胡小英+翁哲芳+蒋良华+尉敏琦+诸光花

摘 要 社区糖尿病管理可有效改善患者自我管理行为，本文以糖尿病的中西医结合防治为切入点，综合分析中西医结合的手段防治糖尿病的优势，社区中西医结合糖尿病管理团队的建立，加强健康教育，提高患者的治疗依从性；以八纲辨证为纲、脏腑辨证为目，系统地辨证探讨社区中西医结合糖尿病防治管理体系的实践和进展，为更全面、系统、有效地开展中西医结合社区糖尿病防治工作奠定基础。

关键词 糖尿病 中西医结合 管理

中图分类号：R587.1 文献标志码：A 文章编号：1006-1533（2016）18-0042-03

Exploration of management of diabetes prevention and treatment in community integrated traditional Chinese and Western Medicine

HU Xiaoying1， WEN Zhefang1， JIANG Lianghua1， WEI Minqi2， ZHU Guanghua1（1.Jiangchuan Community Health Service Center of Minghang District， Shanghai 200240， China； 2. Disease Control and Prevention Center

of Minghang District， Shanghai 201101， China）

ABSTRACT Community diabetes management can effectively improve the self-management behavior of the patients. Taking prevention and treatment of diabetes with integrated traditional Chinese and Western medicine as the breakthrough point， this paper comprehensively analyzes the advantages of the combination of traditional Chinese and Western medicine to prevent and treat diabetes， establishment of the diabetes management team integrated traditional Chinese medicine and Western Medicine in the community， strengthening health education， and improvement of the treatment compliance of the patients. Based on the eight principal syndromes as the outlines and viscera syndrome differentiation as the focuses， it systematically differentiates and studies the practice and progress of the management system of diabetes prevention and treatment with combination of traditional Chinese and Western medicine in the community to lay a foundation for a more comprehensive， systematic and effective development of integrated traditional Chinese and Western medicine in the prevention and treatment of diabetes.

KEY WORDS diabetes； combination of traditional Chinese and western medicine； management

《2011年中国卫生统计提要》[1]显示糖尿病的患病率正随着生活富裕、老龄化、城市化程度的提高而持续升高，成为继心脑血管疾病、肿瘤后的又一严重危害人群健康的慢性非传染性疾病。我国的糖尿病患病率正以惊人的速度增长，但患者的管理率和血糖控制率均不高，2014年我国8省调查的3 586名35岁以上2型糖尿病患者中，患者管理率仅19.1%，患者血糖控制率仅53.9%（城市60.8%，农村44.7%）[2]。由此产生的糖尿病并发症问题也不容小觑，不仅严重威胁着人类健康和生活质量，也为社会带来了沉重负担。研究显示，社区糖尿病管理可有效改善患者自我管理行为，提高血糖控制率[3]。本文以糖尿病的中西医结合防治为切入点，就其如何在社区糖尿病的防治管理中应用进行分析与探讨，以期更好地管理糖尿病，提高糖尿病的控制率。

1 中西医结合防治糖尿病的优势