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目的同伴支持干预表现出对血糖控制的不同影响。本文旨在评估由糖尿病累及人群(患有该疾病人群或护理者)相互提供的同伴支持干预对成人糖尿病患者糖化血红蛋白(HbA_(1c)水平的影响。方法检索Ovid MEDLINE、Cochrane、CINAHL及Scopus多个数据库。检索时间为1960年1月—2015年11月。筛选以成年糖尿病患者接受同伴支持干预为试验组、接受其他类似护理方式为对照组的随机对照试验(RCT)。205条检索文献中有17条符合纳入标准。采用Cochrane偏倚风险评估工具进行质量评估。采用随机效应模型,计算组间基线HbA_(1c)水平变化的标准化均数差(SMD)。结果 7条文献中,3个整群RCT、14个RCT,共4 715例研究对象。与对照组相比,试验组HbA_(1c)水平改善,SMD为0.121[95%CI(0.026,0.217),P=0.01,χ~2=60.66%];HbA_(1c)水平改善了0.24%[95%CI(0.05%,0.43%)]。在以西班牙裔参与者为主要研究对象的文献中,HbA_(1c)水平改善了0.48%[95%CI(0.25%,0.70%),P<0.001,I~2=17.12%];而以少数种族人群为主要研究对象的文献中,HbA_(1c)水平改善了0.53%[95%CI(0.32%,0.73%),P<0.001,I~2=9.24%]。结论成人糖尿病患者间的同伴支持干预总体上而言,差异有统计学意义,但对HbA_(1c)水平改善效果并不显著。然而这些干预措施可能对改善少数种族群体、特别是西班牙裔群体的血糖控制特别有效。
Purpose Peer support interventions show different effects on glycemic control. The purpose of this article is to evaluate the effects of peer supportive interventions on diabetes mellitus (HbA_ (1c)) in adults with diabetes mellitus (patients with this disease or caregivers) .Methods Ovid MEDLINE, Cochrane, CINAHL and Scopus A database was retrieved from January 1960 to November 2015. The screening patients receiving companion supportive intervention in adults with diabetes mellitus were included in the randomized controlled trials (RCTs) of other similar care regimens. 17 were eligible for inclusion.Quality assessment was performed using the Cochrane bias risk assessment tool.A standardized random difference (SMD) was calculated using the random effects model for changes in baseline HbA_ (1c) levels.Results Of the 7 studies, 3 Group RCT, and 14 RCTs, and compared with the control group, the level of HbA 1c in the experimental group was improved, the SMD was 0.121 [95% CI (0.026,0.217), P = 0.01, χ ~ 2 = HbA1c levels improved by 0.24% [95% CI (0.05%, 0.43%)] in the literature with predominantly Hispanic participants, an improvement of 0.48% for HbA 1c levels (60.66% 95% CI (0.25%, 0.70%), P <0.001, I ~ 2 = 17.12%]; The prevalence of HbA 1c was improved by 0.53% (95% CI 0.32%, 0.73%, P 0.001, I 2 = 9.24%) in the literatures of ethnic groups as the main research object.Conclusion Comparing adult patients with diabetes mellitus Supportive interventions overall were statistically significant but not significant for improving HbA_ (1c) levels, but these interventions may be particularly effective in improving glycemic control of ethnic minority groups, especially Hispanics.