吴小秋 何瑞锋 唐明慧 李俊 黎崇裕 朱景智 曹国平

【摘要】 目的：探討中医“治未病”理念的健康管理模式在糖调节受损及其高危人群的干预效果。方法：选取2018年4月-2019年12月珠海市第二人民医院与珠海市人民医院横琴医院的糖调节受损及存在其高危因素患者178例，按干预方法不同将其分为观察组（n=85）与对照组（n=93）。对照组给予一般干预措施，观察组在对照组的基础上给予中医“治未病”健康管理模式干预。比较干预前后两组血糖、血脂、体重指数（BMI）、腰臀比（WHR）、对糖尿病预防的认知程度、自我管理及生活质量。比较两组干预1年后糖尿病转化及血糖正常者比例。结果：干预后，两组空腹血糖（FBG）、餐后2 h血糖（2 h PBG）、BMI及WHR均较干预前降低，且观察组均低于对照组（P<0.05），干预后，两组甘油三酯（TG）、总胆固醇（TC）及低密度脂蛋白（LDL）水平均较干预前降低，且观察组均低于对照组（P<0.05）。干预1年后，两组糖尿病转化率与血糖正常者比例比较，差异均无统计学意义（P>0.05）。干预后，两组糖尿病知识知晓情况、自我管理及生活质量评分较干预前升高，且观察组均高于对照组（P<0.05）。结论：中医“治未病”理念的健康管理模式可以改善糖调节受损及存在其高危因素患者的血糖、血脂及生活质量，且在糖尿病自我管理方面有较强的优势，值得在临床中进一步探索。

【关键词】 “治未病”理念 健康管理 糖调节受损

Intervention Study on the Health Management Model of the Concept of “Preventive Treatment of Disease”in Traditional Chinese Medicine for Impaired Glucose Regulation and the High-risk Population/WU Xiaoqiu， HE Ruifeng， TANG Minghui， LI Jun， LI Chongyu， ZHU Jingzhi， CAO Guoping. //Medical Innovation of China， 2021， 18（13）： -174

[Abstract] Objective： To explore the intervention effect of the health management model of the concept of “preventive treatment of disease”in traditional Chinese medicine for impaired glucose regulation and high risk population. Method： A total of 178 patients with impaired glucose regulation and high risk factors in Zhuhai Second Peoples Hospital and Hengqin Hospital of Zhuhai Peoples Hospital from April 2018 to December 2019 were selected. They were divided into observation group （n=85） and control group （n=93） according to different intervention methods. The control group was given general intervention measures， and and the observation group was given health management model of the concept of “preventive treatment of disease”in traditional Chinese medicine on the basis of the control group. Blood glucose， blood lipid， body mass index （BMI）， waist-to-hip ratio （WHR）， cognition of diabetes prevention， self-management and life quality were compared between the two groups before and after intervention. The proportion of patients with diabetes conversion and normal blood glucose after 1 year intervention was compared between the two groups. Result： After intervention， fasting blood glucose （FBG）， 2 h postprandial blood glucose （2 h PBG）， BMI and WHR in two groups were decreased compared with before intervention， and observation group were lower than those of control group （P<0.05）. After intervention， the levels of triglyceride （TG）， total cholesterol （TC） and low density lipoprotein （LDL） in two groups were decreased compared with before intervention， and the observation group were lower than those of the control group （P<0.05）. After 1 year of intervention， there were no significant differences in diabetes conversion rate and the proportion of patients with normal blood glucose between the two groups （P>0.05）. After intervention， the knowledge of diabetes，self-management and quality of life scores of the two groups were higher than before intervention， and the observation group were higher than those of the control group （P<0.05）. Conclusion： The health management model with the concept of “preventive treatment of disease” in traditional Chinese medicine can improve the blood glucose， blood lipid and life quality of patients with impaired glucose regulation and high risk factors， and has strong advantages in self-management of diabetes， which is worthy of further exploration in clinical practice.

[Key words] Concept of “preventive treatment of disease” Health management Impaired glucose regulation

First-authors address： Zhuhai Center for Chronic Disease Control， Zhuhai 519000， China

doi：10.3969/j.issn.1674-4985.2021.13.041

糖调节受损（IGR）是糖尿病发病之前的一个临床发展阶段，也称为糖尿病前期，是糖代謝介于糖尿病和正常血糖之间的中间状态，包括单纯糖耐量受损、单纯空腹血糖受损及空腹血糖受损合并糖耐量低减三种血糖异常[1]。中华医学会糖尿病学分会于2017年颁布的糖尿病防治指南提示在我国20岁以上的人群中，糖尿病前期的患病率（15.5%）明显高于糖尿病（9.7%）[2-3]。因此积极开展糖尿病前期的健康管理干预是目前重要的课题之一。本研究拟运用中医“治未病”理念的健康管理模式，对糖调节受损患者及其高危人群进行健康干预，观察其效果，现报道如下。……