微信平台随访对2型糖尿病患者坚持八段锦运动依从性及自我管理水平的影响

The influence of follow-up using WeChat platform on the compliance and self-management of patients with type 2 diabetes mellitus with Ba Duan Jin exercise

目的探讨微信晒图打卡教育方式对2型糖尿病(T2DM)患者坚持八段锦第三式运动依从性及自我管理水平的影响。方法选取2019年3月至2020年3月就诊于中国人民解放军联勤保障部队第900医院糖尿病门诊中心的142例T2DM患者,采用随机数字法分为对照组(n=72)和微信组(n=70),要求两组患者每天练习八段锦40 min,共3个月。对照组通过电话报告每日运动情况,微信组采用每日微信晒图打卡报告运动情况。检测两组患者干预前后体重、体重指数(BMI)、血压、空腹血糖(FPG)、糖化血红蛋白A1c(HbA1c)的变化,记录糖尿病自我管理量表(SDSCA)问卷调查结果。结果两组基线相关指标未见统计学差异,共135例患者完成试验。观察3个月末,与观察前比较,微信组收缩压、BMI明显下降(P均<0.05),对照组收缩压下降(P<0.05)。在糖代谢方面,两组的FPG、HbA1c均明显下降(P均<0.05),组间对比,微信组的FPG、HbA1c下降程度大于对照组(P均<0.05)。观察3个月末,与观察前比较,微信组的SDSCA各分项评分和总分均明显提高(P均<0.05),对照组的运动锻炼、血糖监测评分和SDSCA总分有所增加(P均<0.05)。组间对比,微信组的SDSCA各分项评分和总分均大于对照组(P均<0.05)。两组患者均未发生严重不良事件。结论微信平台可以改善T2DM患者坚持八段锦运动的依从性,从而提高八段锦运动对血糖管理的效果,显著改善患者的自我管理水平。

Objective To explore the effect of WeChat educational approach on adherence to the third form of the Ba Duan Jin exercise and self-management level in patients with type 2 diabetes mellitus(T2DM).Methods From March 2019 to March 2020,142 patients with type 2 diabetes mellitus in our diabetes center were randomly divided into the control group(n=72)and the experimental group(n=70).Patients in both groups were asked to practice Ba Duan Jin for 40 min every day for 3 months.The control group reported daily physical activity by telephone,and the WeChat group reported physical activity.The changes in body weight,body mass index(BMI),blood pressure,fasting plasma glucose(FPG)and glycosylated hemoglobin(HbA1c)were measured before and after the intervention in the two groups,and the results of the Summary of diabetes self-management scale(SDSCA)questionnaire were recorded.Results At the end of 3 months,compared with before,systolic blood pressure and BMI of the WeChat group decreased significantly(all P<0.05),while systolic blood pressure of the control group decreased(P<0.05).In the aspect of glucose metabolism,FPG and HbA1c in the two groups decreased significantly(all P<0.05).Compared with the control group,FPG and HbA1c in the Wechat group decreased more than that in the control group(all P<0.05).At the end of 3 months of observation,compared with that before the observation,the scores of sub items and total of SDSCA in WeChat group were significantly increased(all P<0.05).Exercise,blood glucose monitoring and total scores of SDSCA scores were increased in the control group(all P<0.05).Compared with the control group,the scores of each item and total of SDSCA in WeChat group were higher(all P<0.05).No serious adverse events occurred in both groups.Conclusions WeChat platform can improve the compliance of T2DM patients with Ba Duan Jin exercise,so as to improve the effect of Ba Duan Jin exercise on blood glucose management,and improve the level of self-management of patients.