两种管理模式在城市社区2型糖尿病管理中的应用及效果研究

目的 通过对比分析高境镇社区2型糖尿病的自我管理和分级分层管理两种模式的应用及效果,探寻一种适宜城市社区2型糖尿病的管理模式.方法 基于社区进行干预试验,在高境镇社区选取258名2型糖尿病患者,随机分为两组,分别为自我管理模式组（A）,分级分层管理模式组（B）,两组患者接受干预管理,于2013年6月-2014年2月进行为期8个月的试验,试验完成后,通过比较两组患者干预前后,患者糖尿病知识、自我管理水平、抑郁、焦虑状况以及血糖、血压和体质指数方面的变化情况,评价两种管理模式在城市社区2型糖尿病管理中的效果.结果 自我管理模式组和分级分层管理模式组试验结束后其空腹血糖和糖化血红蛋白两项指标均有明显改善（P＜0.05）,自我管理模式组较分级分层管理模式组空腹血糖、体质指数及糖化血红蛋白改善更加明显（P＜0.05）;自我管理模式组与干预前相比,患者糖尿病相关知识掌握达标率均有显著提高（P＜0.01）、患者抑郁和焦虑症状得到缓解;患者自我管理水平的各项评分均明显升高（P＜0.05）,且自我管理模式组患者吃甜食、吃油腻食品及饮酒流行率明显降低（P＜0.05）.结论 城市社区2型糖尿病自我管理模式能够有效提高患者生活质量、维持其正常新陈代谢和减少合并症,效果优于分级分层管理模式,其长期效果值得进一步分析讨论,并推广应用.

Research on the Application and Effects of Two Management Models on Type 2 Diabetes Patients in Urban Communities

OBJECTIVE Comparing and analyzing the application and effects of two different management models on the daily manage- ment of patients with type 2 Diabetes to find a suitable model for the management of type 2 Diabetes patients in Gaojing Town com- munities. METHODS To adopt a community-based field test group, 258 patients with type 2 Diabetes were selected and divided into groups of self-management model（A）and classification management model（B）. Patients accepted the management for 8 months from June 2013 to February 2014. Intervention at the end of knowledge in diabetes awareness, self-management level, depression, anxiety, and blood glucose, blood pressure and body mass index changes were collected to evaluate the management effectiveness and feasibili- ty of two models. RESULTS Fasting glucose and glycosylated hemoglobin levels of patients from two managements were all improved （P〈0.05）. Comparing to classification management model, patients in self-management model possess more effective in improving fast- ing glucose, body mass index and glycosylated hemoglobin levels（P〈0.05）. The mean score of diabetes knowledge, depression, anxiety score were also improved significantly（P〈0.05）. The self-management levels on type 2 diabetes were also improved（P〈O.05）. The ra- tios of eat sweet and greasy food and alcohol drinking in group of A were significant reduced comparing group B（P〈0.05）. CONCLUSION The quality life of patients with type 2 diabetes from self-management model in the urban communities could be improved significantly, as well as maintaining eubolism and reducing the complications. It was more effective than classification management model. The long-time effect should be further discussed and applicated.