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目的 探索糖尿病社区强化管理和治疗的有效模式 ,提高糖尿病患者的治疗达标率 ,减少医药费。 方法 选择已经确诊的糖尿病患者 30 0例 ,按照同等病情分为强化管理和治疗组及普通治疗组。强化管理和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 ,医生对患者一对一地指导等治疗方法 ;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个月病情控制与药费情况。 结果 强化管理和治疗组患者的空腹血糖值平均为 6 .48mm ol/ L,明显低于普通治疗组的 7.6 0 mm ol/ L(P<0 .0 0 1) ;餐后血糖值平均为 8.5 9mm ol/ L,明显低于普通治疗组的 11.31m mol/ L (P<0 .0 0 1)。患者的血糖达到控制良好标准者占 48.4% ,明显高于普通组 2 0 .8% (P<0 .0 0 1)。血糖控制仍在不良状态的患者强化组为 2 6 .1% ,明显低于普通组的 47.7% (P<0 .0 0 1)。强化管理和治疗组糖化血红蛋白 (Hb A1c)平均为 (7.79± 1.13) % ,明显低于普通治疗组 9.31(± 1.85 ) % (P<0 .0 0 1)。 Hb A1c控制良好率为 5 2 .3%明显高于普通组的 18.8% (P<.0 0 1)。 BMI、腰围、血脂两组无明显差别。糖尿病患者的医药费强化管理和治疗组每人每月下降 5 9.9元 ,下降幅度为2 3.6 %。普通治疗组每人每月上涨 1.8元 ,上
Objective To explore an effective mode of strengthening management and treatment in diabetes community, improve the treatment compliance rate of diabetic patients and reduce the medical expenses. Methods 30 patients with confirmed diabetes were selected and divided into intensive management and treatment group and general treatment group according to the same condition. The intensive management and treatment group adopted quantitative dietary therapy, quantitative exercise therapy, guidance of rational drug use, health education and psychological counseling, and the doctors gave guidance to patients on one-on-one treatment. The general treatment group was drug treatment and general education. Two groups of continuous treatment for 3 months to observe the condition control and drug costs. Results The mean fasting blood glucose level of intensive management and treatment group was 6.48 mm ol / L, significantly lower than that of the control group (7.6 0 mm ol / L, P <0.01 01). The average postprandial blood glucose level was 8.5 9mm ol / L, significantly lower than the 11.31m mol / L of the normal treatment group (P <0. Patients with good blood sugar control accounted for 48.4%, significantly higher than the common group 20.8% (P <0.001). Patients in the still-poor glycemic control group had an enhancement of 26.1%, significantly lower than the 47.7% (P <0.001) of the usual group. The mean Hb A1c level in intensive management and treatment group was (7.79 ± 1.13)%, which was significantly lower than that in the general treatment group (9.31 ± 1.85%, P <0.01). Hb A1c control rate of 5.23% was significantly higher than the 18.8% of the normal group (P <.0 0 1). BMI, waist circumference, blood fat no significant difference between the two groups. Medical expenses management and treatment of diabetes patients per month per month decreased 5 9.9 yuan, a decrease of 23.6%. The average treatment group rose 1.8 yuan per person per month, on