动机性访谈联合行为塑造法对2型糖尿病患者血糖及体质指数控制效果的随机对照研究

Motivational interviewing combined with behavior shaping change for BMI and Glycemic control among patients with type 2 diabetes:A single-center randomized controlled trial

目的探讨4个月的行为干预对血糖控制不佳的2型糖尿病(T2DM)患者血糖及体质指数(BMI)的影响。方法选取2016年10月-2017年3月上海市嘉定区中心医院糖尿病护理门诊就诊的T2DM患者129例,随机分为试验A组44例、试验B组45例和对照组40例。对照组予常规糖尿病健康教育,试验组A组在常规教育的基础上给予7次45min的动机性访谈(Motivational interviewing,MI),试验B组则在常规教育基础上,采用7次45min动机性访谈联合行为塑造(Motivational interviewing and behavior shaping,MI-BS),观察3组患者干预前、4个月(干预后)、随访期间(6个月、1年)的血糖指标及BMI的变化情况。结果试验A组及试验B组患者血糖指标、BMI改善均优于对照组,但试验B组要优于试验A组(P<0.01)。结论 MI-BS联合可使血糖控制不佳的T2DM患者的行为更稳固,BMI及血糖长时间(1年)控制在更佳水平。

Objective To investigate the effects of 4 months of behavioral intervention on the control of blood glucose and body mass index(BMI) in patients with poorly controlled type 2 diabetes mellitus(T2 DM).Methods The enrolled participants were 129 patients of T2 DM with poor glucose from diabetes care clinic of Shanghai Jiading central hospital from October 2016 to March 2017.Using randomization method,they were allocated into intervention group A of 44 cases, intervention group B of 45 cases and control group of 40 cases.During the intervention period,the intervention group A received 7 times of motivational interviewing(MI),the intervention group B received 7 times of 45 min motivational interviewing and behavior shaping(MI-BS), while the control group received regular health education for the control of T2 DM in China.The main outcome indicators include BMI,HbAlc, FPG, 2 hPG level of 4 months after intervention, follow-up period(6 months, 12 months).Results Compared with the control group,the intervention group A and B showed reduced average BMI, HbAlc,FPG and 2 hPG level, and compared with the intervention group A, the intervention group B demonstrated significantly reduced average BMI,HbAlc, FPG, 2 hPG level(P<0.01).Conclusion The combination of MI-BS can make the behavior of T2 DM with poor blood glucose control more stable, and BMI and blood glucose are better controlled for long-time(1 year).