自我管理教育在门诊胃食管反流性哮喘患者中的应用

Application of self-management program on outpatient swith gastroesophageal reflux asthma

目的：探讨门诊自我管理教育在胃食管反流性哮喘患者自我管理中的应用效果。方法便利抽取呼吸科门诊的胃食管反流性哮喘患者71例为研究对象，按就诊单双号分为观察组35例和对照组36例，对照组给予常规药物治疗和门诊指导，观察组在药物治疗的基础上给予系统性门诊自我管理教育，总管理时间为6个月。比较教育前后两组患者的胃食管反流症状、哮喘控制水平、肺通气功能改善程度。结果干预后，观察组患者胃食管反流症状评分为（5．1±1．2）分，低于对照组评分（6．8±1.6）分，两组比较差异有统计学意义（t＝5．07，P＜0．01）；观察组哮喘控制自评得分为（23．5±0．6）分，高于对照组自评得分（22．7±0．9）分，两组比较差异有统计学意义（ t＝4．41，P＜0．01）；观察组在肺通气功能指标方面1秒用力肺活量占预计百分比（ FEV1％）为（87．4±3．9）％、1秒率（ FEV1/FVC％）为（86.7±3．1）％、峰流速（PEF）为（8．8±1．8）L/s，分别高于对照组的（83．4±4．6）％，（84．3±4．2）％，（7．7±1.2）L/s，两组比较差异有统计学意义（t值分别为3．96，2．74，3．05；P＜0．01）。结论门诊自我管理教育能提高胃食管反流性哮喘患者的自我管理水平，可缓解患者的临床症状，提高患者的肺功能。

Objective To evaluate the effect of self-management education on gastroesophageal reflux asthma .Methods 71 gastroesophageal reflux asthma patients were divided into two groups , the management group （n=35） and the control group （n=36）.The control group received routine drug therapy and routine outpatient guidance, while the management group was given routine drug treatment and systematic outpatient self -management education.The self-management lasted for 6 months.The symptoms of gastroesophageal reflux , control level of asthma and the pulmonary ventilation function were compared between the two groups .Results After the intervention, the score of symptoms of gastroesophageal reflux in the management group was （5.1 ±1.2）, which was significantly lower than （6.8 ±1.6） in the control group （t=5.07,P〈0.01）.The score of asthma control in the management group was （23.5 ±0.6）, which was significantly lower than （22.7 ±0.9） in the control group （t=4.41,P〈0.01）.On the aspects of pulmonary ventilation function , the 1 second forced vital capacity of the expected percentage , the 1 second forced expiratory rate and peek expiratory flow rate were （87.4 ± 3.9）%,（86.7 ±3.1）%and （8.8 ±1.8） L/s in the management group , which were significantly higher than （83.4 ±4.6）%,（84.3 ±4.2）% and （7.7 ±1.2） L/s in the control group （t =3.96,2.74,3.05, respectively;P〈0.01）.Conclusions The systematic outpatient self-management education can improve the ability of self care , decrease patients＇symptoms and improve patients pulmonary ventilation function .