高尿酸血症的社区综合干预效果研究
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摘要
目的研究分析高尿酸血症(hyperuricemia,HUA)的社区综合干预效果,探索适宜社区推广的HUA患者干预管理模式。方法选取2017年4～10月在本单位体检的社区重点人群,且符合HUA诊断标准的患者200例作为研究对象,随机分为两组,其中干预组100例,对照组100例。与干预组患者签订家庭医生服务协议,进行系统规范的健康教育和医学指导,建立家庭医生签约微信联系群实时追踪指导;对照组患者不实施任何其他干预措施。统计患者干预前后生活方式改变情况,研究分析患者干预前后的血尿酸下降水平。结果干预组患者干预前后疾病知识与健康认知、饮食运动等生活方式发生了较大改变,干预前后差异均具有统计学意义(P <0.01);两组患者实验前后血尿酸水平均有下降,血尿酸水平差异具有统计学意义(P <0.01),但干预组血尿酸指标水平下降高于对照组,实验后干预组与对照组患者血尿酸水平差异具有统计学意义(P <0.01)。结论对HUA患者进行社区综合干预,建立家庭医生签约服务,积极开展患者医学教育,加强健康生活方式管理,有利于提高患者防病治病意识和治疗依从性,显著降低患者血尿酸水平。
Objective To tudy and analyze the effect of community comprehensive intervention on hyperuricemia(HUA),to explore the appropriate intervention management model for HUA patients suitable for community promotion.Methods Two hundred patients from the community key population in the physical examination of our unit from April to October 2017,who met the diagnostic criteria of HUA were selected as subjects and randomly divided into two groups,100 in the intervention group and 100 in the control group.Signed a family doctor service agreement with patients in the intervention group,conducted systematic and standardized health education and medical guidance,and established a real-time follow-up guidance for the family doctor to sign a Wechat contact group.The patients in the control group did not implement any other interventions.The changes of life style before and after intervention were counted,and the level of serum uric acid before and after intervention was studied and analyzed.Results There were significant changes in disease knowledge,health awareness,diet and exercise and other lifestyles before and after intervention in the intervention group,and there were significant differences between before and after intervention(P< 0.01).The level of serum uric acid in both groups decreased before and after the experiment,and the difference of serum uric acid level was statistically significant(P < 0.01),but the level of serum uric acid in the intervention group was higher than that in the control group.After the experiment,the level of serum uric acid in the intervention group and the control group had statistical significance(P < 0.01).Conclusion Comprehensive community interventions for HUA patients,establishment of family doctor signing services,active medical education for patients,and strengthening healthy lifestyle management,which are conducive to improving patients' awareness of disease prevention and treatment compliance,and significantly reducing blood uric acid levels.
Objective To tudy and analyze the effect of community comprehensive intervention on hyperuricemia(HUA),to explore the appropriate intervention management model for HUA patients suitable for community promotion.Methods Two hundred patients from the community key population in the physical examination of our unit from April to October 2017,who met the diagnostic criteria of HUA were selected as subjects and randomly divided into two groups,100 in the intervention group and 100 in the control group.Signed a family doctor service agreement with patients in the intervention group,conducted systematic and standardized health education and medical guidance,and established a real-time follow-up guidance for the family doctor to sign a Wechat contact group.The patients in the control group did not implement any other interventions.The changes of life style before and after intervention were counted,and the level of serum uric acid before and after intervention was studied and analyzed.Results There were significant changes in disease knowledge,health awareness,diet and exercise and other lifestyles before and after intervention in the intervention group,and there were significant differences between before and after intervention(P< 0.01).The level of serum uric acid in both groups decreased before and after the experiment,and the difference of serum uric acid level was statistically significant(P < 0.01),but the level of serum uric acid in the intervention group was higher than that in the control group.After the experiment,the level of serum uric acid in the intervention group and the control group had statistical significance(P < 0.01).Conclusion Comprehensive community interventions for HUA patients,establishment of family doctor signing services,active medical education for patients,and strengthening healthy lifestyle management,which are conducive to improving patients' awareness of disease prevention and treatment compliance,and significantly reducing blood uric acid levels.
引文
[1]彭瑶,高景然,黄建刚.社区重点人群高尿酸血症现状分析[J].中国医药科学,2018,8(22):180-183.
