家庭干预对2型糖尿病患者的自我管理和血糖控制效果:Meta分析和系统综述

Effectiveness of family intervention for self-management and glycaemic control in patients with type 2 diabetes:a Meta-analysis and systematic review

目的系统评价家庭干预对2型糖尿病患者的干预效果。方法计算机检索PubMed、Medline、Embase和Cochrance图书馆,中国知网、万方数据库中关于家庭干预对2型糖尿病患者影响的临床试验研究型文献,文献检索时限为2016年1月至2023年6月。以2型糖尿病患者自我管理行为、体重指数和糖化血红蛋白作为本次Meta分析的结局指标,采用Review Manager 5.3软件进行Meta分析和绘图。对于使用糖尿病患者自我管理行为量表以外其他工具测量自我管理行为指标的文献进行系统综述。结果共检索到1342篇相关文献,有13篇文献纳入分析,共包含1454例研究对象,干预组740例,对照组714例。Meta分析结果显示,与医院-患者的常规二元模式相比,家庭干预的加入有助于提高成年2型糖尿病患者自我管理水平(WMD=5.03,95%CI:4.43~5.63,P<0.001),降低糖化血红蛋白(WMD=-0.77,95%CI:-1.32~-0.21,P=0.007),但是对体重指数的影响不明显(WMD=-0.38,95%CI:-1.04~0.28,P=0.25)。系统综述结果支持家庭干预可以改善成年2型糖尿病患者自我管理行为。结论家庭干预可以改善成年2型糖尿病患者自我管理行为,降低糖化血红蛋白水平。

Objective To evaluate the effect of family intervention on self-management and glycaemic control in patients with type 2 diabetes mellitus(T2DM).Methods Clinical interventional trials on the family intervention for T2DM patients were searched in PubMed,Medline,Embase,Cochrance libraries,the CNKI,and the Wan Fang Database from January 2016 to June 2023.Literature was screened according to the inclusion and exclusion criteria.Self-management behavior,BMI and glycated haemoglobin of T2DM patients were used as outcome indicators.Meta-analysis and mapping were performed using Review Manager 5.3 software.A systematic review of the literature on indicators of self-management behavior measured using other instruments except Summary of Diabetes Self-Care Activities.Results A total of 1342 relevant papers were retrieved and 13 papers were included in the analysis,involving 1454 patients,740 in the intervention group and 714 in the control group.Meta-analysis showed that the inclusion of home-based intervention helped adult T2DM patients to improve self-management(WMD=5.03,95%CI:4.43-5.63,P<0.001)and reduce glycated hemoglobin compared with the hospital-patient dichotomous model(WMD=-0.77,95%CI:-1.32--0.21,P=0.007),but the effect on BMI was unclear(WMD=-0.38,95%CI:-1.04-0.28,P=0.25).The results of the systematic review supported that home-based intervention improving self-management behaviors of adult T2DM patients.Conclusion Family intervention can improve self-management behaviors and reduce glycated haemoglobin levels in adults T2DM patients.