【摘要】 目的 探索社区高血压病患者综合治疗的有效模式,提高高血压病患者的治疗达标率,减少医药费。方法 选择已经确诊的高血压病患者312例,分别按照同等病情匹配分为综合治疗组(153例)和普通治疗组(159例)。综合治疗组采用量化饮食治疗、量化运动治疗、指导合理用药、健康教育和心理疏导、医生对患者一对一指导;普通治疗组为药物治疗和一般性教育。观察两组连续治疗3个月病情控制与医药费的变化情况。结果 综合治疗组患者的平均血压为128.7/78.2mmHg(1 mm Hg=0.133 kPa),比普通组的139.1/86.2mm Hg明显降低。其中血压降至<140/90mmHg的比例,综合治疗组为53.8％,明显高于普通组的18.2％。综合治疗组患者的腰围为83.3cm,小于普通组的87.9cm,而体重指数、血脂两组差异无显著性。综合治疗组每人每月医疗费下降28.9元,下降幅度为20.93％。普通治疗组每人每月下降6.3元,下降幅度为4.61％。结论 高血压患者社区综合治疗的疗效比一般性治疗提高,且医药费用明显降低。更多还原

【Abstract】 Objective To explore an effective pattern of comprehensive intervention for the patients with hypertension in communities, and to improve their cure rate and reduce their medical cost. Methods Three hundred and twelve patients with hypertension in the communities were randomized into two groups with similar severity: one group with comprehensive intervention, including health education, quantified dietary intake, quantified exercise, rational use of antihyperteaive drugs, psychological help, etc., and another group with regular drugs and general education as control. All the patients with comprehensive intervention were instructed individually by physicians. Participants were followed up for 3 months, including the changes in their blood pressure, and serum levels of total cholesterol,triglyceride and high-density lipoprotein cholesterol. Results Average systolic blood pressure in the intervention group [(128.7±13.89) mm Hg] was significantly lower than that in the control group [(139.1±12.17) nun Hg], with P < 0.001, and average diastolic blood pressure was (78.2±7.73) mm Hg in the intervention group and (86.2±8.52) mm Hg in the control group, respectively, with P < 0.001. Those with blood pressure < (140 /90) mm Hg accounted for 53. 8% in the intervention group, two times higher than that in the control group (18.2%). Average waist circumference was 83.3 cm in the intervention group, significantly lower than that in the control group (87.9 cm) with P < 0.05, but no significant difference in body mass index between them was found. Monthly medical cost decreased by 28.9 Chinese yuan (Renminbi) (20.93%) in the intervention group and by 6.3 Chinese yuan (4.61%) in the control group. Conclusions The efficacy of comprehensive intervention in communities was two to three times higher than that in the control group, and medical cost decreased by 20.93% in average in the intervention group.更多还原