the management group（P〈0.05）, while the differences of physical activities between two groups before and after intervention were all not significant （P〉0.05）. Conclusions It revealed that community-based health management in residents with overweight and obesity is consecutive and long-time process, and it can control the trend of weight gain and reduce the risk factors of obesity-related chronic disease.