行为转变理论在空腹血糖受损人群生活方式干预中的应用

目的探讨行为转变理论(trans-theoretical model of behavior,TTM)在空腹血糖受损(impaired fasting glucose,IFG)人群生活方式干预中的应用效果。方法便利抽样法选取2012年3月至2013年3月在无锡市人民医院体检中心体检且符合IFG诊断的40例患者为研究对象。由研究团队根据TTM理论,制定综合、分阶段干预措施,一对一进行为期1年的运动、医学营养、糖尿病知识和心理等干预,使其逐步建立合理的饮食结构及适当的运动量,形成健康的生活方式。结果应用TTM方法干预生活方式后,IFG人群体质量指数(body mass index,BMI)、收缩压、舒张压、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL)、空腹血糖(fasting plasma glucose,FPG)明显低于干预前,差异均有统计学意义(均P0.05);但是腰围(waist circumference,WC)、高密度脂蛋白(high-density lipoprotein,HDL)较干预前好转不明显,差异均无统计学意义(均P0.05)。干预后,IFG人群三餐饮食搭配合理例数明显高于干预前,差异有统计学意义(P0.01)。每天摄入三种主要营养素、食用油、食盐、蔬菜摄入的合理例数明显高于干预前,差异有统计学意义(P0.01)。IFG人群每天有效运动时间、总运动量、有效运动量均明显增加,与干预前比较,差异均有统计学意义(均P0.01)。结论应用TTM干预有助于帮助IFG人群逐步建立和维持合理的膳食、适当的运动、改善代谢指标,从而降低发病危险因素,达到健康的生活方式,逐步从源头上控制2型糖尿病的发生与发展。

Application of Intervention on Lifestyle in People with Impaired Fasting Glucose by Trans-Theoretical Model of Behavior

Objective To evaluate the effect ot intervention on htestyle m people witn impaireo fasung glu- cose by trans-theoretical model of behavior.Methods By convenience sampling,40 patients with impaired fasting glucose were selected, and through phased interventions to had one to one exercise, diet, diabetes knowledge and psychological intervention based on TTM theory by our research team for 1 year,in order to construct a healthy dietary structure and proper exercise to form a healthy lifestyle. Results After the interventions, the BMI, systolic pressure, diastolic pressure, TG, TC, LDL, FPG of IFG group were signifi- cantly lower than before intervention（all P〈0.05）,while there was no significant difference in WC and HDL（P〉0.05）.The daily meals collocation index were significantly higher than before intervention（P 〈0.01）, and the intakes of three main nutrients, edible oil, salt,vegetables in intervention group were reason- able than before intervention（P 〈0.01）.The total amount of exercise, effective exercise and exercise time after intervention were increased than before intervention（P〈0.01）.Conclusion The application of TTM interventions helps IFG patients gradually establish and maintain a reasonable diet, healthy exercise and improve metabolism,and thus reduce risk factors, to achieve a healthy lifestyle, gradually stop the develop- ment and progress of type 2 diabetes mellitus.