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目的比较以家庭医生为主导的糖尿病精细化管理与传统的以公卫医生为主导的糖尿病管理模式的效果,为糖尿病的防控提供依据。方法从社区糖尿病管理系统中随机选取100例与家庭医生签约的2型糖尿病患者作为精细化管理组,对性别、年龄、病程进行匹配后,选取100例未签约的2型糖尿病患者作为传统管理组。传统管理组予以常规药物治疗和社区管理,精细化管理组由家庭医生根据拟定的糖尿病精细化管理方案进行治疗和管理,比较1年后两组患者管理前后体重、腰围、生活行为方式、血糖水平、糖尿病知信行(KAP)认知水平及就诊次数的差异。应用SPSS 19.0对数据进行χ~2检验和t检验。结果两组患者管理前后体重、吸烟和饮酒情况比较,差异均无统计学意义(P>0.05),精细化管理组管理后腰围较管理前明显减小,运动人数较管理前明显增多,差异均有统计学意义(P<0.05)。1年后,精细化管理组空腹血糖、餐后2 h血糖、糖化血红蛋白(Hb A1C)水平及就诊次数均明显低于传统管理组,患者运动人数明显增加,糖尿病KAP认知得分明显升高,差异均有统计学意义(P<0.05)。结论以家庭医生为主导的糖尿病精细化管理采取防治一体化的管理模式,为糖尿病患者提供持续、优质、负责制的医疗照护和疾病管理,效果明显优于传统管理模式,值得推广。
Objective To compare the effect of family doctor-oriented diabetes management with the traditional diabetes management mode led by public health doctors to provide the basis for the prevention and control of diabetes. Methods A total of 100 type 2 diabetic patients with family doctors were randomly selected from the community diabetes management system as the meticulous management group. After matching the sex, age and course of disease, 100 unsigned T2DM patients were selected as the traditional management group . The traditional management group was given routine medication and community management. The intensive management group was treated and managed by the family doctor according to the proposed meticulous management plan of diabetes. The weight, waist circumference, lifestyle behavior, blood glucose level , Cognitive level of diabetes (KAP) and the number of visits. Data SPSS 19.0 was used to performχ ~ 2 test and t test. Results There was no significant difference in body weight, smoking and alcohol consumption between the two groups before and after management (P> 0.05). After management, the waistline of the intensive management group decreased significantly compared with that before management and the number of exercise increased significantly compared with that before management There was statistical significance (P <0.05). One year later, the fasting blood glucose, 2-hour postprandial blood glucose, Hb A1C level and number of visits in the intensive management group were significantly lower than those in the traditional management group. The number of exercise patients was significantly increased, the KAP cognitive score of diabetes was significantly increased, The differences were statistically significant (P <0.05). Conclusion The family doctor-oriented management of diabetes meticulous management to take prevention and control of integrated management for patients with diabetes to provide sustained, high quality, responsible medical care and disease management, the effect is obviously better than the traditional management model, it is worth promoting.