并发症体验式健康教育对2型糖尿病患者自我管理影响的系统评价

Effect of complications-simulating experience education on self-management ability of patients with type 2 diabetes mellitus

目的系统评价并发症体验式健康教育对2型糖尿病(T2DM)患者自我管理的影响。方法计算机检索Pubmed、EMbase、Cochrane Library、CINAHL、万方数据库、中国生物医学数据库以及中国知网,收集从建库至2018年6月关于并发症体验式健康教育对T2DM患者自我管理影响的随机对照试验。由两名研究者独立筛选文献、提取资料、评价偏倚风险,并用Rev Man5. 3. 5软件进行荟萃(Meta)分析。结果共纳入7项研究,967例研究对象。Meta分析结果显示,相较于常规糖尿病教育,这种教育能提高患者的自我管理能力[SMD=3. 72,95%CI(0. 88,6. 56),P=0. 01],降低糖化血红蛋白[WMD=-1. 05,95%CI(-1. 39,-0. 72),P <0. 00001]、空腹血糖[WMD=-0. 51,95%CI(-0. 85,-0. 16),P=0. 004]、餐后2 h血糖[WMD=-2. 24,95%CI(-2. 83,-1. 64),P <0. 00001]。结论并发症体验式健康教育可提高T2DM患者的自我管理水平,改善糖化血红蛋白、空腹血糖和餐后2 h血糖水平。受纳入研究的数量和质量限制,上述结论尚需更多高质量研究加以验证。

Objective To systematically evaluate the effects of complications-simulating experience education on self- management ability of patients with type 2 diabetes mellitus （T2DM）. Methods We searched such databases as Pubmed, EMbase, Cochrane Library, CINAHL, WanFang data, CBM and CNKI to collect randomized controlled trials （RCTs） on complications-simulating experience education on self-management ability of patients with T2DM from inception to June 2018. Two researchers independently screened the literature, extracted data and assessed the risk of bias of included studies. RevMan 5.3.5 software was used for Meta-analysis. Results Seven RCTs involving 967 patients were included. The results of Meta-analysis showed that the complications-simulating experience education group was superior to the control group in self-management [ SMD = 3.72, 95% CI （0. 88,6.56）, P = 0.01 ], hemoglobin Alc （HbAlc） [ WMD = - 1.05, 95% CI （ - 1.39, - 0.72）, P 〈 0. 00001 ], fasting plasma glucose （FPG） [ WMD = - 0.51, 95 % CI （ - 0.85, - 0.16）, P = 0.004 ], and 2 h postprandial plasma glucose （2hPG） [ WMD = - 2.24, 95 % CI （ - 2.83, - 1.64 ）, P 〈 0. 00001 ]. Conclusion This form of education is an effective way to improve self-management ability and decrease the level of blood glucose. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the conclusions.