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目的了解社区强化管理2型糖尿病合并高血压的效果。方法 2016年6月—2017年5月,选择7个社区卫生服务站登记管理的175名2型糖尿病合并高血压患者作为观察组给予1年的强化管理,选择邻近相似社区卫生服务站的187名2型糖尿病合并高血压患者作为对照组给予常规干预。评估两组血糖、血压、血脂、行为生活方式变化。计数资料采用χ2检验,计量资料采用t检验,P<0.05为差异有统计学意义。结果观察组遵医行为、服药依从性、饮食控制率分别为93%、94%、95%,均优于干预前的79%、81%、84%,差异均有统计学意义(均P<0.05)。观察组干预后周运动次数、体质指数(body mass index,BMI)、空腹血糖(fasting plasma glucose,FPG)、餐后2小时血糖(2h plasma glucose,2h PG)、糖化血红蛋白(Hb A1c)、收缩压(systolic blood pressure,SBP)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)水平分别为(5.53±1.64)次、(23.51±3.87)kg/m2、(5.52±0.59)、(7.57±0.76)mmol/L、(6.45±1.05)%、(123.17±8.89)mm Hg(1 mm Hg=0.133 k Pa)、(5.03±1.09)、(1.67±0.73)mmol/L,均较干预前的(4.92±2.59)次、(24.19±3.72)kg/m2、(6.40±1.01)、(9.88±2.56)mmol/L、(7.51±1.95)%、(128.47±9.64)mm Hg、(5.40±1.27)、(1.89±0.92)mmol/L显著改善,差异均有统计学意义(均P<0.05)。观察组遵医行为、服药依从性、饮食控制率均优于对照组(83%、87%、88%),差异均有统计学意义(均P<0.05)。干预后观察组周运动次数、FPG、2h PG、Hb A1c、SBP、TC、TG均优于对照组[(5.01±2.61)次、(6.03±0.80)、(8.73±1.26)mmol/L、(6.79±1.53)%、(130.04±8.76)mm Hg、(5.31±1.35)、(1.86±0.89)mmol/L],差异均有统计学意义(均P<0.05)。结论社区强化管理提高了2型糖尿病合并高血压的治疗、控制和管理效果。
Objective To understand the effect of community-based management of type 2 diabetes with hypertension. Methods From June 2016 to May 2017, 175 patients with type 2 diabetes mellitus and hypertension who were registered and managed by 7 community health service stations were given one year of intensive management as the observation group, 187 of whom were selected from similar community health service stations Patients with type 2 diabetes complicated with hypertension were given routine intervention as control group. Assessment of two groups of blood glucose, blood pressure, blood lipids, behavioral changes in lifestyle. Count data using χ2 test, measurement data using t test, P <0.05 for the difference was statistically significant. Results The compliance rate, medication compliance and diet control rate in the observation group were 93%, 94% and 95% respectively, which were all better than 79%, 81% and 84% before intervention (all P < 0.05). The number of weeks of exercise, body mass index (BMI), fasting plasma glucose (FPG), 2h plasma glucose (2h PG), Hb A1c, The levels of systolic blood pressure (SBP), total cholesterol (TC) and triglyceride (TG) were 5.53 ± 1.64, 23.51 ± 3.87, 5.52 ± 0.59, (7.57 ± 0.76) mmol / L, (6.45 ± 1.05)%, (123.17 ± 8.89) mm Hg (1 mm Hg = 0.133 kPa), (5.03 ± 1.09) and (4.92 ± 2.59), (24.19 ± 3.72) kg / m2, (6.40 ± 1.01), (9.88 ± 2.56) mmol / L, (7.51 ± 1.95)%, (128.47 ± 9.64) mm Hg before intervention, (5.40 ± 1.27) and (1.89 ± 0.92) mmol / L, respectively, with significant difference (all P <0.05). The observing group’s compliance behavior, medication compliance and diet control rate were better than those of the control group (83%, 87%, 88%). The differences were statistically significant (both P <0.05). After intervention, the numbers of peripheral motions in the observation group were better than those in the control group [(5.01 ± 2.61), (6.03 ± 0.80), (8.73 ± 1.26) mmol / L, FPG, 2h PG, Hb A1c, 6.79 ± 1.53)%, (130.04 ± 8.76) mm Hg, (5.31 ± 1.35) and (1.86 ± 0.89) mmol / L, respectively. There were significant differences between the two groups (all P <0.05). Conclusion Community-based management enhances treatment, control and management of type 2 diabetes with hypertension.