【摘要】 目的 综合评价我国家庭医生服务模式下慢性病控制率情况，为进一步开展家庭医生签约服务、树立居民签约信心、提高慢性病控制水平提供依据。方法 系统检索知网、万方、维普、Cochrane Library、EMBASE、PubMed数据库，收集2010年1月1日—2021年5月31日公开发表的家庭医生签约服务对慢性病防治作用的随机对照研究，采用Meta分析的方法，计算合并的慢性病控制率，并按照签约时间、地区、疾病种类进行亚组分析，对结果进行敏感性分析和发表偏倚的评价。结果 共纳入文献21篇，总样本量5 482人，其中签约组2 687人、对照组2 595人。签约组与对照组慢性病控制率的率差(risk difference,RD)为0.18(95%CI:0.14～0.21),高血压、糖尿病控制率的RD值均为0.16(95%CI:0.10～0.21);经亚组分析，签约时间和疾病种类为异质性来源；敏感性分析显示研究结果稳定。结论 家庭医生签约服务对慢性病控制具有积极作用。应积极开展签约服务，重视多病共存人群，延长服务时间，加快中西部地区发展，逐步提高慢性病控制水平。更多还原

【Abstract】 Objective To comprehensively evaluate the control rate of chronic diseases under the service model of family doctors in China, to provide a basis for further development of services, and to establish residents’ confidence in signing contracts, and improve the level of chronic disease control.Methods A systematic search of the CNKI,Wanfang, Weipu, Cochrane Library, EMBASE,PubMed, and controlled studies on the control of chronic diseases by family doctor published from January 1,2010 to May 31,2021 were collected.Meta-analysis was used to calculate the merger rate, and subgroup analysis was conducted according to the contract time, region, and the kinds of chronic di-seases.Sensitivity analysis of the results and evaluation of publication bias were performed.Results A total of 21 articles were included, with a total sample size of 5 482,including 2 687 and 2 595 in the study and control group.The RD of the chronic disease control rate of the contracted and control group was 0.18(95%CI:0.14-0.21),and the RD of the control rate of hypertension and diabetes was 0.16(95%CI:0.10-0.21).Subgroup analysis showed that the contract time and the kinds of chronic diseases were the source of heterogeneity.Sensitivity analysis showed that the research results were stable.Conclusion The contracted service of family doctors has a significant positive effect on the control of chronic diseases.It is necessary to actively carry out contracted services, pay attention to people with many kinds of diseases, extend service hours, and accelerate the development of the central and western regions, to improve the level of chronic disease control.更多还原