运用健康管理模式为糖尿病的临床治疗提质增效

Application of Health Management Model to Improve Quality and Iucreasing Efficiency in Clinical Treatment of Diabetes Mellitus

目的:探讨健康管理模式对治疗2型糖尿病(T2DM)的临床效果、血糖控制指标、患者临床依从性和精神状态以及不良反应的影响。方法:选择2016-10-2018-09 T2DM患者80例,以随机数字表法分为常规管理组(n=39)和健康管理组(n=41),前者采用常规疾病管理干预,后者采用健康管理模式干预。比较两组临床疗效、空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbAlc)等血糖水平变化,患者治疗依从性,焦虑自评量表(SAS)和抑郁自评量表(SDS)评分以及不良反应发生率。结果:治疗后,健康管理组患者临床总有效率明显高于常规管理组(95.12%vs 66.67%,P<0.01)。治疗后,两组患者FBG、2hPBG、HbAlc均明显下降(P<0.05),健康管理组降低程度较常规管理组更显著(P<0.01);健康管理组患者临床依从性较常规管理组显著改善;健康管理组患者SAS、SDS评分低于常规管理组[23.14±1.21 vs 38.97±1.69(SAS), 8.27±2.03 vs 29.67±2.36(SDS),均P<0.01];健康管理组患者不良反应发生率也明显低于常规管理组(12.20%vs 48.72%,P<0.01)。结论:T2DM患者采用健康管理模式可显著提高临床效果,有效增加患者依从性,降低患者血糖水平和不良反应,值得推广运用。

Objective: To explore the effect of health management model on clinical effect, laboratory examination, prognostic benefit and adverse reactions in the treatment of diabetes mellitus(DM). Method: 80 patients with DM from October 2016 to September 2018 were selected and divided into routine management group(n=39) and health management group(n=41) by random number table. The former adopted routine disease management intervention, and the latter adopted health management mode intervention. The clinical efficacy, laboratory parameters, fasting blood glucose(FBG), postprandial blood glucose(2hPBG), glycosylated hemoglobin(HbAlc), treatment compliance, self-rating anxiety scale(SAS) and self-rating depression scale(SDS), clinical treatment costs and the incidence of adverse reactions were compared between the two groups. Results: After treatment, the total clinical effective rate of the health management group was significantly higher than that of the routine management group(95.12% vs 66.67%,P<0.01). After treatment, FBG, 2h PBG and HbAlc in the two groups decreased significantly(P<0.05), and the degree of reduction in the health management group was more significant than that in the routine management group(P<0.01);the scores of SAS and SDS in the health management group were significantly lower than those in the routine management group(SAS:23.14±1.21 vs 38.97±1.69,SDS:8.27±2.03 vs 29.67±2.36,P<0.01) the incidence of adverse reactions in the health management group was lower than that in the routine management group(12.20% vs 48.72%, P<0.01). Conclusion: The health management model for diabetic patients can significantly improve the clinical effect, effectively increase patient compliance, improve blood sugar level,reduce treatment costs and complications,which is worthy of promotion and application.