【摘要】 目的分析社区家庭医生个性化管理对慢性阻塞性肺疾病（COPD）患者生命质量的影响,为探索COPD患者防治策略提供参考。方法选取2018年10月至2019年4月苏州市姑苏区平江新城社区卫生服务机构接诊的稳定期COPD患者109例,随机分为试验组（55例）和对照组（54例）。对照组给予常规药物维持治疗,试验组在常规药物治疗基础上给予社区家庭医生个性化管理,比较管理前后2组患者综合评估测试（CAT）评分、第1秒用力呼气容积/用力肺活量（FEV₁/FVC）、第1秒用力呼气容积（FEV₁）预估值及管理后1年内急性加重次数>1次的患者比例。结果试验组患者管理前和管理后3、6个月的CAT评分分别为（17.61±7.21）、（14.14±7.13）、（13.25±6.24）分,差异具有统计学意义（P<0.05）;且试验组患者管理后CAT评分较对照组[（17.14±8.41）、（17.42±8.02）分]明显下降（P<0.05）。试验组患者FEV₁/FVC由管理前59.14±7.3改善为管理后65.56±6.10,FEV₁预估值由管理前（48.36±5.2）%改善为管理后（63.22±5.90）%,差异均具有统计学意义（P均<0.05）。管理后试验组1年内急性加重次数>1次的患者比例（16.36%）明显少于对照组（33.33%）,差异有统计学意义（P<0.05）。结论社区家庭医生个性化管理明显改善患者肺功能,减缓COPD发展。更多还原

【Abstract】 Objective To analyze the impact of personalized management by community family doctors on the quality of life of patients with chronic obstructive pulmonary disease（COPD）, to provide a reference for exploring prevention and treatment strategies for COPD. Methods A total of 109 patients with stable COPD who were admitted to Pingjiang Xincheng Community Health Service Center from October2018 to April 2019 were selected. They were randomly divided into either an experimental group（55 cases）or a control group（54 cases）. The control group was given routine drug maintenance therapy, while the experimental group was given individualized management by community family doctors on the basis of routine drug therapy. Comprehensive assessment test（CAT） score, forced expiratory volume in one second/forced vital capacity（FEV1/FVC）, estimated FEV₁ were compared between the two groups before and after management. The percentage of patients with acute exacerbation more than once in 1 year was compared after management. Results The CAT scores in the experimental group at 3 and 6 months after management（14.14±7.13 and 13.25±6.24） were significantly lower than that before management（17.61±7.21, P<0.05） and those in the control group after management（17.14±8.41, 17.42±8.02, P<0.05）. The FEV₁/FVC in the experimental group improved from 59.14±7.3 before administration to 65.56±6.1 after administration（P<0.05）, and the estimated FEV₁ also improved from（48.36±5.20）% before management to（63.22±5.90）% after management（P<0.05）. The percentage of patients with acute exacerbation more than once in one year in the experimental group（16.36%） was significantly lower than that in the control group（33.33%, P<0.05）. Conclusion The individualized management by community family doctors significantly improve patients’ lung function, which can slow the development of chronic obstructive pulmonary disease.更多还原