摘要
目的《国家基本公共卫生服务规范(第三版)》中明确要求中医药健康管理要参与到健康教育、慢性病、老年人、孕产妇和儿童等基本公共卫生服务项目中。高血压是社区常见病、多发病,本研究探讨中医药服务融入高血压患者的健康管理模式对高血压患者管理效果。方法选取2017-04-01—2017-07-01上海市宝山区罗店镇社区卫生服务中心门诊就诊的原发性高血压患者200例作为研究对象,按照年龄和性别接近的原则分为干预组和对照组,每组各100例。对照组使用常规药物治疗,即常规降压药物治疗,发放宣传手册和定期讲座宣传基础干预;干预组在常规药物治疗基础上增加辨证施膳、辨证施功和辨证施治中医药治疗方法。观察患者体质量、血压和中医症候变化情况,随访12个月。结果融入中医药服务的高血压患者健康管理模式干预后,干预组体质量为(66.42±9.06)kg,与对照组的(65.66±9.03)kg比较,差异无统计学意义,t=0.601,P=0.548;干预组中医证候评分为(18.89±5.37)分,与对照组的(21.13±4.60)分比较,差异有统计学意义,t=-3.491,P<0.001;干预后1、2、3、6、9和12个月监测患者收缩压和舒张压,两组患者收缩压和舒张压均随时间延长逐渐减低,且组间比较差异有统计学意义,均P<0.001。干预组收缩压和舒张压下降的程度高于对照组,差异有统计学意义,均P<0.001。结论中医药服务融入高血压患者健康管理,能够明显改善高血压患者中医症候,有效和稳定地控制血压。
OBJECTIVE The National Standard for Basic Public Health Services(the third edition)clearly requires TCM health management to be involved in basic public health services such as health education,chronic diseases,the elderly,pregnant and postpartum women,and children.Hypertension is a common disease in the community.The study aims to explore the effect of integrating TCM services into the health management of hypertension patients.METHODS Two hundred cases of community hypertension were selected,randomly divided into two groups(100 cases in each group).The control group received conventional drug therapy,that is,conventional antihypertensive drug therapy,and distributed brochures and regular lectures to publicize the basic intervention.On the basis of conventional drug treatment,the intervention group added the methods of dialectical diet,dialectical performance and dialectical treatment of traditional Chinese medicine.Observation on the patients′weight,blood pressure and symptoms of the syndromes of Chinese medicine were carried out for 12 months.RESULTS The health management model of hypertension patients integrated with TCM services showed that after the intervention,the weight of the intervention group was(66.42±9.06)kg.Compared with the control group(65.66±9.03)kg,the difference was not statistically significant(t=0.601,P=0.548).After the intervention,the TCM syndrome score of the intervention group was(18.89±5.37)points.Compared with(21.13±4.60)points in the control group,the differences between the groups were statistically significant(t=-3.491,P<0.001).Systolic and diastolic blood pressure was monitored at 1,2,3,6,9 and 12 months after intervention.The systolic and diastolic blood pressure decreased gradually with time between the two groups,and the changes between the groups were statistically significant(P<0.001).Systolic and diastolic blood pressure in the intervention group were significantly lower than those in the control group(P<0.001).CONCLUSIONS The integration of TCM services into the health management of hypertension patients can not only significantly improve the symptoms of hypertension patients,but also effectively and steadily control their blood pressure.
作者
蔡传
张明明
吕红城
CAI Chuan;ZHANG Ming-ming;LU Hong-cheng(Department of Traditional Chinese Medicine,Health Service Center of Luodian Community,Baoshan District,Shanghai 201908,P.R.China)
出处
《社区医学杂志》
2019年第18期1156-1159,共4页
Journal Of Community Medicine
基金
上海市家庭医生中医药服务示范(Jtyszyfw19).
关键词
高血压
中医药服务
中医证候
收缩压
舒张压
hypertension
traditional Chinese medicine service
traditional Chinese medicine syndrome
systolic blood pressure
diastolic blood pressure