摘要
目的:评价家庭医生个性化指导对老年高尿酸血症(HUA)患者的影响.方法:本研究纳入体检发现的198 名老年无症状HUA患者,使用随机数字表法分为试验组和对照组.试验组有 100 例,其中男性 65 例,女性 35 例,平均年龄(70.31±5.07)岁;对照组有 98 例,其中男性 62 例,女性 36 例,平均年龄(70.89±6.49)岁.试验组的家庭医生由专科医生进行HUA规范化诊疗培训,根据患者的基本资料制定个性化指导包括健康教育、饮食和运动指导、降尿酸药物治疗并定期电话、面访等随访指导.对照组由门诊医生按照目前常规的健康指导、降尿酸药物治疗进行管理,无定期随访.结果:干预 6个月后,试验组和对照组干预后血尿酸(UA)均较干预前有所下降,但试验组干预后的UA水平显著低于对照组[(411.57±68.55)mmol/L比(431.75±70.05)mmol/L,P＜0.05].干预后试验组的空腹血糖、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、体重指数均明显降低(P＜0.05),对HUA的认知及健康行为执行情况显著高于对照组,对家庭医生的满意度也显著优于对照组,差异均有统计学意义(均P＜0.05).结论:家庭医生对老年无症状HUA患者开展个性化指导,可在降低UA的同时,有效改善HUA患者血糖、血压、血脂、体重指数,降低发生痛风风险,改善HUA患者的预后.
Abstract
Objective:To evaluate the effect of individualized guidance of family doctors on elderly patients with hyperuricemia(HUA).Methods:A total of 198 elderly patients with asymptomatic HUA detected by physical examination were enrolled in this study,and divided into an experimental group and a control group with the random number table method.The experimental group had 100 cases,among them,there were 65 males and 35 females,and the average age was(70.31±5.07)years;the control group had 98 cases,among them,there were 62 males and 36 females,and the average age(70.89±6.49)years.In the experimental group,the family doctors were trained by specialists in the standardized diagnosis and treatment of HUA,and individualized guidance was formulated according to the basic data of patients,including health education,diet and exercise guidance,uric acid-lowering drug treatment,and regular follow-up guidance by telephone and face-to-face visits.The control group was managed by outpatient doctors according to the current routine health guidance and uric acid-lowering drug treatment,without regular follow-up.Results:After 6 months of intervention,uric acid(UA)decreased in both groups,but the UA level in the experimental group was significantly lower than that in the control group(411.57±68.55 μmol/L vs 431.75±70.05 μmol/L,P<0.05).After intervention fasting plasma glucose,systolic blood pressure,diastolic blood pressure,total cholesterol,low density lipoprotein and body mass index in the experimental group decreased significantly(P<0.05),and the cognition of HUA and the implementation of health behaviors in the experimental group were significantly higher than those in the control group,and the satisfaction of family doctors was also significantly better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The individualized guidance provided by family doctors to elderly HUA patients can effectively improve blood glucose,blood pressure,blood lipids and body mass index,reduce the risk of developing gout,and improve the prognosis of HUA patients,while reducing UA.
基金项目
中国社区健康联盟护理中心资助项目(N-PSBH2021-22)
NETL
NSTL
万方数据