家庭医生签约服务模式下采用中西医结合方式对社区老年糖尿病脑病患者进行健康管理的效果

Effect of integrated traditional Chinese and Western medicine health management on elderly patients with diabetic encephalopathy in thecommunityunder the family doctor contract service model

目的探讨家庭医生签约服务模式下采用中西医结合对社区糖尿病脑病患者进行健康管理的效果。方法将2019年3月至2020年3月该院体检中心体检的符合2型糖尿病诊断标准且自愿接受认知评估后具有认知功能障碍患者60例采用随机数表法分为签约组和对照组,每组30例。对照组依托社区糖尿病慢病管理平台路径进行规范化管理,签约组在社区糖尿病慢病管理平台路径进行规范化管理基础上增加由包含针灸医生的中西医结合团队专家提供的太极拳、针灸和耳穴压豆等治疗方案。比较两组患者持续干预1年后血糖控制和认知功能改善情况。结果两组患者年龄、性别、受教育程度比较,差异均无统计学意义(P>0.05)。两组患者干预1年后空腹血糖、餐后2 h血糖、糖化血红蛋白均较治疗前明显下降,且签约组患者降幅明显大于对照组,差异均有统计学意义(P<0.05);签约组患者干预后认知评分明显高于对照组,差异有统计学意义(P<0.05)。结论家庭医生签约服务模式下采用中西医结合对糖尿病脑病患者血糖控制及认知功能障碍的改善均具有促进作用。

Objective To explore the efficacy of integrated traditional Chinese and western medicine health management on elderly diabetic encephalopathy patients under the family doctor contract service model in community.Methods Sixty patients with diabetic encephalopathy in the first hospital of Hebei Medical University from March 2019 to March 2020 were randomly divided into control group and intervention group.The control group receives routine health management methods.The intervention group was given standardized management,Tai Chi,acupuncture,and ear point pressing beans provided by the team experts of integrated Chinese and western medicine.The control of Blood glucose and the improvement of cognitive function were compared after continuous intervention for one year.Results There was no statistical difference in age,sex,and education level between the two groups(P>0.05).After continuous intervention for one year,the FPG of patients in the intervention group and the control group were[(6.49±1.04)mmol/L vs.(8.06±1.81)mmol/L],2 HPG were[(10.72±2.96)mmol/L vs.(14.14±4.12)mmol/L],HbA1c were[(7.10(2.03)%vs.(8.38±1.68)%]in both groups were decreased significantly,and the decreases in the intervention group were significantly greater than those in the control group(P<0.05);In addition,after intervention,cognitive scores in the intervention group were significantly higher than those in the control group(P<0.05).Conclusion Integrated traditional Chinese and western medicine health management under the family doctor contract service model in community is helpful to improve blood glucose control and cognitive dysfunction in patients with diabetic encephalopathy.