【摘要】 目的对社区高血压、糖尿病患者实施健康管理的效果进行分析。方法按照以社区为基础的随机对照试验研究设计,将320名自愿参加社区健康管理的高血压、糖尿病慢性患者随机分为管理组(n=160)和对照组(n=160)。对管理组实施为期1年的健康管理,根据患者病情制定适宜的科学运动和平衡膳食,同时对其不良嗜好或习惯予以纠正,对心理问题予以疏导。结果通过健康管理,提高了慢性病患者的健康意识,管理后管理组体重、腰围和体质指数显著低于对照组,差异有统计学意义(均P<0.01)。管理组、对照组管理后平衡膳食、科学运动、戒烟限酒、控制情绪、健康生活方式形成比较,差异均有统计学意义(均P<0.05)。与管理前比较,管理后管理组SBP、DBP降低,差异有统计学意义(P<0.05);管理组、对照组管理后血压控制率比较,差异有统计学意义(P<0.05)。与管理前比较,管理后管理组FBG、PBG、Hb A1c降低,差异有统计学意义(P<0.05);管理组、对照组管理后血糖控制率比较,差异有统计学意义(P<0.05)。管理前后管理组和对照组的健康状况(精力、健康担忧、情绪低落、健康自评)及卫生资源利用(看门诊次数、住院次数)变化值比较,差异均有统计学意义(均P<0.05)。结论对慢性病患者开展健康管理是一个长期和渐进的过程,在社区中实施科学、有效、系统、长期的健康管理,使慢性病患者的饮食、运动治疗落实到实际生活中,生活方式得到了明显的优化,病情得到了良好的控制,对慢性病的防控起到积极的作用。更多还原

【Abstract】 [Objective] To analyze the effect of health management on community patients with hypertension or diabetes.[Methods]According to the community-based randomized controlled trial study design, 320 patients with hypertension or diabetes, who voluntarily received the community health management, were randomly divided into the management group( n=160)and the control group(n =160). One-year health management was implemented on the management group, and the contents included suggestions of appropriate exercises and balanced diet based on the patients’ condition, correcting their bad habits, and solving their psychological problems.[Results]The health consciousness of patients with chronic diseases improved through the health management. After the management intervention, the levels of weight, waist circumference and body mass index in the management group were significantly lower than those in the control group(all P <0.01). There were statistically significant differences in the formation rates in balanced diet, appropriate exercises, smoking cessation and abstinence, emotion control and healthy lifestyle between the management group and the control group(all P<0.05). In the management group, the levels of SBP and DBP after the management were lower than those before the management, and the difference was statistically significant(P <0.05). After the management intervention, the difference in the control rate of blood pressure between two groups was statistically significant(P<0.05). In the management group, the levels of FBG, PBG and Hb A1 c after the management were lower than those before the management, and the differences were statistically significant(P<0.05). After the management, the difference in the control rate of blood glucose between two groups was statistically significant(P<0.05). There were statistically significant differences in the health status(energy, health concerns, depression, and self-evaluation of health) and health resources utilization(times of visiting the outpatient, and times of hospitalization) in both two groups between before and after the management(P <0.05).[Conclusion]Health management on patients with chronic diseases is a long-term and gradual process. Scientific,effective, systematic and long-term health management implemented in the community can encourage chronic diseases patients to put diet and exercise therapy into practice, obviously optimize their lifestyle, control the disease condition, and play a positive role in prevention and control of chronic diseases.optimize their lifestyle, control the illness condition, and play a positive role in prevention and control of chronic diseases.更多还原