三种不同管理模式对社区2型糖尿病患者血糖控制效果的比较研究  

Effect of Three Different Management Modes on the Blood Glucose Control of Patients With Type 2 Diabetes: A Comparative Study

作　　者：崔学利 施小明[4] 李园[1] 赵辰梅 

机构地区：[1]中国疾病预防控制中心慢性病防治与社区卫生处 [2]中国疾病预防控制中心研究生院,北京市102206 [3]三里屯社区卫生服务中心 [4]中国疾病预防控制中心环境与健康相关产品安全所

出　　处：《中国全科医学》2015年第31期3798-3802,共5页Chinese General Practice

摘　　要：目的探讨三种不同管理模式对社区2型糖尿病患者血糖控制的效果。方法于2012年8—10月在三里屯社区卫生服务中心门诊招募已确诊的2型糖尿病患者213例,采用随机数字表法分为标准组(n=106)和强化组(n=107),再根据强化组患者的意愿,进一步分为单纯强化组(n=75)和综合组(n=32)。设计社区卫生服务中心糖尿病标准化管理、强化管理和综合管理三种管理模式,从2012年11月—2014年4月对所有患者进行为期18个月的分组管理。比较3组基线和管理18个月后空腹血糖、糖化血红蛋白达标率及不同时间点糖化血红蛋白水平。结果 3组基线空腹血糖、糖化血红蛋白达标率间差异均无统计学意义(P>0.05);而管理18个月后空腹血糖、糖化血红蛋白达标率间差异均有统计学意义(P<0.05),其中单纯强化组和综合组空腹血糖、糖化血红蛋白达标率均高于标准组。3组患者不同时间点糖化血红蛋白水平间差异有统计学意义(P<0.05),其中标准组管理后6个月内糖化血红蛋白水平呈升高趋势,之后逐渐下降;单纯强化组管理后3~12个月糖化血红蛋白水平到达一个平台期,之后呈下降趋势;综合组管理后糖化血红蛋白水平一直呈下降趋势。结论综合管理糖尿病,更有利于患者的病情控制,提高空腹血糖和糖化血红蛋白的达标率。Objective To investigate the effect of three different management modes on the blood glucose control of patients with type 2 diabetes. Methods From August to October 2012, we enrolled 213 patients who were definitely diagnosed with type 2 diabetes in Sanlitun Community Health Service Center. Using random number table method, the patients were divided into two groups： standard group （n = 106 ） and intensified group （n = 107 ） . According to the will of the patients in intensified group, they were further divided into pure intensified group （ n = 75 ） and comprehensive group （ n = 32 ） . Three kinds of management modes were designed, including standardized diabetes management of community health service center, intensified management and comprehensive management. From November 2012 to April 2014, all the patients received group management for 18 months. Comparison was made on the standard reaching rates of FBG and HbA^c at baseline, and after 18 months＇ management and HbA^o level at different time points among the three groups. Results The three groups ~vere not significantly different （ P 〉 0. 05 ） in the standard reaching rates of FBG and HbA1c at baseline, but they were significantly different in the standard reaching rates of FBG and HbA1c after 18 months＇ management （P 〈 0. 05 ） ; pure intensified group and comprehensive group were higher than standard group in the standard reaching rates of FBG and HbA1c. The three groups were significantly different in HbA1c level at different time points among the three groups （ P 〈 0.05 ） ; standard group saw HbA1c level increased in the first 6 months＇management and decreased afterwards; pure intensified group saw HbA1c level reached a stable stage in the 3 - 12 months＇ management and took a decreasing trend afterwards ; comprehensive group saw HbA1c level took a decreasing trend all the time. Conclusion The comprehensive management of diabetes can better control the illness condition of patients and improve the standard reachin

关 键 词：糖尿病 2型 社区卫生服务 管理模式 血糖 血红蛋白A 糖基化 

分 类 号：R587.1[医药卫生—内分泌] R197[医药卫生—内科学]