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| 社区早期糖尿病肾病综合干预效果评价 | |
| 引用本文： | 朱兰, 顾丹, 傅华. 社区早期糖尿病肾病综合干预效果评价[J]. 上海预防医学, 2016, 28(7): 448-452. |
| 作者姓名： | 朱兰 顾丹 傅华 |
| 作者单位： | 1.1. 上海市徐汇区斜土街道社区卫生服务中心, 上海 200032 |
| 摘 要： | 目的 评价社区早期糖尿病肾病综合干预效果。方法 采用随机对照方法,将201名社区早期糖尿病肾病患者随机分为干预组和对照组,干预组接受糖尿病肾病社区综合干预和规范化管理,对照组接受常规的糖尿病管理。比较两组患者在项目实施前和实施12个月后的指标变化情况。结果 干预12个月后,干预组在对疾病的认知、态度及自我管理行为方面的得分明显优于对照组,其中疾病知识认知较对照组多增加了1.20分,疾病相关态度较对照组多增加了0.52分,服药依从性、周锻炼次数、医患交流分别较对照组多增加了0.19分、0.74次/周和0.44分(P均<0.05)。干预组餐后2 h血糖、糖化血红蛋白较对照组多下降1.13 mmol/L和0.42%,尿微量白蛋白/尿肌酐较对照组多下降26.81 mg/g,收缩压较对照组多下降3 mmHg (P均<0.05)。结论 规范的社区综合干预较常规的糖尿病管理能更明显提高早期糖尿病肾病患者的疾病认知、态度和自我管理行为,更好地改善尿微量白蛋白/尿肌酐、餐后血糖和血压等生物学指标。 |
| 关 键 词： | 早期糖尿病肾病 社区综合干预管理 效果评价 随机对照试验 |
| 收稿时间： | 2016-03-18 |
Evaluation on the effect of comprehensive management of patients with early diabetic nephropathy in a Community |
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| ZHU Lan, GU Dan, FU Hua. Evaluation on the effect of comprehensive management of patients with early diabetic nephropathy in a Community[J]. Shanghai Journal of Preventive Medicine, 2016, 28(7): 448-452. | |
| Authors: | ZHU Lan GU Dan FU Hua |
| Affiliation: | 1.Xietu Community Health Service Center, Xuhui District, Shanghai 200032 China |
| Abstract: | Objective To evaluate the effect of comprehensive management of patients with early diabetic nephropathy in community. Methods A randomized controlled trial was adopted and 201 patients with early diabetic nephropathy in a community were randomized into two groups:intervention group(n=101) and control group(n=100).The intervention group received comprehensive intervention and standardized management, while the control group received routine medical services of diabetes mellitus. The changes of related indicators were compared between the patients in two groups before and after twelve months of intervention. Results After twelve months of intervention, the patients in the intervention group showed greater improvement in cognition, attitude and self-management behavior for the disease compared with the patients in the control group. The values of disease-related knowledge and attitude in the intervention group increased by 1.20 points and 0.52 points significantly more than those in the control group. Medication compliance, weekly exercise time, communication between doctors and patients in the intervention group increased by 0.19 points, 0.74 times/week and 0.44 points significantly more than those in the control group(all P<0.05).Two-hour postprandial blood glucose, glycosylated hemoglobin decreased by 1.13 mmol/L and 0.42% respectively, significantly more than those in the control group. Urinary albumin/urine creatinine, systolic blood pressure decreased by 26.81 mg/g and 3 mmHg respectively, significantly more than those in the control group (all P<0.05). Conclusion Compared with the routine medical services of diabetic nephropathy, the comprehensive intervention and standardized management of early diabetic nephropathy in community is more effective on the improvement in disease-related cognition, attitude and self-management behavior, as well as the biological indexes such as urine albumin/urine creatinine, postprandial blood glucose and blood pressure. |
| Keywords: | early diabetic nephropathy comprehensive management community effect evaluation |
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