健康管理对老年2型糖尿病并心理障碍治疗的影响
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摘要
目的探讨健康管理对老年2型糖尿病并心理障碍治疗的影响。方法选取2016年05月—2018年05月在本院、新会区第三人民医院、佛山市顺德区明景糠尿病医院等门诊及住院受理的100例老年2型糖尿病并心理障碍患者作为研究对象,按照随机数字表的方法分为观察组(n=50)和对照组(n=50),两组均实施常规治疗和疾病指导宣教,观察组在此基础上加以实施健康管理,分别对两组患者管理前后的焦虑自评量表(SAS)、抑郁自评量表(SDS)、简易精神病量表(BPRS)及汉密顿抑郁量表(HAMD)进行客观的评估,同时测定两组患者治疗前后的空腹血糖、餐后2 h血糖和糖化血红蛋白等指标以及生活质量(SF-36)。结果比较管理前后的SAS、SDS、BPRS、HAMD等心理状态指标发现,观察组患者管理后的指标出现明显下降,较之管理前和对照组存在统计学差异(P <0. 05);两组管理前后的空腹血糖、餐后2 h血糖和糖化血红蛋白指标比较存在统计学差异(P <0. 05),管理后的组间比较亦差异明显(P <0. 05);此外,观察组和对照组的生活质量量表全部指标均存在明显差异(P <0. 05)。结论健康管理模式可以有助于改善老年2型糖尿病并心理障碍患者的不良心理症状及生理症状,并在一定程度上提高了患者的生活质量。
Objective To explore the effect of health management on elderly patients with type 2 diabetes mellitus and psychological disorders. Methods 100 cases of elderly patients with type 2 diabetes and mental disorders were selected from 05 months from 2016 to 2018 in 05 months in the hospital,the third people’s Hospital of the Xinhui District and the Shunde District of Foshan. The two groups were divided into the observation group( n = 50) and the control group( n = 50).The two groups all carried out the routine treatment and the disease guidance education. The observation group implemented the health management on this basis. The anxiety self rating scale( SAS),the self rating Depression Scale( SDS) and the simple psychosis scale( BPRS) were carried out before and after the management of the patients( BPRS). And the Hamilton Depression Scale( HAMD) was evaluated objectively,and the fasting blood glucose,postprandial 2H blood sugar and glycated hemoglobin were measured and the quality of life( SF-36) before and after treatment in two groups of patients. Results the psychological indexes of SAS,SDS,BPRS and HAMD before and after the comparison were found. The indexes of the patients in the observation group were significantly decreased after management,compared with those before and in the control group( P < 0. 05). The fasting blood glucose,postprandial 2H blood sugar and glycosylated hemoglobin index existed in the two groups before and after management. There was significant difference( P < 0. 05) between the groups after management( P < 0. 05),and all the indexes of the quality of life scale of the observation group and the control group were significantly different( P < 0. 05). Conclusion the health management model can help to improve the bad psychological symptoms and physiological symptoms of elderly patients with type 2 diabetes and mental disorders,and to some extent improve the quality of life of the patients.
Objective To explore the effect of health management on elderly patients with type 2 diabetes mellitus and psychological disorders. Methods 100 cases of elderly patients with type 2 diabetes and mental disorders were selected from 05 months from 2016 to 2018 in 05 months in the hospital,the third people’s Hospital of the Xinhui District and the Shunde District of Foshan. The two groups were divided into the observation group( n = 50) and the control group( n = 50).The two groups all carried out the routine treatment and the disease guidance education. The observation group implemented the health management on this basis. The anxiety self rating scale( SAS),the self rating Depression Scale( SDS) and the simple psychosis scale( BPRS) were carried out before and after the management of the patients( BPRS). And the Hamilton Depression Scale( HAMD) was evaluated objectively,and the fasting blood glucose,postprandial 2H blood sugar and glycated hemoglobin were measured and the quality of life( SF-36) before and after treatment in two groups of patients. Results the psychological indexes of SAS,SDS,BPRS and HAMD before and after the comparison were found. The indexes of the patients in the observation group were significantly decreased after management,compared with those before and in the control group( P < 0. 05). The fasting blood glucose,postprandial 2H blood sugar and glycosylated hemoglobin index existed in the two groups before and after management. There was significant difference( P < 0. 05) between the groups after management( P < 0. 05),and all the indexes of the quality of life scale of the observation group and the control group were significantly different( P < 0. 05). Conclusion the health management model can help to improve the bad psychological symptoms and physiological symptoms of elderly patients with type 2 diabetes and mental disorders,and to some extent improve the quality of life of the patients.
引文
[1]张沛峰.老年2型糖尿病患者发生严重低血糖的危险因素分析[J].现代医院,2017,17(04):573-575.
[2]龙艳,苏珂,彭鹰,等.血糖波动与氧化应激对2型糖尿病微血管病变的影响[J].中华老年心脑血管病杂志,2014,16(2):147-150.
[3]凌雪梅,杨春霞.沙格列汀改善2型糖尿病患者β细胞功能的Meta分析[J].中国循证医学杂志,2013,13(4):436-440.
[4]凌珠娟,黄瑾,费红敏.探讨老年2型糖尿病患者的心理干预分析与策略[J].检验医学与临床,2015(2):140-142.
[5]DE MAN F H,CABEZAS M C,VAN BARLINGEN H H,et al.Triglyceride-rich lipoproteins in non-insulin-dependent diabetes mellitus:post-prandial metabolism and relation to premature atherosclerosis[J].European Journal of Clinical Investigation,2015,26(2):89-108.
