中西医结合健康管理对社区中老年卒中高危人群的危险因素干预效果研究  

Intervention effect of health management with integrated traditional Chinese and western medicine on risk factors in middle-aged and elderly high-risk population of stroke in the community

作　　者：祝翊倩 罗剑锋[2] 陈冬冬[3] 张敏[4] 杨华 Zhu Yiqian;Luo Jianfeng;Chen Dongdong;Zhang Min;Yang Hua(Department of Neurosurgery,Huashan Hospital,Fudan University,Shanghai 200040,China;Statistics Center,School of Public Health,Fudan University,Shanghai 200032,China;Huajing Town Community Health Service Center,Xuhui District,Shanghai 200231,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department of General Practice,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属华山医院神经外科,上海200040 [2]复旦大学公共卫生学院生物统计教研室,上海200032 [3]上海市徐汇区华泾镇社区卫生服务中心,上海200231 [4]上海中医药大学附属岳阳中西医结合医院,上海200437 [5]复旦大学附属中山医院全科医学科,上海200032

出　　处：《中华全科医师杂志》2022年第9期872-876,共5页Chinese Journal of General Practitioners

基　　金：上海市老年基金会(S16034)。

摘　　要：选择2017年1—7月上海市10家社区卫生服务中心全科门诊就诊的872例中老年卒中高危人群为研究对象,采用整群随机的方法,抽取5家社区卫生服务中心的高危人群为干预组(427例),另外5家的高危人群为对照组(445例)。对照组采用常规治疗,干预组在常规治疗的基础上开展健康教育及中医健康操学习活动。12个月后再次对高危人群进行体格检查及相关实验室检查,比较干预前后两组人群危险因素的改善情况。通过12个月的干预研究发现,干预组和对照组的收缩压和舒张压、血尿素氮和肌酐、血同型半胱氨酸在干预前后的差值比较有统计学意义(P<0.05),干预组改善更明显,而总胆固醇、甘油三酯、低密度脂蛋白在干预前后的差值比较均无统计学意义(P>0.05)。结果提示中西医结合健康管理干预能控制卒中发生的部分高危因素,对社区卒中的防控具有重要意义。From January to July 2017,872 high-risk middle-aged and elderly patients of stroke who visited general practice clinics in 10 community health service centers in Shanghai were enrolled in the study.Cluster randomization was used to select 427 patients from 5 community centers as the intervention group,and 445 patients from other 5 community centers as the control group.The intervention group received health education and traditional Chinese exercise training on the basis of conventional treatment;while the control group received conventional treatment only.After 12 months of intervention physical examinations and related laboratory tests were performed,and the risk factors were compared between two groups before and after the intervention.The results showed that there were significant differences in the systolic and diastolic blood pressure,blood urea nitrogen(BUN),creatinine(Cr)and homocysteine before and after the intervention in both groups(all P<0.05);and compared the control group the improvement of above indicators was more marked in the intervention group.There was no significant difference in cholesterol,triglyceride,and low-density lipoprotein between the two groups before and after the intervention(P>0.05).The health management with integrated traditional Chinese and western medicine can effectively control some risk factors of stroke for middle-aged and elderly people,which is beneficial for the prevention and control of stroke in the community.

关 键 词：卒中 高危 中医健康操 健康教育 社区卫生服务 

分 类 号：R743.3[医药卫生—神经病学与精神病学]