田世宏①　陈朗郎　王德恒　黄振凤

【摘要】 目的：探討家庭动力学干预对社区糖尿病患者管理的影响。方法：选取2016年1-12月社区收治糖尿病患者200例，按照信封法随机分为对照组和观察组，每组各100例，对照组给予常规护理及药物降糖治疗，观察组在此基础上实施家庭动力学干预，比较6个月后两组患者血糖标率、空腹及餐后2 h血糖、糖化血红蛋白及干预后遵医师行为评分情况。结果：干预前，两组患者血糖代谢指标空腹血糖、餐后2 h血糖及糖化血红蛋白（HbA1c）比较差异均无统计学意义（P>0.05）；干预后6个月，观察组患者血糖代谢各项指标均较对照组有显著改善，比较差异均有统计学意义（P<0.05）。干预前，两组患者血糖达标率比较差异无统计学意义（P>0.05）；干预后6个月，观察组患者血糖达标率86.00%显著高于对照组62.00%，两组比较差异有统计学意义（P<0.05）；干预6个月后，观察组患者各项遵医行为评分均明显优于对照组，两组比较差异均有统计学意义（P<0.05）。结论：家庭动力学干预对糖尿病患者管理效果显著，明显提高患者遵医行为，有效自我控制血糖，改善生活质量水平，值得临床推广运用。

【关键词】 糖尿病； 家庭动力学干预； 血糖代谢； 遵医行为

Effect of Family Dynamics Intervention on Diabetes Management/TIAN Shihong，CHEN Langlang，WANG Deheng，et al.//Medical Innovation of China，2018，15（01）：133-136

【Abstract】 Objective：To investigate the influence of family dynamics intervention on the management of diabetic patients in community.Method：200 cases with diabetes in community were selected from January 2016 to December 2016，they were randomly divided into control group and observation group， 100 cases in each group，the control group was given routine nursing care and treatment of hypoglycemic drugs，the observation group on the basis of control group was given the implementation of family dynamics intervention.After 6 months，the blood glucose standard rate，2 hour postprandial blood glucose，glycosylated hemoglobin（HbA1c）and after intervention with physician behavior of two groups were compared.Result：Before intervention，the 2 hour postprandial blood glucose，HbA1c and after intervention with physician behavior of two groups had no statistical difference（P>0.05）；after intervention 6 months，the indicators of glucose metabolism in observation group were significantly lower than those of control group，the differences were statistically significant（P<0.05）.Before intervention，the blood glucose standard rate of two groups had no statistical difference（P>0.05）；after intervention 6 months，the observation group blood sugar compliance rate of 86.00% was significantly higher than the control group of 62.00%，the difference was statistically significant （P<0.05）.After intervention 6 months，the compliance behavior scores in observation group were significantly better than those of control group，the differences were statistically significant （P<0.05）.Conclusion：Family dynamics intervention has remarkable effect on the management of patients with diabetes mellitus.It can obviously improve the compliance behavior of patients，effectively control blood sugar and improve the quality of life.It is worthy of clinical application.endprint

【Key words】 Diabetes mellitus； Family dynamics intervention； Blood sugar metabolism； Compliance behavior

First-authors address：Nanshan District Peoples Hospital，Shenzhen 518000，China

doi：10.3969/j.issn.1674-4985.2018.01.037

糖尿病為我国最常见慢性内分泌疾病，随着生活水平提高、生活习惯改善，发病率呈逐年上升趋势。糖尿病为心脑血管疾病发生的独立危险因素，严重威胁着人类生命健康。据统计，糖尿病患者大多数为2型糖尿病，约占90%[1-2]。目前，对于2型糖尿病患者主要通过饮食控制、合理运动及降糖药物治疗，其治疗效果较好。但也有相关研究发现，糖尿病患者出院后遵医行为仍较差，血糖波动大，发生糖尿病并发症导致死亡的风险比住院期间高[3-4]。Hartayu等[5]研究中对糖尿病患者实施家庭动力学干预，即对患者进行院外延续性护理干预，从而有效控制患者血糖，降低因糖尿病并发症致死的高风险率。现为……