延续护理对我国糖尿病患者干预效果的Meta分析

Effect of transitional care intervention on diabetes:a Meta-analysis

目的综合评价对我国糖尿病患者实施延续护理的干预效果。方法遵循Cochrane干预评价手册,严格制定文献检索策略,收集2000~2014年在中国生物医学数据库、万方、知网、维普数据库公开发表的关于糖尿病延续护理的随机对照试验。依据纳入和排除标准筛选文献,应用RevMan5.0软件对数据进行Meta分析。结果 8篇文献符合纳入标准,Meta分析显示干预6个月后,干预组与对照组在并发症低血糖发生率[RR=0.69,95%CI（0.21,2.27）,P=0.540]差异无统计学意义,在空腹血糖[WMD=-1.54,95%CI（-2.89,-0.19）,P=0.030]差异有统计学意义。干预12个月后,干预组与对照组在并发症低血糖发生率[RR=0.34,95%CI（0.16,0.72）,P=0.005],在空腹血糖[WMD=-1.03,95%CI（-2.78,0.72）,P=0.250],在糖化血红蛋白[WMD=-1.73,95%CI（-2.43,-1.04）,P〈0.01]均有差异有统计学意义。干预18个月后,干预组与对照组在并发症低血糖发生率[RR=0.28,95%CI（0.12,0.67）,P=0.004]差异有统计学意义。结论对我国对糖尿病患者进行延续护理干预能够降低患者的空腹血糖、糖化血红蛋白,减小低血糖的发生率,但对低血糖发生率的干预时间需大于6个月。

Objective To evaluate comprehensively the effectiveness of transitional care for patients with diabetic in china. Methods Cochrane Handbook for systematic reviews of interventions was followed,and strictly designed search strategies, pub- lished literatures were searched through Chinese biomedical literature database（CBM）, Wanfang, CNKI, VIP database. These data- bases were searched to collect the randomized controlled trials of transitional care for patients with diabetic in China. The retrieval time was limited from 2000 to 2014,All the literatures were selected according to the strictly designed strategies. A Meta analysis was performed by RevManS. 0 software. Results Totally 8 trials were included. Meta analysis showed that 6 months after the in- tervention,the continuing nursing and the control group in the incidence of complications of hypoglycemia had no significant differ- encerRR= 0. 69, 95% CI（0. 21,2. 27）, P = 0. 540], while fasting glucose had significant difference[WMD = - 1. 54, 95g CI （- 2.89,- 0.19）, P = 0. 030]. 12 months after the intervention, the continuing nursing and control groups in the incidence of com- plications of hypoglycemia [RR = 0. 34,95 % CI （0. 16,0. 72）, P = 0. 005 ], in fasting plasma glucose [WMD = - 1. 03,95 M CI （ - 2.78,0.72）, P = 0. 250], in glycated hemoglobin [WMD = - 1.73,95 % CI（ - 2.43, - 1.04）, P〈0.01 ] had significantly differ- ence. 18 months after the intervention, the continuing nursing and control groups in the incidence of complications of hypoglycemia were significantly different[RR= 0.28,95 % CI（0. 12,0.67）, P = 0. 004]. Conclusion Transitional care intervention on patients with diabetes can reduce fasting blood glucose, glycated hemoglobin,and the incidence of complications, but the complications of in- tervention time should be greater than 6 months.