全科团队对社区老年慢性便秘综合干预的疗效评价

Comprehensive Intervention by GP Team in Elderly Chronic Constipation in Communities

目的探讨全科团队对社区老年居民慢性便秘的综合干预治疗作用。方法选择2010年1—10月在上海市金山区山阳镇社区卫生服务中心门诊就诊的老年慢性便秘患者116例,按序号单、双号将便秘患者分成干预组58例和对照组58例。对照组实施患者自主就诊给予泻药治疗的模式管理半年。干预组由全科团队分析病因,结合患者的特点,进行心理、饮食、运动及药物指导、中医针灸等健康教育和干预措施,1次/月上门治疗和随访,为期半年的电话或上门随访强化管理。结果两组患者治疗后疗效比较,差异有统计学意义(P<0.05)。两组患者治疗后3个月第1周和治疗后6个月第1周的排便次数均较治疗前增多、大便性状评分和排便困难程度评分均较治疗前降低,差异均有统计学意义(P<0.05);干预组治疗后3个月第1周和治疗后6个月第1周的排便次数均较对照组增多、大便性状评分和排便困难程度评分均较对照组降低,差异均有统计学意义(P<0.05)。结论全科团队通过对社区老年慢性便秘患者的综合干预,对防治功能性便秘起到不同程度的改善效果。

Objective To explore the effect of comprehensive intervention on elderly chronic constipation （CC） in communities. Methods A total of 116 elderly CC patients were divided, based on odd or even numbers, into groups interven- tion and control, 58 in each. Control group were given a half- year management model ＂ going to doctors by themselves and ca- thartic treatment＂, intervention group given, based on patients＇ characteristics, health education and intervention such as psy- chological, diet, exercise and drug guidance, and TCM acupuncture, visiting treatment and follow -up （1 time/month）, and a strengthened management of telephone follow - ups. Results After treatment, the CC symptom improved significantly in 2 groups （P 〈 0. 05）. Bowel movement was significantly improved, scoring of stool consistence and difficult defecation were sig- nificantly decreased after months 3, 6 of treatment in two groups （P 〈 0. 05 ）. Intervention group were more frequent in bowel movement than control group （P 〈0.05）. However, scoring of stool consistence and difficult defecation decreased significantly in intervention group as compared with control group （P 〈 0. 05）. Conclusion GP team can improve elderly functional C C by comprehensive intervention.