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目的比较丽水市农村2型糖尿病患者社区干预不同方式的效果。方法于2011—2013年选择丽水市莲都区3个农村社区的210例2型糖尿病患者,随机分为常规干预组、分级干预组和标准干预组三组,采用不同方式开展为期3年的社区随访干预。比较三组患者在干预前后不良生活方式和指标控制情况。结果干预前三组患者的体重指数、收缩压、空腹血糖、餐后2 h血糖、甘油三酯、饮食控制和口服降糖药等7项指标分别比较,差异均无统计学意义(P>0.05);干预后三组间比较,其中分级随访干预组和标准随访干预组患者的体重指数、收缩压、空腹血糖、餐后2 h血糖和甘油三酯等5项指标的下降程度(干预前后差值均数)分别高于常规干预组(P<0.05);标准干预组患者体重指数、收缩压和空腹血糖这3项指标的下降程度(干预前后的差值均数)均高于分级干预组(P<0.05),而标准干预组患者的超重、血压异常和空腹血糖异常检出率均分别低于分级干预组和常规干预组(P<0.05)。结论标准干预和分级干预比常规干预更能有效控制糖尿病危险因素,标准干预比分级干预在血糖控制等方面更有优势。
Objective To compare the effects of community intervention in rural patients with type 2 diabetes in Lishui City. Methods A total of 210 type 2 diabetic patients from 3 rural communities in Liantu District of Lishui City from 2011 to 2013 were randomly divided into three groups: routine intervention group, graded intervention group and standard intervention group. The three-year community Follow-up intervention. Three groups of patients were compared before and after the intervention of poor lifestyles and indicators of control. Results There were no significant differences in body mass index, systolic blood pressure, fasting blood glucose, postprandial blood glucose 2 h, triglyceride, diet control and oral hypoglycemic agents among the three groups before intervention (P> 0.05 ). After intervention, the body mass index, systolic blood pressure, fasting blood glucose, postprandial 2-h blood glucose and triglyceride were significantly decreased among the three groups (grading follow-up intervention group and standard follow-up intervention group (P <0.05). The decline of the body mass index, systolic blood pressure and fasting blood glucose in the standard intervention group were higher than those in the intervention group (mean difference before and after intervention) (P <0.05). However, the detection rates of overweight, abnormal blood pressure and fasting blood glucose in the intervention group were lower than those in the intervention group and the routine intervention group respectively (P <0.05). Conclusion Standard intervention and graded intervention are more effective than routine intervention in controlling the risk factors of diabetes. Standard intervention is superior to grading intervention in controlling blood glucose.