CAJ | 학술논문

目的：探讨医院社区联合式干预在糖尿病前期人群中的应用效果。方法采用抽签法将选定的4个社区随机整群分为两个对照组社区和两个研究组社区，首先对4个社区的人群进行糖尿病筛查，然后对筛查出的糖尿病前期人群进行干预。共确定121人，研究组57人，对照组64人。对照组给予每3个月一次的社区医护人员随访，研究组给予医院社区联合式干预，包括每3个月一次的社区医护人员随访、医院医护人员健康讲座、现场咨询与个体化的饮食和运动处方，时间均为12个月。干预前后收集两组血糖、体质量指数等临床指标的变化。结果研究组失访1人，共120人完成研究。干预前两组空腹血糖、餐后2 h血糖、糖化血红蛋白、体质量指数比较差异无统计学意义（ P＞0．05）；干预后研究组以上指标分别为（5．70±0．66）mmol／L，（7．29±1．85）mmol／L，（6．26±0．45）％，（26．00±3．11）kg／m2，对照组分别为（6．21±0．99）mmol／L，（8．18±2．26）mmol／L，（6．55±0．74）％，（27．20±3．13）kg／m2，差异有统计学意义（ t值分别为3．148，2．271，2．379，2．070；P＜0．05）。两组健康信念问卷得分干预前比较差异无统计学意义（P ＞0．05），干预后研究组健康信念得分为（127．63±11．64），高于对照组的（121．76±12．53）分，差异有统计学意义（t＝2．944，P＜0．05）。干预1年后，研究组有53．57％糖代谢恢复正常，对照组31．25％恢复正常，差异有统计学意义（ Z＝2．560，P＜0．05）。结论医院社区联合式干预可以改善糖尿病前期人群异常的糖代谢状态，降低糖尿病的发病率。
목적：탐토의원사구연합식간예재당뇨병전기인군중적응용효과。방법채용추첨법장선정적4개사구수궤정군분위량개대조조사구화량개연구조사구，수선대4개사구적인군진행당뇨병사사，연후대사사출적당뇨병전기인군진행간예。공학정121인，연구조57인，대조조64인。대조조급여매3개월일차적사구의호인원수방，연구조급여의원사구연합식간예，포괄매3개월일차적사구의호인원수방、의원의호인원건강강좌、현장자순여개체화적음식화운동처방，시간균위12개월。간예전후수집량조혈당、체질량지수등림상지표적변화。결과연구조실방1인，공120인완성연구。간예전량조공복혈당、찬후2 h혈당、당화혈홍단백、체질량지수비교차이무통계학의의（ P＞0．05）；간예후연구조이상지표분별위（5．70±0．66）mmol／L，（7．29±1．85）mmol／L，（6．26±0．45）％，（26．00±3．11）kg／m2，대조조분별위（6．21±0．99）mmol／L，（8．18±2．26）mmol／L，（6．55±0．74）％，（27．20±3．13）kg／m2，차이유통계학의의（ t치분별위3．148，2．271，2．379，2．070；P＜0．05）。량조건강신념문권득분간예전비교차이무통계학의의（P ＞0．05），간예후연구조건강신념득분위（127．63±11．64），고우대조조적（121．76±12．53）분，차이유통계학의의（t＝2．944，P＜0．05）。간예1년후，연구조유53．57％당대사회복정상，대조조31．25％회복정상，차이유통계학의의（ Z＝2．560，P＜0．05）。결론의원사구연합식간예가이개선당뇨병전기인군이상적당대사상태，강저당뇨병적발병솔。
Objective To investigate the application effect of joint hospital and community intervention in the population with impaired glucose regulation ( IGR) .Methods Four selected communities were divided into the control group and the experimental group.All samples were screened for diabetes mellitus and then given different interventions.Totals of 121 samples were included.There were 57 cases in the experimental group, and 64 cases in the control group.The control group was given a three-month follow-up by the community health workers, while the experimental group was given a joint community and hospital worker’ intervention, including a three-month follow-up of the community, the first three months of hospital health lectures, on-site consultation, individualized diet and exercise prescription.The intervention time was 12 months.Before and after the intervention, samples were asked to complete an IGR health belief questionnaire and other clinical indicators of changes in blood glucose and body mass index were collected.Results One case in the experimental group was lost during follow-up, and 120 cases finished the research.The fasting blood glucose, postprandial 2 h blood glucose, glycated hemoglobin, body mass index were not statistically different between two groups before the intervention (P >0.05).After the intervention, fasting blood glucose, postprandial 2 hour plasma glucose, glycated hemoglobin, body weight index of the experimental group were ( 5.70 ± 0.66)mmol/L, (7.29 ±1.85) mmol/L, (6.26 ±0.45)% and (26.00 ±3.11)kg/m2, respectively.Those values of the control group were (6.21 ±0.99) mmol/L, (8.18 ±2.26) mmol/L, (6.55 ±0.74)% and (27.20 ±3.13)kg/m2.There were significant differences between the two groups (t=3.148, 2.271, 2.379, 2.070, respectively;P<0.05).The score of health belief was not statistically different between the two groups before the intervention (P>0.05).After the intervention, the score of health belief of the experimental group was (127.63 ±11.64), which was significantly higher than (121.76 ±12.53) of the control group (t=2.944, P<0.05 ) .One year after the intervention, 53.57% cases in the experimental group returned to normal glycometabolism, and 31.25%cases in the control group returned to normal, and the difference was significant ( Z=2.560, P <0.05 ) .Conclusions Joint hospital and community intervention can improve the state of abnormal glucose metabolism, and reduce the incidence of diabetes in population with IGR.