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[4]吴雁鸣,尤华,顾卫霞,等.血糖与尿酸关系的流行病学分析[J].江苏医药,2014,40(15):1848-1849.
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[7]中华医学会内分泌学会.高尿酸血症和痛风治疗中国专家共识[J].中华内分泌代谢杂志,2013,29(11):913-920.
[8]中华医学会风湿病学分会.2016中国痛风诊疗指南[J].中国内科杂志,2016,55(11):892-899.
[9]陈素娥,陈彩琴,朱晨平.高尿酸血症合并血脂异常患者生活方式干预效果评价[J].中国农村卫生事业管理,2014,34(6):748-750.
[10]陈洁,杜雪平,chen J,等.北京市月坛地区高尿酸血症患者及医护人员高尿酸血症的认知情况调查[J].中华全科医师杂志,2016,15(3):194-197.
[11]高景然,彭瑶,毛敏芝.高尿酸血症患者血尿酸水平与饮食结构的关系及社区综合干预效果[J].深圳中西医结合杂志,2018,28(8):133-135.
[12]Singh JA,Reddy SG,Kundukulam J.Risk factors for gout andpreveention:a systematic review of the literature[J].Curr Opin Rheumatol,2011,23(17):192-202.
[13]Choi HK,Atkinson K,Karlson EW,et al.Purine-rich foods,dairy andprotein intake,and the risk of gout in men[J].N Engl J Med,2004,35(23):1093-1103.
[14]刘爱秀,雷利锋.针对性护理干预对无症状高尿酸血症人群的影响[J].中国现代医药,2015,22(36):123-125.
[15]郭艳青,郑爱民.无症状高尿酸血症患者综合干预的疗效观察[J].中国现代医药,2018,20(10):41-42.
[16]陈飞鹏,杨月华,陈燕.“健康”体检人群中“非健康因素”的分析与探讨[J].中国农村卫生事业管理,2011,31(6):650-651.
[2]李静.高尿酸血症的流行病学研究[J].中国心血管杂志,2016,21(2):83-86.
[3]李盼.高尿酸血症流行病学及危险因素的研究进展[J].流行病学调查,2017,31(12):93-95.
[4]吴雁鸣,尤华,顾卫霞,等.血糖与尿酸关系的流行病学分析[J].江苏医药,2014,40(15):1848-1849.
[5]何青,刘德平.高尿酸血症[M].北京:人民卫生出版社,2016:1-2.
[6]李融融,于康.痛风及高尿酸血症医学营养治疗的系统评价[J].中华临床营养杂志,2017,25(1):12-21.
[7]中华医学会内分泌学会.高尿酸血症和痛风治疗中国专家共识[J].中华内分泌代谢杂志,2013,29(11):913-920.
[8]中华医学会风湿病学分会.2016中国痛风诊疗指南[J].中国内科杂志,2016,55(11):892-899.
[9]陈素娥,陈彩琴,朱晨平.高尿酸血症合并血脂异常患者生活方式干预效果评价[J].中国农村卫生事业管理,2014,34(6):748-750.
[10]陈洁,杜雪平,chen J,等.北京市月坛地区高尿酸血症患者及医护人员高尿酸血症的认知情况调查[J].中华全科医师杂志,2016,15(3):194-197.
[11]高景然,彭瑶,毛敏芝.高尿酸血症患者血尿酸水平与饮食结构的关系及社区综合干预效果[J].深圳中西医结合杂志,2018,28(8):133-135.
[12]Singh JA,Reddy SG,Kundukulam J.Risk factors for gout andpreveention:a systematic review of the literature[J].Curr Opin Rheumatol,2011,23(17):192-202.
[13]Choi HK,Atkinson K,Karlson EW,et al.Purine-rich foods,dairy andprotein intake,and the risk of gout in men[J].N Engl J Med,2004,35(23):1093-1103.
[14]刘爱秀,雷利锋.针对性护理干预对无症状高尿酸血症人群的影响[J].中国现代医药,2015,22(36):123-125.
[15]郭艳青,郑爱民.无症状高尿酸血症患者综合干预的疗效观察[J].中国现代医药,2018,20(10):41-42.
[16]陈飞鹏,杨月华,陈燕.“健康”体检人群中“非健康因素”的分析与探讨[J].中国农村卫生事业管理,2011,31(6):650-651.