农村社区糖尿病患者四年综合干预效果评价

目的观察对糖尿病患者进行综合干预的效果，为在农村社区中实施有效的干预措施提供依据。方法抽取常州市武进区4个农村社区，对其中2个社区的糖尿病患者（173例）进行综合干预，2个社区作对照（142例）。进行为期4年的社区综合干预。对干预组给予药物治疗、健康教育、饮食、运动以及生活行为指导；对照组仅给予药物治疗。结果干预后干预组患者对空腹血糖正常值范围、糖尿病的主要危险因素、科学饮食与治疗方法的知晓率分别为90．8％、74．6％、89．6％与59．5％，认知水平明显高于对照组（均P〈0．05），在饮食控制与规律运动方面的行为改变率分别为68．8％、58．4％，也高于对照组（均P〈0．05）。而干预后干预组患者的收缩压、舒张压、空腹血糖以及总胆固醇的平均水平分别为（130．6±10．4）mmHg（1mmHg=0．133kPa）、（78．4±7．5）mmHg、（6．2±3．1）mmol／L、（4．5±0．9）mmol／L，均低于对照组（均P〈0．05）。结论综合干预措施对农村社区的糖尿病患者有明显的干预效果。

Effectiveness of comprehensive intervention on rural community patients with diabetes

Objective To evaluate the impacts of comprehensive diabetes intervention to provide evidence for effective diabetic control in rural communities. Methods Diabetic patients from four communities at Wujin District of Changzhou City were selected. One hundred and seventy-three patients from two communities received comprehensive intervention, including medication therapy, diabetes education, and diet, exercise, and behavior instruction （intervention group） ; 142 patients from the other two communities got medication therapy only （control group）. All the participants were interviewed with structured questionnaire and physical examination. The second epidemic investigation was conducted at 4 years to evaluate the effects of the intervention. Results At the end of the intervention, the awareness rates of normal fasting plasma glucose, major diabetes risk factors, healthy diet, and therapeutic strategies in the intervention group were 90. 8% ,74. 6% ,89. 6% ,and 59. 5% ,respectively,which were significantly higher than those in the control group （ all P 〈 0. 05 ）. For the intervention group, the rates of diet behavior or physical exercise change were 68.8% and 58.4% ,respectively ,which were much higher than those of the control group （ all P 〈 0.05 ）. The average levels of systolic pressure, diastolic pressure, fasting plasma glucose, and total cholesterol were （130.6±10.4） mm Hg（1 mm Hg=0. 133 kPa）,（78.4±7.5） mm Hg,（6.2±3.1）mmol/L,and（4. 5 ± 0. 9） mmol/L, respectively, in the intervention group, which were lower than those in the control group （ all P 〈 0. 05 ）. Conclusion Comprehensive intervention shows significant effects on rural community patients with diabetes.