中医“治未病”理念的健康管理模式在糖调节受损及其高危人群的干预研究

Intervention Study on the Health Management Model of the Concept of“Preventive Treatment of Disease”in Traditional Chinese Medicine for Impaired Glucose Regulation and the High-risk Population

目的:探讨中医"治未病"理念的健康管理模式在糖调节受损及其高危人群的干预效果。方法:选取2018年4月-2019年12月珠海市第二人民医院与珠海市人民医院横琴医院的糖调节受损及存在其高危因素患者178例,按干预方法不同将其分为观察组(n=85)与对照组(n=93)。对照组给予一般干预措施,观察组在对照组的基础上给予中医"治未病"健康管理模式干预。比较干预前后两组血糖、血脂、体重指数(BMI)、腰臀比(WHR)、对糖尿病预防的认知程度、自我管理及生活质量。比较两组干预1年后糖尿病转化及血糖正常者比例。结果:干预后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、BMI及WHR均较干预前降低,且观察组均低于对照组(P<0.05),干预后,两组甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白(LDL)水平均较干预前降低,且观察组均低于对照组(P<0.05)。干预1年后,两组糖尿病转化率与血糖正常者比例比较,差异均无统计学意义(P>0.05)。干预后,两组糖尿病知识知晓情况、自我管理及生活质量评分较干预前升高,且观察组均高于对照组(P<0.05)。结论:中医"治未病"理念的健康管理模式可以改善糖调节受损及存在其高危因素患者的血糖、血脂及生活质量,且在糖尿病自我管理方面有较强的优势,值得在临床中进一步探索。

Objective:To explore the intervention effect of the health management model of the concept of"preventive treatment of disease"in traditional Chinese medicine for impaired glucose regulation and high risk population.Method:A total of 178 patients with impaired glucose regulation and high risk factors in Zhuhai Second People’s Hospital and Hengqin Hospital of Zhuhai People’s Hospital from April 2018 to December 2019 were selected.They were divided into observation group(n=85)and control group(n=93)according to different intervention methods.The control group was given general intervention measures,and and the observation group was given health management model of the concept of"preventive treatment of disease"in traditional Chinese medicine on the basis of the control group.Blood glucose,blood lipid,body mass index(BMI),waist-to-hip ratio(WHR),cognition of diabetes prevention,self-management and life quality were compared between the two groups before and after intervention.The proportion of patients with diabetes conversion and normal blood glucose after 1 year intervention was compared between the two groups.Result:After intervention,fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),BMI and WHR in two groups were decreased compared with before intervention,and observation group were lower than those of control group(P<0.05).After intervention,the levels of triglyceride(TG),total cholesterol(TC)and low density lipoprotein(LDL)in two groups were decreased compared with before intervention,and the observation group were lower than those of the control group(P<0.05).After 1 year of intervention,there were no significant differences in diabetes conversion rate and the proportion of patients with normal blood glucose between the two groups(P>0.05).After intervention,the knowledge of diabetes,self-management and quality of life scores of the two groups were higher than before intervention,and the observation group were higher than those of the control group(P<0.05).Conclusion:The health management model with the concept of"preventive treatment of disease"in traditional Chinese medicine can improve the blood glucose,blood lipid and life quality of patients with impaired glucose regulation and high risk factors,and has strong advantages in self-management of diabetes,which is worthy of further exploration in clinical practice.