基于“一日门诊”的持续性管理模式对改善更年期综合征的可行性研究

Study on the feasibility of improving menopausal syndrome using the one-day outpatient based continuous management model

通过构建基于更年期“一日门诊”的持续性管理模式,探讨其对改善女性更年期综合征及情绪的可行性及初步成效。2020年5月至2021年5月在重庆医科大学附属第三医院妇产中心开展临床干预研究。整合多学科资源构建基于“一日门诊”的持续性管理模式,包括线下更年期“一日门诊”健康教育、线上7周团体式“健康生活方式”持续性干预和线下半日焦点团体访谈。对参与基于“一日门诊”的持续性管理的78例女性患者,年龄为40~60岁,采用改良Kupperman量表和PANAS量表测量比较干预前后的更年期综合征程度及情绪体验水平,并对患者参加持续性管理前后的血脂和人体成分指标进行对比分析。采用配对t检验或Wilcoxon符号秩检验,结果显示,基于更年期“一日门诊”的持续性管理干预患者的Kupperman评分为(干预前14.65±8.51 vs干预后10.26±5.83),更年期综合征得到显著改善(t=-5.59,P<0.01);正性情绪评分(干预前28.53±5.85 vs干预后30.13±6.30)显著提高(t=2.59,P=0.012)和负性情绪评分[干预前20.5(10)vs干预后17.0(7)]显著下降(Z=-5.09,P<0.01)。同时,患者的甘油三酯水平显著降低[干预前(1.27±0.54)mmol/L vs干预后(1.09±0.38)mmol/L,t=-2.45,P<0.05];体重指数(干预前22.52±2.34 vs干预后22.06±2.22)、体脂百分比(干预前31.72±6.22 vs干预后30.91±6.52)和内脏脂肪面积(干预前83.96±30.26 vs干预后79.66±29.71)均得以改善(t=-3.58,t=-2.57,t=-2.59,P<0.05)。因此,基于更年期“一日门诊”的持续性管理可有效改善更年期综合征和不良情绪,降低患者血脂、改善人体成分,可能有助于预防远期慢性疾病。

To explore the mode of"one-day outpatient"based continuous management and examine its feasibility and preliminary effects for improving menopausal syndrome and mood among menopausal women.Clinical intervention study was conducted in Obstetrics and Gynecology Center of the Third Affiliated Hospital of Chongqing Medical University from May 2020 to May 2021.The continuous management mode of"one-day outpatient service"for menopause was constructed in terms of multidisciplinary resources,including offline"one-day outpatient"health education,online 7-week group continuous intervention on"healthy lifestyle"and offline half-day focus group interview.Pre-and post-scores of the modified Kupperman scale and the positive/negative emotional scale(PANAS)were measured to compare the status of menopausal syndrome and emotional experience of Seventy-eight female participants(40-60 years old),meanwhile,before and after comparison of the blood lipid and body composition indexes of participants were also performed.Paired t test or Wilcoxon signed rank test were used.Results show that the pre-and post Kupperman scores were 14.65±8.51 vs 10.26±5.83(t=-5.59,P<0.01),and the positive emotional scores(pre-28.53±5.85 vs post-30.13±6.30)were improved(t=2.59,P=0.012)and negative emotional scores[pre-20.5(10)vs post-17.0(7)]were decreased(Z=-5.09,P<0.01).The triglyceride level of participants declined from(1.27±0.54)mmol/L to(1.09±0.38)mmol/L(t=-2.45,P<0.05).In addition,the body mass index(pre-22.52±2.34 vs post-22.06±2.22),percentage of body fat(pre-31.72±6.22 vs post-30.91±6.52)and Visceral fat area(pre-83.96±30.26 vs post-79.66±29.71)were all improved(t=-3.58,t=-2.57,t=-2.59,P<0.05).Therefore,the mode of"one-day outpatient"based continuous management can effectively improve menopausal syndrome and adverse mood,reduce patients′blood lipid,improve the body composition,and maybe contribute to the prevention of long-term chronic diseases.