论文部分内容阅读
目的:评价对2型糖尿病患者实施全程健康教育临床效果。方法检索 Cochrane Library、PubMed、EMbase、CNKI 和WanFang Data 等数据库中关于对糖尿病患者实施全程健康教育的随机对照试验或临床对照试验研究。采用 Cochrane Handbook(5.0.1)对文献质量进行评价,并采用RevMan 5.3软件进行Meta分析。结果共纳入8项研究。首先对各指标纳入的研究进行异质性分析,并采用敏感性分析寻找异质性来源。5项研究分析结果显示,全程健康教育组患者的遵医依从性较常规健康教育组显著提高。其中“合理用药”结果为RR=1.60,95%CI(1.44,1.78),P<0.001;“合理饮食”RR=1.56,95%CI(1.34,1.81), P<0.001;“适量运动”结RR=1.73,95%CI(1.41,2.11),P<0.001;“自我监测”RR=3.53,95%CI(2.53,4.92),P<0.001。全程健康教育同时能够提高2型糖尿病患者的血糖控制效果,其中空腹血糖结果为MD=-1.21,95%CI(-1.47,-0.95),P<0.001;餐后2 h血糖为MD=-2.15,95%CI(-2.92,-1.38),P<0.001。描述性分析显示实施全程健康教育能够降低HbA1c值(均P<0.01)。其余异质性来源的研究描述性分析结果与meta分析结果一致。结论门诊-住院-出院后全程健康教育是糖尿病治疗中具有系统性、全程性的干预措施,不仅能够提高患者遵医行为的依从性,而且有利于患者控制病情。“,”ObjectiveTo evaluate the clinical effect of implementation of whole course health education on type 2 diabetes patients.MethodsCochrane Library, PubMed, EMbase, Web of Science, VIP, CNKI and WanFang Database were searched to recruit randomized controlled trials no matter written in Chinese or English. The qualities of studies were critically appraised and data were extracted by 2 reviewers independently. The effects of Hemostatic compression device were determined by Meta-analysis with Review Manager 5.3.Results8 studies were finally included, which included a total of 1100 patients. 5 studies concerned treatment compliance. The meta-analysis results showed that, the whole course health education can promote the patients in regular use of drugs [RR=1.60,95%CI(1.44,1.78),P<0.001], reasonable diet [RR=1.56,95%CI(1.34,1.81),P<0.001], moderate exercise [RR=1. 73,95%CI(1.41,2.11),P<0.001] and timely self monitoring [RR=3.53,95%CI(2.53,4.92),P<0.001]. Whole course health education can improve blood glucose control in patients with type 2 diabetes. Meta analysis showed that fasting blood glucose and postprandial 2 hours blood glucose results of experimental group were lower than control group [FBG:MD=-1.21,95%CI(-1.47,-0.95),P<0.001; 2hBG: MD=-2.15,95%CI(-2.92,-1.38),P<0. 001]. Descriptive analysis also showed that the whole course health education could reduce the HbA1c value (P<0.01). Descriptive analysis results about the other studies with heterogenicity were consistent with the results of meta analysis.ConclusionThe whole course health education including outpatient service-be hospitalized-post discharge education was a systematic and complete intervention in the treatment of type 2 diabetes. It can not only improve the compliance of patients behavior on treatment, but also help patients to control the levels of blood glucose.