数字医疗管理对社区原发性高血压伴躯体化症状障碍患者管理效果的探讨  

Effect of digital health management on the management of essential hypertension patients with somatization symptom disorder in the community

作　　者：倪凌雁 毛家亮[2] 秦宁 陈霞 龚静 Ni Lingyan;Mao Jialiang;Qin Ning;Chen Xia;Gong Jing(Community Health Service Center in Jiangwan Town,Hongkou District,Shanghai 200343,China;Department of Cardiology,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China)

机构地区：[1]上海市虹口区江湾镇街道社区卫生服务中心,上海200343 [2]上海交通大学医学院附属仁济医院心内科,上海200001

出　　处：《中华全科医师杂志》2025年第4期434-440,共7页Chinese Journal of General Practitioners

基　　金：上海市虹口区卫生健康委员会医学科研课题(虹卫2202-04)。

摘　　要：目的探讨数字医疗管理对社区原发性高血压伴躯体化症状障碍患者的管理效果。方法该研究为干预性试验。纳入2022年1至12月在上海市虹口区江湾镇街道社区卫生服务中心门诊就诊的原发性高血压伴躯体化症状障碍的患者。按照首诊时间分为数字医疗管理组(首诊时间为2022年1至6月)和对照组(首诊时间为2022年7至12月)。收集患者的基线临床资料。对照组采用常规方式进行干预,数字医疗管理组在不改变原药物治疗方案的基础上利用健康云5.3.11对患者进行数字化医疗管理。干预时间为24周,在干预前及干预24周末分别采用躯体化症状自评量表(SSS)、9项患者健康问卷(PHQ-9)和7项广泛性焦虑障碍量表(GAD-7)对患者的躯体化症状、抑郁、焦虑状况进行评分,并计算SSS减分率,同时测量患者的血压、心率等指标。躯体化症状干预效果的评价标准:干预终点时SSS≤29分或SSS减分率≥75%为痊愈,SSS减分率50%~<75%为显效,SSS减分率25%~<50%为有效,SSS减分率<25%为无效。总有效率=(痊愈患者例数+显效患者例数+有效患者例数)/总患者例数×100%。结果数字医疗管理组62例患者、对照组65例患者纳入最终分析。数字医疗管理组患者年龄(50.5±3.5)岁,男性30例(48.4%),对照组年龄(50.2±3.2)岁,男性31例(47.7%),两组患者的年龄和性别构成差异均无统计学意义(均P>0.05)。干预前两组患者SSS各单项得分及总分、PHQ-9得分、GAD-7得分以及血压和心率差异均无统计学意义(均P>0.05),干预24周末两组患者上述各项得分均下降,血压、心率也下降(均P<0.05),干预24周末数字医疗管理组患者干预前后SSS各单项得分及总分、PHQ-9得分、GAD-7得分以及血压和心率的差值均大于对照组(均P<0.05)。数字医疗管理组患者躯体化症状障碍干预有效者占比高于对照组[57例(91.9%)比38例(58.5%),P<0.001]。结论数字医疗管理可更好地改善原发�Objective To explore the effectiveness of digital health management in the management of community patients with essential hypertension comorbid with somatization symptom disorder.Methods This was an intervention-controlled study.Patients with essential hypertension comorbid with somatization symptom disorder who visited the outpatient clinic of Jiangwan Town Community Health Service Center in Hongkou District,Shanghai from January to December 2022 were enrolled.Based on the time of initial diagnosis,patients were divided into a digital health management group(initial diagnosis from January to June 2022)and a control group(initial diagnosis from July to December 2022).Baseline clinical data were collected.The control group received conventional interventions,while the digital health management group utilized the Health Cloud APP 5.3.11 platform for online digital health management without altering the original medication regimen.The intervention lasted for 24 weeks.Before and after the intervention,the Somatization Symptom Scale(SSS),9-item Patient Health Questionnaire(PHQ-9),and 7-item Generalized Anxiety Disorder Scale(GAD-7)were used to assess somatization symptoms,depression,and anxiety,respectively.The reduction rate in SSS scores was calculated,and blood pressure and heart rate were measured.The evaluation criteria for somatization symptom intervention effectiveness were as follows:at the endpoint of the intervention,SSS≤29 or a reduction rate of SSS≥75%was considered"cured";a reduction rate of 50%to<75%was considered"markedly effective";a reduction rate of 25%to<50%was considered"effective";and a reduction rate of<25%was considered"ineffective".The overall effectiveness rate=(number of cured patients+number of markedly effective patients+number of effective patients)/total number of patients×100%.Results A total of 62 patients in the digital health management group and 65 patients in the control group were included in the final analysis.The mean age of the digital health management group was(50.5±3.5

关 键 词：高血压 躯体化障碍 数字医疗管理 

分 类 号：R544.1[医药卫生—心血管疾病]