| Objective:1.Further perfect, promotion and application of the non-drug therapy of TCM, which was used to intervented the T2DM and hypertension of community, then to evaluate the effect after the intervention;2.To strengthen the management and prevention and control work which community-based chronic noncommunicable diseases such as T2DM and hypertension, to explore the community chronic disease management of TCM appropriate technologies.Methods:1.The research methods:The research used the cross-sectional study and signed "technical cooperation contract" with identified five community health service centers (they include Dashala community, Guangnei community, Taoranting community, Shichahai community and Zhanlanlu community) in Xicheng District in Beijing, then carried out the research which from 2015 May to December.We used the Patients with risk factors questionnaire (self-designed), the symptoms of T2DM and hypertension scores questionnaire, SF-36 life quality scale, and measured the patient’s height, weight,and calculated the patient’s HR, BP, BMI, examined patients’FBG, Ph2PG, HbAlc. We used the descriptive statistics, one-way analysis of variance, chi-square test, non-parametric test and the binary Logistic regression and so on to statistics and analysis all the raw data by SPSS20.0.2.The intervention methods:190 cases were divided into control group with 95 cases and intervention group with 95 cases, the study period was 6 months.The control group with the conventional treatment (including drug therapy and regular exercise),beside those treatment,the intervention group with health propaganda and education of TCM prevention health knowledge, dietetic therapy of TCM,exercise of TCM(give priority to with baduanjin),emotional adjustment,First of all, comparison of the enumeration data and measurement data between the intervention group and the control group at baseline,to determine whether it can be compared;After finished the study in all patients,used EpiData3.1 set up a database to input respectively the original data of intervention group and control group,by two ways that include manually and computer in order to inspect data if there are logic errors.Secondly, comparison the baseline and 6th intervention month data of the control group with 95 cases;Thirdly,comparison the baseline,third and sixth intervention month data of the intervention group with 95 cases;Fourthly,comparison the sixth intervention month data of the control group and the intervention group;Finally, to gather statistics that 190 cases of community choronic disease management status of T2DM and hypertension patients in Xicheng District in Beijing.Measurement data conforms to normal distribution using the one-way analysis of variance, not conforms to the normal distribution using the non-parametric test, counting data by chi-square test.Result:1.In 190 cases of T2DM and hypertension patients in community,there are 72 cases of men, accounting for 37.90%,118 cases of women, accounting for 62.10%. According to binary Logistic regression analysis,Course of the disease (OR=1.113) is a risk factor for FBG-. P2hPG; while the cultural degree (OR= 0.507) is a protective factor for P2hPG;Gender (OR=10.100), smoking (OR=14.964) is a risk factor for DBP.Measurement data of two groups of nonparametric test showed that all the baseline data of the control group and intervention group are compared to P> 0.05, there is no statistical significance, that is to say, can be comparable between two groups.2.Among 190 cases of T2DM and hypertension patients’ baseline data of SF-36 life quality’s score investigation, male patients’SF-36 life quality’s each latitude average score over 80 points, including physiological function (81.74+16.91), social function (83.85±20.39) and role emotional (88.89±27.41); female patients’ SF-36 life quality’s each latitude average score over 80 points, including only an emotional functions (80.79±37.34), the rest of the latitude’average score such as physiological function and general health, body pain, vitality and mental health are not high, the lowest average score in SF-36 life quality’s each latitude is general health,male(62.56 ±14.01)、female(59.68±16.55). Compare between different course of SF-36 life quality’s each latitude,body pain<4.9group>10.0-14.9group,5.0-9.9group>10.0-14.9 group,P< 0.05,with statistical significance,others no statistically significant.3.After 6 months, the control group had statistical significances in DBP(P=0.011), P2hPG (P=0.005), HbAlc (P=0.037), RP (P=0.005), SF (P=0.013), P<0.05; had Significant statistical significance in PE (P=0.000),GH (P=0.000), P<0.01,others no statistically significant.4.After 3 months and 6 months, the intervention group had statistical significances in SBP (P=0.024), FBG (P=0.033),the symptoms of T2DM and hypertension scores (P=0.001), PF(P=0.027), RP(P=0.004),P<0.05, had statistical significance.5.The comparison of general health trends:after 6 months, the general health trends of control group P>0.05, there is no statistically significant; After 3 months and 6 months comparied with belined general health trends of intervention group, P<0.01, had Significant statistical significance,but 3 months comparied with 6 months P>0.05, there is no statistically significant; After 6 months, the comparison of control group general health trends and the intervention group general health trends, P<0.01, had Significant statistical significance.6.According to the analysis of the 190 cases of T2DM and hypertension patients’ community choronic disease management investigation, the health records coverage rate is 91.9%, health service satisfaction is 98.9%, there are 76.8% patients thought that choronic disease prevention and control knowledge can get help form the community general practitioners timely when they needed,90.0% of the patients can accept the medical costs which from the community service center referral to the superior hospital,92.6% of the patients thought beteween the community service center to the superior hospitals’ traffic is convenient.Under the same condition of ttherapeutic effect,93.2% of patients considered community drug prices are relatively cheaper than the superior hospitals. In the case of community physicians have equal treatment capacity,85.3% of patients who would choose the community health service centers.71.6% of the patients said that they had received movement guidance from community general practitioners, while there are just 30.5% of patients had received emotional guidance.Only 3.7% of the patients could get choronic disease intervention by once a week, however,34.7% of patients every three months to get a chance to choronic disease intervention.Conclusion:1.To strengthen the patients’health promotion education that choronic disease prevention and control knowledgethe, guidance and counseling patients to quit smoking, condition monitoring are the key to control the risk factors and improve the patients’ self management ability.2.We need to effectively control the T2DM and hypertension patients’condition, but at the same time should be strengthened in physical exercise and modern cultivate intervention, can help patients improve the general quality of survival.3.Community health management play an important role in T2DM and hypertension patients.4.Non-drug therapy of TCM ntegrated scheme can produce exactly curative effect on T2DM and hypertension patients in community intervention, at the same time it could make the community choronic dieseas intervention appropriate technologies to be more complement and rich.5.Five communities health service centers in Xicheng District in Beijing are suitable to carry out the "grading diagnosis" medical management model, Speed up and improve the mechanism of the cultivationand and policy guarantee of TCM general practitioners,to develop the TCM appropriate technology into the communities is the key.6.Non-drug therapy of TCM integrated scheme is a set of curative effect appropriate technology for choronic disease intervention and the effective way to improve community general practitioners of TCM professional skills, but also a right way of promotional and has strong feasibility and fully inherited and enriched the TCM theory of preventive treatmentl which applied to the community choronic disease intervention work. |
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