北京中医药大学学报2024，Vol.47Issue(1)：107-115,9.DOI:10.3969/j.issn.1006-2157.2024.01.015
"三级医院—社区一体化"中医管治结合方案干预糖尿病肾脏疾病患者60例实施效果评价
Evaluation of the effect of the"tertiary hospital-community integrated"TCM-based management and treatment program in 60 patients with diabetic kidney disease
摘要
Abstract
Objective We aimed to observe the effect of the traditional Chinese medicine(TCM)-based"tertiary hospital-community integrated"treatment program in patients with diabetic kidney disease.Methods A total of 126 patients from the Jiangtai and Cuigezhuang Communities in Chaoyang District were randomly divided into the experimental group and the control group(n=63 patients per group).In the experimental group,the"tertiary hospital-community integrated"treatment program was implemented(including TCM differentiated health preservation,chronic disease management,comprehensive diagnosis and treatment program of integrated Chinese and Western medicine),while in the control group,the existing chronic disease diagnosis,treatment,and management program in the community was implemented(including chronic disease management with regular follow-ups,diagnosis and treatment program of Western medicine).The observation period was 6 months,with 3 months as a course of treatment.The 24 h urine total protein level(24 hUTP),the serum level of creatinine(Scr),and the estimated glomerular filtration rate(eGFR)were compared between the two groups,as well as the effective rates of 24 hUTP,Scr,and eGFR,the rate of achieving standard glucose levels and normal lipid metabolism,including low-density lipoprotein-cholesterol(LDL-C),triglyceride(TG),and glycosylated hemoglobin(GHB),the level of patients'self-management,and the medical service in utilization.Results There were 120 patients included for analysis(60 in the experimental group and 60 in the control group).The difference in 24 hUTP was significantly different(P＜0.05),while Scr and eGFR were not statistically different between the experimental and control groups after 3 months of treatment.The differences in 24 hUTP,Scr,and eGFR were statistically significant after 6 months(P＜0.05).After 6 months of treatment in both groups,the effective rates of 24 hUTP,Scr,and eGFR were higher in the experimental group than in the control group(78.3％,48.3％,and 50.0％in the experimental group and 35.0％,18.3％,and 15.0％in the control group,respectively)(P＜0.05);after 6 months,the LDL-C,TG,and GHB qualified rates were higher in the experimental group than in the control group(75.0％,83.3％,and 71.7％in the experimental group and 56.7％,63.3％,and 46.7％in the control group,respectively;P＜0.05);comparing the self-management levels of the two groups after 3 and 6 months of treatment,the total self-management score and the total self-efficacy score were both higher in the experimental group than in the control group(P＜0.05);comparing the time of hospitalization and hospitalization costs of the two groups 6 months after enrollment,the time of hospitalization and hospitalization costs were lower in the experimental group(P＜0.05).Conclusion The"tertiary hospital-community integrated"TCM-based treatment program improves renal function,glucose and lipid metabolism,and patients'self-management;it can reduce the economic burden of families,save medical resources,and improve the utilization of medical services.关键词
糖尿病肾脏疾病/中医辨证/中医养生/慢性病管理/管治结合/一体化/随机对照试验Key words
diabetic kidney disease/TCM syndrome differentiation/TCM health preservation/chronic disease management/integration of management and treatment/integration/randomized control trial分类
医药卫生引用本文复制引用
黄雪莹,李同侠,张宁,石凯峰,闫璞,李翔宇,张倩,王鑫,姚国召,黄莺.."三级医院—社区一体化"中医管治结合方案干预糖尿病肾脏疾病患者60例实施效果评价[J].北京中医药大学学报,2024,47(1):107-115,9.基金项目
北京市中医药科技发展资金项目(No.JCZX-2020-10)Beijing Traditional Chinese Medicine Science and Technology Development Fund Project(No.JCZX-2020-10) （No.JCZX-2020-10）
