支气管哮喘患者社区综合防治效果评估

目的评估社区综合防治支气管哮喘的效果,探讨社区综合防治措施在支气管哮喘缓解期中的作用。方法于2007年2月—2009年2月对124例哮喘缓解期患者给予社区综合干预措施,即健康教育、中药穴位敷贴疗法、变应原特异性免疫疗法、长期个人用药计划、规范化管理和跟踪随访,随访期为2年。结果 2年后哮喘被部分控制或完全控制的患者占84.7%;患者肺功能明显改善(P0.05),且随综合管理时间的推移而进一步改善。综合防治6个月后患者生存质量明显提高(P0.05),但生存质量子项目"心理状态"差异无统计学意义,1年后生存质量总分及各子项目差异均有统计学意义(P0.01)。门诊和住院次数由(2.3±2.6)次/年下降为(1.1±1.7)次/年,医疗费用由(3487±2568)元/年下降为(1685±1352)元/年,差异均有统计学意义(P0.01)。结论综合防治可有效减少哮喘的发作频率,延长缓解期,提高生活质量。

Evaluation of the Community Comprehensive Prevention and Treatment on Patients with Bronchial Asthma

Objective To evaluate the effect of comprehensive prevention and treatment on bronchial asthma in the community, to explore its role in the remission stage of bronchial asthma. Methods 124 of asthmatic patients in remission stage were selected during Feb. 2007 to Feb. 2009 to take the community comprehensive interventions, namely health education, acupoint application therapy of Chinese medicine, allergen-specific immunotherapy and long-term individual medication plans, standardized management and tracking of 2-years follow-up. Results After 2-years follow-up, the proportion of asthma patients achieving partial control effect and over accounted for 84.7% （P〈0.01）; Pulmonary function of Patients improved obviously （P〈 0.01）, and it was further improved with the time of the comprehensive management; After 6 months management, their quality of life obviously improved, but the difference of sub-item ＂psychological status＂ was not statistically significant （P〉0.05）; after 1 year management, the differences of quality of life score and various items evaluation were significant （all P〈0.01）; Outpatient service and hospitalizations times reduced from 2.3±2.6 to 1.1±1.7 （times/year）, medical expenses reduced from 3 487±2 568 to 1 685±1 352 （RMB Yuan/year） （all P〈0.01）. Conclusion The comprehensive prevention and treatment on asthma control plays an important role and can effectively reduce the frequency of asthma attacks and prolong remission and improve quality of life.