家庭医生团队服务对社区高血压合并高尿酸血症患者的干预效果

The Influence of Family Doctor Team Services on Blood Pressure and Uric Acid in Elderly Patients with Hypertension Complication Hyperuricemia

目的:探讨家庭医生团队服务对社区高血压合并高尿酸血症患者的干预效果。方法:选取2021—2022年在上海市浦东新区三林社区卫生服务中心门诊就诊的高血压合并高尿酸血症患者124例,将其随机分为对照组(n=62)和观察组(n=62)。对照组接受常规干预模式,观察组接受家庭医生团队服务模式。干预6个月后比较两组患者的健康管理效果。结果:干预后,两组患者收缩压、舒张压和血尿酸水平均较干预前下降,且观察组下降幅度均高于对照组,差异均有统计学意义(t值分别为4.983、8.421、14.458,P<0.05);观察组患者疾病诊断标准、危害、危险因素、治疗方法、预防知识5个模块疾病相关知识知晓率明显高于对照组,差异均有统计学意义(χ^(2)值分别为5.446、5.962、6.459、4.397、7.008,P<0.05);观察组患者合理运动、饮食控制、心理调节、规律用药、定期复查5个方面自我管理能力问卷评分明显高于对照组,差异均有统计学意义(χ^(2)值分别为4.059、6.937、6.499、5.167、6.459,P<0.05);观察组患者白细胞介素6、肿瘤坏死因子α、超敏C反应蛋白下降程度均高于对照组,差异均有统计学意义(t值分别为9.497、7.279、9.810,P<0.05)。结论:家庭医生团队服务可提升高血压合并高尿酸血症患者对疾病的认知能力及自我管理能力,降低炎症反应,更好地改善患者的血压和血尿酸水平。

OBJECTIVE To explore the effect of family doctor team services on the elderly patients with hypertension complication hyperuricemia.METHODS From January 2021 to December 2022,124 patients with hypertension complication hyperuricemia in outpatient department of Sanlin Community Health Service Center were divided into control group(n=62)and observation group(n=62).The patients of control group received the usual intervention mode,while the patients of observation group received family doctor team services.After 6 months,the clinical efficacy of the two groups was compared.RESULTS After treatment,the blood pressure and uric acid of two groups had decreased,the observation group were more significant(t=4.983,8.421,14.458,P<0.05).The awareness rate of disease related knowledge in 5 modules of diagnosis criteria,harm,risk factors,treatment methods and prevention knowledge in observation group was significantly higher than that in control group,and the differences were statistically significant(χ^(2)=5.446,5.962,6.459,4.397,7.008,P<0.05).The self-management ability questionnaire score of the observation group was significantly higher than that of the control group in five aspects:reasonable exercise,diet control,psychological adjustment,regular medication and regular review,and the differences were statistically significant(χ^(2)=4.059,6.937,6.499,5.167,6.459,P<0.05).The levels of IL-6,TNF-α,and hs-CRP in observation group were higher than those in control group,and the differences were statistically significant(t=9.497,7.279,9.810,P<0.05).CONCLUSION The family doctor team services can improve disease-related knowledge and self-management ability,reduce inflammation and improve blood pressure and uric acid on the elderly patients with hypertension complication hyperuricemia.