群组干预模式在延安市慢性病管理中的应用

The effect of group intervention mode in the management of chronic diseases in Yan′an City

目的探讨群组干预模式对延安市高血压前期、糖尿病前期患者生活方式及血压、血糖水平的影响。方法选取延安市宝塔区内10个社区中高血压前期、糖尿病前期的患者,随机分成干预组和对照组,通过群组干预模式对患者的生活方式进行健康教育及管理。通过重复测量方差分析比较患者基线水平与干预第3、6、12个月时的各项指标变化。结果本研究共纳入研究对象1099人,其中干预组554人,对照组545人。重复测量方差分析结果显示,通过群组干预模式后,干预组患者在吸烟量、饮酒量、收缩压、舒张压、血糖、体重指数方面均较基线水平明显下降,且随着时间延长,下降程度逐渐增大(P<0.05)。虽然对照组在吸烟量、饮酒量两项指标中也较基线水平下降(P<0.05),但干预组较对照组下降幅度更大(P<0.05)。而对照组收缩压和血糖水平均较基线组升高(P>0.05)。重复测量方差分析显示7个指标均在时间与组别中存在交互作用。结论群组干预模式在延安地区高血压前期、糖尿病前期的管理中可有效地改变患者的生活方式,且对血压、血糖具有良好的控制作用。

Objective To discuss the effect of group intervention mode on lifestyle,blood pressure and blood glucose level of patients with pre-hypertension and pre-diabetes in Yan′an city.Methods Patients with pre-hypertension and pre-diabetes in 10 communities in Baota District of Yan’an City were selected and randomly divided into two groups:intervention group and control group.The group intervention mode was used to conduct health education and management of patients’lifestyles.The repeated measures analysis of variance was used to assess changes in measurement indicators at baseline and at 1,6,and 12 months post of intervention.Results A total of 1,099 subjects were included in this study,including 554 cases and 545 controls.The results showed that the intervention group patients′smoking,alcohol consumption,systolic blood pressure,diastolic blood pressure,blood glucose,and BMI were significantly lower than the baseline after intervention,and the degree of decline was increased over time(P<0.05).Although the two indicators of smoking and alcohol consumption in the control group were also lower than the baseline(P<0.05),but the intervention group had a greater decline(P<0.05).The systolic blood pressure and blood glucose of the control group were higher than those of the baseline(P>0.05).Repeated measures analysis of variance showed that all 7 indicators had interactions in time and group.Conclusion Group intervention can effectively change the lifestyle of patients in the management of pre-hypertension and pre-diabetes in Yan′an city,and has a good control effect on blood pressure and blood glucose.