北京市某社区家医签约失眠伴多病共存患者治疗方式调查的横断面研究  

Multimorbidity in patients with insomnia in a community health center in Beijing:a cross-sectional study

作　　者：刘静[1] 丁静[1] 季燕[1] 丁兰[1] Liu Jing;Ding Jing;Ji Yan;Ding Lan(Yuetan Community Health Service Center,Affiliated Fuxing Hospital,Capital Medical University,Beijing 100032,China)

机构地区：[1]首都医科大学附属复兴医院月坛社区卫生服务中心,北京100032

出　　处：《首都食品与医药》2024年第24期103-107,共5页Capital Food Medicine

基　　金：北京市中医药科技发展资金项目(编号:JJ2018-62)。

摘　　要：目的了解月坛社区失眠伴多病共存患者治疗方式,为全科医生选择合理、有效的治疗方式提供数据支持。方法以便利抽样法抽取2019年1-3月在月坛社区卫生服务中心就诊的签约家庭医生服务(家医签约)45-74岁失眠患者326例为研究对象,分为多病共存组209例(64.1%)和非多病共存组117例(35.9%),收集两组患者基本信息、失眠治疗方式和效果等,分析影响因素、治疗方式和治疗效果。结果本研究显示,64.1%家医签约的失眠患者存在多病现象,多病共存组和非多病共存组性别、年龄、职业差异有统计学意义(P均<0.05)。在治疗方面,303例(92.9%)失眠患者采取措施进行治疗,仅有88例(27.0%)采用综合干预措施,进行西医、中医治疗者分别为180例(55.2%)、120例(36.8%),仅有18例(5.5%)进行过心理治疗,另有73例(22.4%)采取其他措施改善睡眠质量,多病共存组与非多病共存组失眠治疗方式差异无统计学意义(P均>0.05)。在209例家医签约失眠伴多病患者中,是否进行西医治疗、中医治疗、其他治疗者PSQI分级不同,差异有统计学意义(P均<0.05);疾病数量、是否患有冠心病、是否患有脑卒中者的PHQ-9分级不同,差异有统计学意义(P均<0.05)。结论本社区家医签约失眠患者多病共存率高,治疗方式需拓展,睡眠质量需提高。全科医师应加强对家医签约失眠患者多病共存现象的重视,采取有效治疗措施以提高睡眠质量、降低抑郁发生可能。Objective To understand the treatment methods of patients with insomnia and multimorbidity in Yuetan community,and provide data support for general practitioners to choose effective treatment methods.Methods 326 insomnia patients aged 45-74 who signed contracted family doctor service at Yuetan Community Health Service Center from January to March 2019 were selected,and they were divided into multimorbidity group and non-multimorbidity group.The basic information,insomnia treatment methods and effects were collected,and analyzed the influencing factors and treatment effects.Results 64.1%of patients had more than one chronic disease,and were statistically significant differences in gender,age,and employed status between two groups(P<0.05).303(92.9%)of insomnia patients took measures to treat,and only 88(27.0%)treated with comprehensive intervention measures.180 cases(55.2%)and 120 cases(36.8%)who were treated with western medicine and Chinese medicine respectively,only 18 cases(5.5%)received psychotherapy,and 73 cases(22.4%)took other measures to improve sleep quality.There was no statistically significant difference in insomnia treatment between two groups(P>0.05).Among the 209 multimorbidity patients,the PSQI are different for patients with Western medical treatment,TCM treatment,and other treatments(P<0.05);for different disease types,whether they have coronary heart disease or stroke,the PHQ-9 are different,and the difference is statistically significant(P<0.05).Conclusion The multimorbidity rate of insomnia patients with contracted family doctor service is high,the treatment methods need to be expanded,and sleep quality need to be improved.General practitioners should pay more attention to the coexistence of multiple diseases in contracted patients with insomnia,and take effective treatment measures to improve sleep treatment and reduce the possibility of depression.

关 键 词：家医签约 多病 失眠 治疗方式 睡眠质量 横断面研究 

分 类 号：R740[医药卫生—神经病学与精神病学]