丽水市农村2型糖尿病患者社区干预不同方式效果评价

A study on the effects of different interventions among patients with type 2 diabetes in rural communities in Lishui City

目的比较丽水市农村2型糖尿病患者社区干预不同方式的效果。方法于2011—2013年选择丽水市莲都区3个农村社区的210例2型糖尿病患者,随机分为常规干预组、分级干预组和标准干预组三组,采用不同方式开展为期3年的社区随访干预。比较三组患者在干预前后不良生活方式和指标控制情况。结果干预前三组患者的体重指数、收缩压、空腹血糖、餐后2 h血糖、甘油三酯、饮食控制和口服降糖药等7项指标分别比较,差异均无统计学意义(P>0.05);干预后三组间比较,其中分级随访干预组和标准随访干预组患者的体重指数、收缩压、空腹血糖、餐后2 h血糖和甘油三酯等5项指标的下降程度(干预前后差值均数)分别高于常规干预组(P<0.05);标准干预组患者体重指数、收缩压和空腹血糖这3项指标的下降程度(干预前后的差值均数)均高于分级干预组(P<0.05),而标准干预组患者的超重、血压异常和空腹血糖异常检出率均分别低于分级干预组和常规干预组(P<0.05)。结论标准干预和分级干预比常规干预更能有效控制糖尿病危险因素,标准干预比分级干预在血糖控制等方面更有优势。

Objective To compare the intervention effects of different methods among patients with type 2 diabetes in rural communities. Methods A total of 210 patients with type 2 diabetes during 2011—2013 were selected and randomly allocated to routine follow- up intervention group,average grade intervention group and standard follow- up intervention group. They were receiving community intervention for 3 years. Diabetes related knowledge and indexes of prevention and control were measured before and after the intervention. Results At the baseline,there were no significant difference on body mass index,systolic blood pressure,fasting blood glucose,postprandial glucose,glycerin three greases,diet control,oral hypoglycemic drugs among the 3 groups( P > 0. 05). After the intervention the body mass index,systolic blood pressure,fasting blood glucose,postprandial glucose,glycerin three greases of average grade intervention group and standard follow-up intervention group were significantly lower than that of the conventional intervention group( P < 0. 05). The degree of decline of body mass index,systolic blood pressure,and fasting blood glucose of standard follow- up intervention group were more than that of the grading intervention group( P < 0. 05). The rate of overweight,abnormal blood pressure and abnormal fasting blood glucose of the standard follow- up intervention group were lower than the grading intervention group and conventional intervention group( P < 0. 05). Conclusions Comparing with conventional intervention group,average grade intervention group and standard follow- up intervention could reduce the risk of diabetes,and standard follow- up intervention were more effective than average grade intervention.