CAJ | 학술논문

目的：分析循证思想在2型糖尿病患者健康指导中的应用，并评价其效果。方法将140例清远市人民医院内分泌科收治的2型糖尿病患者随机分为观察组与对照组，每组各70例，对照组患者进行常规护理指导，观察组患者应用循证思想进行健康指导，按照循证依据、提出问题、循证护理目的及计划、循证护理健康指导实施步骤进行，比较两组患者血糖相关指标、再入院率及并发症情况。结果观察组患者干预3个月后的空腹血糖(7.8±1.8 mmol/L vs.8.9±2.2 mmol/L)、餐后2 h血糖(10.1±2.3 mmol/L vs.14.0±2.6 mmol/L)、糖化血红蛋白(7.8±1.1% vs.9.6± 1.3%)及身高体重指数(23.8 ± 3.4 kg/m2 vs.24.9±3.8 kg/m2)均显著低于对照组同期水平(p<0.001)，观察组干预6个月后的空腹血糖(7.4±1.7 mmol/L vs.9.0±1.9 mmol/L)、餐后2 h血糖(9.6± 2.5 mmol/L vs 13.8 ± 2.2 mmol/L)、糖化血红蛋白(7.2± 0.9% vs.9.4± 1.3%)及体重指数(23.5±2.9 kg/m2 vs.24.6±3.9 kg/m2)均显著低于对照组同期水平(p<0.001)，观察组患者干预3个月(3.8±1.5次/周vs.2.6±1.9次/周)及6个月(4.9±2.0次/周vs.3.2±0.8次/周)的运动次数均显著高于对照组同期水平(p<0.001)。观察组患者的门诊率(21.4% vs.37.1%)及总计并发症发生率(8.6% vs.24.3%)显著低于对照组(p<0.05)。结论循证思想指导下的2型糖尿病健康教育可有效降低空腹血糖、餐后2h血糖及糖化血红蛋白水平，提升运动次数，降低门诊率及总并发症发生率。
목적：분석순증사상재2형당뇨병환자건강지도중적응용，병평개기효과。방법장140례청원시인민의원내분비과수치적2형당뇨병환자수궤분위관찰조여대조조，매조각70례，대조조환자진행상규호리지도，관찰조환자응용순증사상진행건강지도，안조순증의거、제출문제、순증호리목적급계화、순증호리건강지도실시보취진행，비교량조환자혈당상관지표、재입원솔급병발증정황。결과관찰조환자간예3개월후적공복혈당(7.8±1.8 mmol/L vs.8.9±2.2 mmol/L)、찬후2 h혈당(10.1±2.3 mmol/L vs.14.0±2.6 mmol/L)、당화혈홍단백(7.8±1.1% vs.9.6± 1.3%)급신고체중지수(23.8 ± 3.4 kg/m2 vs.24.9±3.8 kg/m2)균현저저우대조조동기수평(p<0.001)，관찰조간예6개월후적공복혈당(7.4±1.7 mmol/L vs.9.0±1.9 mmol/L)、찬후2 h혈당(9.6± 2.5 mmol/L vs 13.8 ± 2.2 mmol/L)、당화혈홍단백(7.2± 0.9% vs.9.4± 1.3%)급체중지수(23.5±2.9 kg/m2 vs.24.6±3.9 kg/m2)균현저저우대조조동기수평(p<0.001)，관찰조환자간예3개월(3.8±1.5차/주vs.2.6±1.9차/주)급6개월(4.9±2.0차/주vs.3.2±0.8차/주)적운동차수균현저고우대조조동기수평(p<0.001)。관찰조환자적문진솔(21.4% vs.37.1%)급총계병발증발생솔(8.6% vs.24.3%)현저저우대조조(p<0.05)。결론순증사상지도하적2형당뇨병건강교육가유효강저공복혈당、찬후2h혈당급당화혈홍단백수평，제승운동차수，강저문진솔급총병발증발생솔。
Objective Analysis the application of evidence-based in health guidance in type 2 diabetic patients,and evaluate it,s efficacy. Methods R140 patients with type 2 diabetes from Qingyuan City People′s Hospital were randomly divided into observa-tion group and control group. each group contained 70 patients. the control group treated with routine care and guidance. and the obser-vatiom were used evidence-based to guide health. according to evidence-based, ask questions, evidence-based care purposes and plans to guide the implementation of evidence-based health care steps,the related indicators of blood sugar, readmission rates and complications were compared. Results The fasting plasma (7. 8 ± 1. 8 mmol/L vs. 8. 9 ± 2. 2 mmol / L),the glucose blood glucose after 2 h postprandial (10. 1 ± 2. 3 mmol / L vs. 14. 0 ± 2. 6 mmol/L), glycated hemoglobin (7. 8 ± 1. 1% vs. 9. 6 ± 1. 3%) and body mass index (23. 8 ± 3. 4 kg / m2 vs. 24. 9 ± 3. 8 kg / m2 ) in the observation group after 3 months intervention were significantly lower than the same period of the control group(p <0. 001). the fasting plasma glucose (7. 4 ± 1. 7 mmol/L vs. 9. 0 ± 1. 9 mmol/L), 2 h postprandial blood glucose (9. 6 ± 2. 5 mmol/L vs. 13. 8 ± 2. 2 mmol / L), glycated hemoglobin (7. 2 ± 0. 9%vs. 9. 4 ± 1. 3%) and body mass index (23. 5 ± 2. 9 kg / m2 vs. 24. 6 ± 3. 9 kg / m2 ) in the observation group after 6months intervention were signifi-cantly lower than the same period of the control group(p <0. 001). the movement times in the intervention group after 3 months inter-vention (3. 8 ± 1. 5 times / week vs. 2. 6 ± 1. 9 times / week) and after 6 months intervention(4. 9 ± 2. 0 times / week vs. 3. 2 ± 0. 8 times / week) were significantly higher than the level of the same period of the control group. p<0. 001. the outpatient rate (21. 4%vs. 37. 1 %) patients and total complication rate (8. 6 % vs. 24. 3 %) in observation group was significantly lower than the control group,p <0. 05. conclusion Type 2 diabetes health education under the guidance of the idea of evidence-based conclusions could effectively reduce fasting blood glucose, plasma glucose and glycosylated hemoglobin levels, improve exercise times, lower overall out-patient rate and complication rate.