国内社区健康教育对2型糖尿病患者治疗依从性效果的Meta分析

Effect of community health education for treatment compliance of patients with type 2 diabetes in China: a Meta-analysis

目的系统评价国内社区健康教育对2型糖尿病患者治疗依从性的效果。方法计算机检索中国期刊全文数据库(CNKI)、维普数据库(VIP)和万方数据知识平台中所有关于社区健康教育对2型糖尿病患者的随机对照研究(RCT),检索时限为2002年12月～2012年12月。按纳入排除标准由两名筛选员进行独立评价后,采用RevMan 5.1软件进行Meta分析。结果共纳入10个随机对照研究,Meta分析结果显示:与对照组常规治疗比较,经社区健康教育的2型糖尿病患者:饮食控制明显改善[OR=4.60,95%CI(2.89,7.32),P<0.000 01];运动治疗加强[OR=5.54,95%CI(4.17,7.37),P<0.000 01];定时用药率提高[OR=4.39,95%CI(2.22,8.71),P<0.0001];监测血糖率提高[OR=5.12,95%CI(3.70,7.09),P<0.000 01]。结论社区健康教育能够改善2型糖尿病患者治疗依从性,但是缺乏多中心、大样本的随机对照研究,尚需更广泛深入的研究。

Objective To evaluate the effect of community health education for treatment compliance of patients with type 2 diabetes mellitus （T2DM） in China. Methods Such databases as CNKI, VIP and Wangfang were searched from December 2002 to December 2012 for collecting the randomized controlled trials （RCT） involving community health education for the patients with type 2 diabetes. After study selection, assessment and data extraction were conducted by two reviewers independently, and Meta-analyses were performed by the Review Manager 5.1 software （RevMan 5.1）. Results 10 studies were included. The results of Meta-analyses showed that compared with the control group, patients in the community health education group had higher rate of diet control [OR = 4.60, 95%CI （2.89, 7.32）, P 〈 0.000 01], exercise therapy [OR = 5.54, 95%CI （4.17, 7.37）, P 〈 0.000 01], regular medieation [OR = 4.39, 95%CI （2.22, 8.71）,P 〈 0.0001] and regular monitoring of blood glucose [OR = 5.12, 95%CI （3.70, 7.09）, P 〈 0.000 01]. Conclusion Community health education can improve the treatment compliance of patients with type 2 diabetes. However, there is lack of randomized controlled study with large and multicenter sample and it needs further research.