糖尿病患者应用中医适宜技术预后不良的危险因素分析与路径  

Risk factor analysis and path research of traditional Chinese medicine appropriate technology in diabetic patients

作　　者：黄圣雁[1] 龚海燕[2] 赵蕾[1] 张玉琴[3] HUANG Shengyan;GONG Haiyan;ZHAO Lei;ZHANG Yuqin(Department of Geriatrics(Endocrinology),Kunshan Hospital of Chinese Medicine,Kunshan,Jiangsu 215300;Department of Encephalopathy,Kunshan Hospital of Traditional Chinese Medicine,Kunshan,Jiangsu 215300;Department of Nursing,Kunshan Hospital of Traditional Chinese Medicine,Kunshan,Jiangsu 215300)

机构地区：[1]江苏省昆山市中医医院老年病科(内分泌),江苏昆山215300 [2]江苏省昆山市中医医院脑病科,江苏昆山215300 [3]江苏省昆山市中医医院护理部,江苏昆山215300

出　　处：《河北中医》2024年第5期799-803,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：昆山市重点研发计划(社会发展)项目(编号:KS2230)。

摘　　要：目的分析糖尿病患者应用中医适宜技术预后不良的危险因素与路径研究。方法纳入120例应用中医适宜技术干预的糖尿病患者为研究对象,并将其按预后情况分成预后良好组80例、预后不良组40例,统计分析糖尿病患者的临床基本资料。比较2组健康调查简表(SF-36)、血糖相关指标(空腹血糖、餐后2 h血糖及糖化血红蛋白)水平,应用单因素分析及多因素Logistic回归分析糖尿病患者预后不良情况的主要危险因素。结果良好组SF-36各项评分均高于不良组患者(P<0.05)。良好组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均低于不良组(P<0.05)。单因素分析显示,糖尿病患者预后不良情况发生与性别、高血压、吸烟、文化程度无关,比较差异无统计学意义(P>0.05);主要与年龄、体质量指数(BMI)、血脂异常、病程、糖尿病家族史、治疗依从性、科学运动、丙氨酸氨基转移酶(ALT)水平有关,比较差异有统计学意义(P<0.05)。Logistic回归分析结果发现,年龄≥70岁、BMI肥胖或超重、病程长短、血脂异常、糖尿病家族史、未科学运动、治疗依从性差、ALT升高为糖尿病患者发生预后不良情况的主要危险因素(P<0.05)。以糖尿病患者预后是否发生预后不良为因变量,发现病程、BMI、年龄、血脂异常、科学运动、治疗依从性、ALT、糖尿病家族史对糖尿病患者发生预后不良情况具有间接的中介作用。结论通过使用中医适宜技术对糖尿病患者进行干预,可有效改善患者的血糖指标及生活质量,糖尿病患者预后不良情况主要与年龄、病程、BMI指数、糖尿病家族史、血脂异常、ALT相关,为临床改善患者预后情况提供了参考。Objective To analyze the risk factor and path research of traditional Chinese medicine(TCM)appropriate technology in diabetic patients.Methods The basic clinical data of the eligible 120 diabetes patients were statistically analyzed,and the patients were divided into good prognosis group(n=80)and poor prognosis group(n=40)according to the prognosis of the application of TCM appropriate techniques.The 36-Item Short Form Survey(SF-36)score and blood glucose related indicators(fasting blood glucose[FBG],2-h postprandial blood glucose[2h-PBG],and glycosylated hemoglobin[HbA 1c])were compared between the two groups.Univariate and multivariate Logistic regression analysis were used to explore the main risk factors for the prognosis of diabetes patients.Results The SF-36 scores in the good prognosis group were significantly higher than those of the poor prognosis group(P<0.05),but FBG,and 2h-PBG and HbA1c levels were significantly lower(P<0.05).Univariate Logistic regression analysis showed that the occurrence of poor prognosis in diabetic patients was not related to sex,hypertension,smoking,and education level(P>0.05).It was significantly related to age,body mass index(BMI),dyslipidemia,family history of diabetes,disease course,treatment compliance,scientific exercise,and alanine aminotransferase(ALT)level(P<0.05).Multivariate Logistic regression analysis demonstrated that age,BMI,course of disease,dyslipidemia,family history of diabetes,scientific exercise,treatment compliance,and ALT were the main risk factors for poor prognosis of diabetic patients(P<0.05).With the prognosis of diabetic patients as the dependent variable,it was found that the disease course,BMI,age,dyslipidemia,scientific exercise,treatment compliance,ALT,and family history of diabetes had an indirect mediating effect for the poor prognosis of diabetic patients.Conclusion The application of TCM appropriate techniquesin diabetes patients can effectively improve their blood glucose indicators and quality of life,and the poor prognosis of diabetes pati

关 键 词：糖尿病 中医适宜技术 路径研究 生活质量 

分 类 号：R587.1[医药卫生—内分泌]