CAJ | 학술논문

目的探索不同管理模式对糖尿病前期人群生活方式干预效果的影响.方法采取前瞻性观察研究的方法,将1182名糖尿病前期患者随机分为单独访谈组、集体宣教组、通讯访谈组3个干预组和1个对照组,对干预组进行健康教育与指标控制相结合的为期2年的生活方式干预,多组比较采用方差分析或X2检验,组间的两两比较采用q检验.结果干预组空腹血糖、餐后2小时血糖均呈下降趋势(P＜0.05).三个干预组之间的两两比较,干预6个月以后单独访谈组、集体宣教组的空腹血糖均值明显低于通讯访谈组,干预24个月以后单独访谈组的空腹血糖均值开始低于集体宣教组(P＜0.05).干预组转为理想血糖的百分比远远高于对照组,同时发展为糖尿病的百分比远远低于对照组.接受不同干预方案后与对照组相比,3个干预组的血压、三酰甘油、胆固醇、肌酐等指标有显著性改善,肥胖的发生率也显著下降(P＜0.05)；心电图、动脉硬化程度则无明显变化(P＞0.05).3种不同管理模式的干预效果比较,单独访谈组和集体宣教组均明显优于通讯访谈组,但单独访谈组的依从性最差.结论对糖尿病前期患者实施健康教育与指标控制相结合的生活方式干预,能预防或延缓糖尿病的发生.综合评价3种不同管理模式,医院体检中心与体检客户联手的集体宣教是较佳的干预管理模式.
목적 탐색불동관리모식대당뇨병전기인군생활방식간예효과적영향.방법 채취전첨성관찰연구적방법,장1182명당뇨병전기환자수궤분위단독방담조、집체선교조、통신방담조3개간예조화1개대조조,대간예조진행건강교육여지표공제상결합적위기2년적생활방식간예,다조비교채용방차분석혹X2검험,조간적량량비교채용q검험.결과 간예조공복혈당、찬후2소시혈당균정하강추세(P＜0.05).삼개간예조지간적량량비교,간예6개월이후단독방담조、집체선교조적공복혈당균치명현저우통신방담조,간예24개월이후단독방담조적공복혈당균치개시저우집체선교조(P＜0.05).간예조전위이상혈당적백분비원원고우대조조,동시발전위당뇨병적백분비원원저우대조조.접수불동간예방안후여대조조상비,3개간예조적혈압、삼선감유、담고순、기항등지표유현저성개선,비반적발생솔야현저하강(P＜0.05)；심전도、동맥경화정도칙무명현변화(P＞0.05).3충불동관리모식적간예효과비교,단독방담조화집체선교조균명현우우통신방담조,단단독방담조적의종성최차.결론 대당뇨병전기환자실시건강교육여지표공제상결합적생활방식간예,능예방혹연완당뇨병적발생.종합평개3충불동관리모식,의원체검중심여체검객호련수적집체선교시교가적간예관리모식.
Objective To explore the effects of different health management on adults with prediabetes.Methods A total of 1182 pre-diabetics were enrolled in this prospective observation study and assigned to one-by-one interview group,in situ education group,communicative interview group and control group.Three intervention groups received life style intervention ( including health education and risk factor control) for 2 years.Analysis of variance,x2 test or q test were used for data analysis.Results After year intervention,fasting plasma glucose (FPG) and 2 h plasma glucose of the intervention groups were significantly decreased ( P ＜ 0.05 ).FPG of the one-by-one interview group and the in situ education group was significantly lower than that of the communicative interview group at 6 months ( P ＜ 0.05 ). At 24months,FPG of the one-by-one interview group was lower than that of the in situ education group (P ＜0.05).The percentage of participants who showed appropriate blood glucose control was increased in the intervention groups. In addition,blood pressure,triglyceride,cholesterol,creatinine and body weight of those in the intervened groups were significantly improved compared with the control group ( all P ＜ 0.05 ),although electrocardiogram results and arteriosclerosis showed no significant changes (P ＞ 0.05 ).Conclusion Health management may contribute to life style change and hypertension control of prediabetics.Furthermore,in situ education may be the most effective life style interventions.