长期系统性强化教育干预对糖尿病并发症的影响

Effects of long term health education on diabetic complications

目的研究长期系统性强化教育干预对糖尿病并发症的影响。方法采用前瞻性研究方法，强化教育干预组（干预组）、对照组各130例。对照组实施常规糖尿病治疗和糖尿病基本知识教育，干预组除接受与对照组相同的措施外，对糖尿病患者及家属进行系统性、个体化、一对一的指导与行为干预，试验前和试验后5年收集相关资料，以评价代谢变化及各种并发症的发生情况。结果糖尿病教育干预5年后，干预组代谢指标控制均较对照组好，干预组的体重指数（BMI）、空腹血糖（FBG）、餐后2h血糖（2hPBG）、糖化血红蛋白（Hb）A1C、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白-胆固醇（LDL—C）均低于对照组（P〈0．05）；高血压、糖尿病视网膜病变、糖尿病肾病、糖尿病神经病变、糖尿病性脑梗死、糖尿病性心脏病、糖尿病足病的发生率均低于对照组，差异有统计学意义（P〈0．05）；干预组的发生率分别为3．7％，3．9％，8．8％，8．8％，1．96％，1．96％，0．1％；对照组的发生率分别为33％，15．1％，23％，28％，9％，9％，9％。结论对糖尿病患者进行长期系统性、个体化、一对一的全方位教育干预能全面持久的改善糖、脂代谢，减少或延缓各种并发症的发生和发展。

Objective To study the effect of long term health education on diabetic complications. Methods In this prospective study, 260 patients with diabetes were recruited. All the patients were divided into intensive health education group （intervention group,n = 130） and control group （n = 130）. Patients in both group were given routine treatment of diabetes and health education, while patients and their family members in intervention group were given systemic, individual, one-on-one instruction and behavior inter- vention. At the beginning and five years after the study, collected related data to evaluate the metabolic changes and the development of diabetic complications. Results Five years after the intervention, body mass index（BMI）, fast blood glucose （FBG）, postprandial 2 h blood glucose （2 hPBG）, hemoglobulin Alc （ HhA1 c） , total cholesterol （ TC ）, triglyeeride （ TG ） and low density lipoprotein-eholesterol （ LDL-C ） in the intervention group were lower than the corresponding index in the control group（P 〈 0.05 ）. Compared with the control group, the incidence of hypertension, diabetic retinopathy, diabetic nephropathy, diabetic neu- ropathy, diabetic cerebral infarction, diabetic heart disease and diabetic foot in the intervention group were 3.7 % , 3.9 % , 8.8 % , 8.8 % , 1.96%, 1.96 % ,0.1% , while the incidence of the complications in the control group were 33%, 15.1% ,23% ,28% ,9% ,9% ,9% , the difference had statistically significant（ P 〈 0.05 ）. Conclusions The long term systemic and individual health education can improve glucose and lipid metabo- lism. It also can reduce or delay the occurrence and development of diabetic complications.