[6]易松,王翠苹,刘婵,等.老年糖尿病的心理指导[J].现代医院,2015,15(02):151-154.
[7]VIJAYALINGAM S,PARTHIBAN A,SHANMUGASUNDARAMK R,et al.Abnormal antioxidant status in impaired glucose tolerance and non-insulin-dependent diabetes mellitus[J].Diabet Med,2015,13(8):715-719.
[8]王俊玲,马丽娜,张立华,等.老年2型糖尿病患者的认知功能水平及与胰岛素抵抗的相关性[J].神经疾病与精神卫生,2015(5).
[9]毛秀英,邱宏亮.社区老年2型糖尿病患者合并轻度认知功能障碍危险因素分析[J].实用老年医学,2014(7):587-590.
[10]张彦琦,张玲,易东,等.重庆市高血压和糖尿病患者社区健康管理现状及影响因素研究[J].中国全科医学,2015(28):3473-3477.
[11]李园,任多富,丁萍飞,等.中国8省(自治区)高血压和2型糖尿病患者健康管理服务实施现状[J].中华流行病学杂志,2014,35(1):35-39.
[12]刘静,王春梅.2型糖尿病患者抑郁、焦虑与自我管理能力的相关性研究[J].国际内分泌代谢杂志,2013,33(4):283-286.
[13]潘恩春,张芹,李园,等.基层医务人员开展基本公共卫生服务项目高血压及糖尿病健康管理情况调查[J].中国全科医学,2014,17(28):3316-3320.
[14]冯强,赵旭东,Feng Qiang,等.焦虑障碍与抑郁障碍的心理治疗策略[J].中华全科医师杂志,2016,15(5):340-343.
[15]赵伟,吴国华,王鹏,等.家庭参与式健康管理对社区2型糖尿病患者自护行为影响研究[J].中国全科医学,2013,16(40):4062-4064.
[16]韩伟斌,刘木松,孙风仙.全科团队信息化健康管理对上海市泥城社区原发性骨质疏松患者生存质量的影响[J].职业与健康,2017,33(4):546-548.
[17]樊宇华.个体化健康管理及随访对原发性高血压患者高血压相关知识、态度及行为的影响[J].医学临床研究,2017,34(10):2074-2076.
[18]涂英,程蕾,欧丽萍,等.家庭医生式综合干预在老年2型糖尿病患者健康管理中的应用[J].国际医药卫生导报,2018,24(17):2593-2596.
[2]龙艳,苏珂,彭鹰,等.血糖波动与氧化应激对2型糖尿病微血管病变的影响[J].中华老年心脑血管病杂志,2014,16(2):147-150.
[3]凌雪梅,杨春霞.沙格列汀改善2型糖尿病患者β细胞功能的Meta分析[J].中国循证医学杂志,2013,13(4):436-440.
[4]凌珠娟,黄瑾,费红敏.探讨老年2型糖尿病患者的心理干预分析与策略[J].检验医学与临床,2015(2):140-142.
[5]DE MAN F H,CABEZAS M C,VAN BARLINGEN H H,et al.Triglyceride-rich lipoproteins in non-insulin-dependent diabetes mellitus:post-prandial metabolism and relation to premature atherosclerosis[J].European Journal of Clinical Investigation,2015,26(2):89-108.
[6]易松,王翠苹,刘婵,等.老年糖尿病的心理指导[J].现代医院,2015,15(02):151-154.
[7]VIJAYALINGAM S,PARTHIBAN A,SHANMUGASUNDARAMK R,et al.Abnormal antioxidant status in impaired glucose tolerance and non-insulin-dependent diabetes mellitus[J].Diabet Med,2015,13(8):715-719.
[8]王俊玲,马丽娜,张立华,等.老年2型糖尿病患者的认知功能水平及与胰岛素抵抗的相关性[J].神经疾病与精神卫生,2015(5).
[9]毛秀英,邱宏亮.社区老年2型糖尿病患者合并轻度认知功能障碍危险因素分析[J].实用老年医学,2014(7):587-590.
[10]张彦琦,张玲,易东,等.重庆市高血压和糖尿病患者社区健康管理现状及影响因素研究[J].中国全科医学,2015(28):3473-3477.
[11]李园,任多富,丁萍飞,等.中国8省(自治区)高血压和2型糖尿病患者健康管理服务实施现状[J].中华流行病学杂志,2014,35(1):35-39.
[12]刘静,王春梅.2型糖尿病患者抑郁、焦虑与自我管理能力的相关性研究[J].国际内分泌代谢杂志,2013,33(4):283-286.
[13]潘恩春,张芹,李园,等.基层医务人员开展基本公共卫生服务项目高血压及糖尿病健康管理情况调查[J].中国全科医学,2014,17(28):3316-3320.
[14]冯强,赵旭东,Feng Qiang,等.焦虑障碍与抑郁障碍的心理治疗策略[J].中华全科医师杂志,2016,15(5):340-343.
[15]赵伟,吴国华,王鹏,等.家庭参与式健康管理对社区2型糖尿病患者自护行为影响研究[J].中国全科医学,2013,16(40):4062-4064.
[16]韩伟斌,刘木松,孙风仙.全科团队信息化健康管理对上海市泥城社区原发性骨质疏松患者生存质量的影响[J].职业与健康,2017,33(4):546-548.
[17]樊宇华.个体化健康管理及随访对原发性高血压患者高血压相关知识、态度及行为的影响[J].医学临床研究,2017,34(10):2074-2076.
[18]涂英,程蕾,欧丽萍,等.家庭医生式综合干预在老年2型糖尿病患者健康管理中的应用[J].国际医药卫生导报,2018,24(17):2593-2596.