手机App对2型糖尿病患者血糖控制和行为管理效果的Meta分析  

Meta-analysis on the effect of blood glucose control and behavior management in patients with type 2 diabetes using mobile App

作　　者：罗莎 李军文[2] 曹璐璐[3] 文奕[3] 杨俊[3] LUO Sha;LI Jun-wen;CAO Lu-lu;WEN Yi;YANG Jun(College of Nursing,Chengdu University of Traditional Chinese Medicine,Sichuan Province,Chengdu610075,China;Department of Nursing,Chengdu First People′s Hospital,Sichuan Province,Chengdu610041,China;Department of Endocrinology,Chengdu First People′s Hospital,Sichuan Province,Chengdu610041,China)

机构地区：[1]成都中医药大学护理学院,四川成都610075 [2]成都市第一人民医院护理部,四川成都610041 [3]成都市第一人民医院内分泌科,四川成都610041

出　　处：《中国当代医药》2019年第27期12-16,共5页China Modern Medicine

基　　金：四川省卫生和计划生育委员会科研课题(普及应用项目)(18PJ260)

摘　　要：目的采用Meta分析方法,综合评价国外应用手机App对2型糖尿病患者进行血糖控制和行为管理的有效性。方法以英文关键词“type 2 diabetes/T2DM,mobile health/telehealth/mHealth/smartphone,App/application,self-management”检索PubMed,Cochrane Library,Web of Science,OVID,MEDLINE,EMBASE,截止时间为2018年4月28日。采用Revman 5.3进行统计分析。结果共纳入13项研究,1217例研究对象。Meta分析结果显示,观察组手机App干预后的糖化血红蛋白(HbA1c)水平明显改善(MD=-0.41,95%CI:-0.56^-0.25,P<0.000 01)。手机App对患者饮食管理有较好的作用(MD=1.58,95%CI:0.26~2.90,P=0.02),在患者运动管理和用药依从性方面,手机App的作用并不优于常规护理(MD=0.49,95%CI:-0.97~1.94,P=0.51;MD=-0.31,95%CI:-2.10~1.49,P=0.74)。亚组分析显示,干预3、6、9、12个月时,观察组的HbA1c水平均明显低于对照组(P<0.05),不同干预持续时间比较,差异无统计学意义(P>0.05)。结论手机App干预能够有效改善2型糖尿病患者的HbA1c水平,但干预持续时间对血糖控制效果没有影响。手机App可提高患者的饮食管理能力,但在运动和用药方面没有明显优势。Objective To comprehensively evaluate the effectiveness of applying mobile App on blood glucose control and behavior management in patients with type 2 diabetes in foreign countries by using Meta-analysis.Methods PubMed,Cochrane Library,Web of Science,OVID,MEDLINE,EMBASE with the keywords as“type 2 diabetes/T2DM,mobile health/telehealth/mHealth/smartphone,App/application,and self-management”were searched.The literature retrieving from these databases were limited to April 28,2018.Revman 5.3 software was used for statistical analysis.Results A total of 13 studies were included with the involvement of 1217 subjects.Meta-analysis showed that the hemoglobin A1c(HbA1c)level was significantly improved after the intervention of the mobile App in the observation group(MD=-0.41,95%CI:-0.56:-0.25,P<0.000 01).Mobile App had a good effect on patient diet management(MD=1.58,95%CI:0.26-2.90,P=0.02).In terms of patient′s exercise management and medication compliance,the effect of the mobile App was not superior to regular care(MD=0.49,95%CI:-0.97-1.94,P=0.51;MD=-0.31,95%CI:-2.10-1.49,P=0.74).Subgroup analysis showed that the HbA1c levels in the observation group were significantly lower than those in the control group after 3,6,9,and 12-month intervention(P<0.05),and there was no statistical difference between the different durations of intervention(P>0.05).Conclusion Mobile App intervention can effectively improve glycosylated hemoglobin levels in patients with type 2 diabetes,but the duration of intervention has no effect on glycemic control.The mobile App improves patients′diet management but has no obvious advantage in exercise and medication.

关 键 词：2型糖尿病 手机App 健康教育 血糖控制 META分析 

分 类 号：R587.1[医药卫生—内分泌]