2型糖尿病合并高血压患者的社区综合干预效果评价  

Evaluation on the effectiveness of comprehensive community intervention for patients with type II diabetes and hypertension

作　　者：顾梅榴 朱秀国 徐先锋 陈冬辉 金智敏[2] 张文[2] 刘鸿翔[2] 

机构地区：[1]上海市松江区叶榭镇社区卫生服务中心(内科),松江区中心医院叶榭分院,上海201609 [2]上海市松江区中心医院,上海201600

出　　处：《现代预防医学》2014年第4期651-653,657,共4页Modern Preventive Medicine

基　　金：上海市松江区重点社区项目建设(09-II-33)

摘　　要：目的探讨对2型糖尿病合并高血压患者进行社区综合干预的效果。方法在松江区叶榭社区内确诊的108名2型糖尿病合并高血压患者中,采取随机,对照的方法,分为干预组50例,实行饮食干预、运动干预、药物治疗、血糖血压监测及糖尿病、高血压教育的综合治疗;对照组58例,仅常规药物治疗,历时1年,检测和比较两组干预前后的血压变化,糖尿病生化指标(空腹血糖,餐后2 h血糖,糖化血红蛋白)及血糖、血压控制率。结果经过1年的社区综合干预措施,干预组的收缩压/舒张压,各项血糖指标均较干预前及对照组明显下降,差异有统计学意义(P<0.05),而对照组干预前后血压,血糖指标无显著变化(P>0.05)。1年后的干预组血糖控制率达到56%,血压达标控制率为38%,明显高于对照组22%的血糖控制率及12%的血压达标率(P<0.01)。结论社区综合干预是促进2型糖尿病合并高血压患者得到有效防治的理想手段,值得在社区内积极开展与推广。Objective The aim of this study was to investigate the effect of comprehensive community intervention on patients with type II diabetes and hypertension for controlling and containing the disease progression. Methods In Yexie community of Songjiang, 108 patients with type II diabetes and hypertension were randomly divided into intervention group （n=50） and control group （n=58）. The intervention group received comprehensive treatments of dietary intervention, exercise intervention, medication, blood glucose and blood pressure monitoring, and education on diabetes and hypertension, while the control group only received conventional drug therapy. The treatments for both groups lasted for one year. The change of blood pressure, bi^hemical indicators of diabetes （fasting glucose, 2-hour postprandial blood glucose, HbA1C）, blood glucose levels and blood pressure control rates were measured before and after the intervention in both groups. Results After one year of comprehensive community interventions, the level of systolic/di- astolic blood pressure and diabetes indicators were significantly decreased in the intervention group compared with the same group before the intervention and the control group after conventional therapy （P〈0.05）, while similar changes of the disease parameters were not observed in the control group before and after the conventional therapy （P〉0.05）. The control rates of blood glucose level and blood pressure were 56% and 38% in the intervention group, respectively, while the rates were 22% and 12% in the control group, respectively （P〈0.01）. Conclusion Comprehensive community intervention is an ideal means to promote effective prevention for patients with type II diabetes and hypertension, and worth to be carried out and encouraged in communities.

关 键 词：社区 2型糖尿病合并高血压 综合干预 

分 类 号：R587.1[医药卫生—内分泌]