浙北农村地区2型糖尿病患者精细化自我管理干预效果分析  

Effects of refined self-management intervention on patients with type 2 diabetes mellitus in rural areas of northern Zhejiang

作　　者：朱秋荣[1] 骆田斌[1] 沈月根[1] 徐惠庆[1] 余梦华[1] ZHU Qiu-rong;LUO Tian-bin;SHEN Yue-gen;XU Hui-qing;YU Meng-hua(Xiuzhou District Center for Diseases Control and Prevention,Jiaxing,Zhejiang Province 314000,China)

机构地区：[1]嘉兴市秀洲区疾病预防控制中心慢病科

出　　处：《中国慢性病预防与控制》2019年第9期658-662,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：秀洲区科技计划项目(2016C009)

摘　　要：目的探讨浙北农村地区2型糖尿病患者精细化自我管理干预对改善生活方式和控制血糖的影响,为2型糖尿病管理提供科学依据。方法于2016年1-3月,采用整群随机抽样方法选取浙北农村地区662名2型糖尿病患者为研究对象,其中干预组454人,采取精细化自我管理进行综合干预,对照组208人采取慢性病常规管理,干预期为1年。在干预前后进行问卷调查、体格检查和生化指标检测。采用SPSS 19.0软件进行t检验、χ^2检验,采用双重差分法(difference in differences,DID)对2型糖尿病患者精细化自我管理干预进行效果评价。结果干预1年后,干预组水果和蔬菜每周摄入率较干预前显著增加,收缩压(SBP)、总胆固醇(TC)、空腹血糖(FPG)、血脂异常率、饮酒率、人均日食盐和味精摄入量等较干预前显著减少,差异均有统计学意义(P<0.05)。干预1年后,对照组患者的腰围(WC)、FPG、人均日吸烟量、人均日食盐和味精摄入量等较干预前均显著增加,差异均有统计学意义(P<0.05)。DID分析结果显示,在调整性别、受教育年限、婚姻、医保类型、年均收入等因素后,干预组患者的SBP、FPG、人均日吸烟量、人均日食盐和味精摄入量较对照组分别显著降低了4.028 mmHg、2.529 mmol/L、12.874支、1.035 g和2.620 g,差异均有统计学意义(P<0.05)。结论浙北农村地区精细化自我管理干预对2型糖尿病人群的生活方式改善起到促进作用,同时也有控制血糖的效果,具有推广价值。Objective To explore the effects of refined self-management intervention on lifestyle and blood glucose control in type 2 diabetes mellitus(T2DM)patients in rural areas of northern Zhejiang,and to provide the scientific basis for T2DM management.Methods From January to March of 2016,the cluster random sampling method was used to select 662 T2DM patients from rural areas of northern Zhejiang as the subjects.The subjects were divided into the intervention group(454 cases,with comprehensive refined self-management intervention)and control group(208 cases,with routine management of chronic diseases),the intervention duration was one year.Before and after intervention,the investigation was performed with questionnaire,physical examination and bio-chemical test.The t test andχ^2 test were used to analyze the data,the difference in differences(DID)method was used to assess the effects of refined self-management intervention on T2DM patients.The used software was SPSS 19.0.Results After intervention for 1 year,the rates of fruits and vegetablas intake weekly in the intervention group were significantly higher than those before intervention,the systolic blood pressure(SBP),total cholesterol(TC),fasting plasma glucose(FPG),dyslipidemia rate,drinking rate and the daily per capita salt or monosodium glutamate intake decreased significantly(P<0.05).After intervention for 1 year,the waist circumference(WC),FPG,daily per capita smoking,daily per capita salt or monosodium glutamate intake in the control group were significantly higher than those before intervention(P<0.05).The results of DID model showed that SBP,FPG,daily per capita smoking,daily per capita salt or monosodium glutamate intake in the control group decreased 4.028 mmHg,2.529 mmol/L,12.874 cigarettes,1.035 g and 2.620 g,respectively,as compared to the control group(P<0.05),after adjusting gender,education level,marital status,health insurance type and annual income.Conclusion The refined self-management intervention of T2DM patients in rural areas of northern Zhe

关 键 词：糖尿病 2型 干预研究 双重差分模型 生活方式 

分 类 号：R587.1[医药卫生—内分泌]