北京市昌平区回龙观社区全科医师进行高血压综合管理及规范化药物对高血压患者的疗效分析

摘要

目的 探讨通过社区全科医师对高血压患者综合管理与规范化药物治疗,患者血压达标率以及血压分级变化.方法 对参加本课题的全科医师进行正规的高血压综合管理及规范化药物治疗培训.将2015年1月～2016年9月于北京市昌平区回龙观社区卫生服务中心全科就诊的高血压患者892例作为入组人群,向高血压患者宣传高血压综合管理及规范化药物治疗内容,将实施综合管理及规范化药物治疗的502例设为观察组,其中男性228例,女性274例.未实施综合管理及规范化药物治疗的390例设为对照组,其中男性213例,女性177例.向观察组患者详细讲解综合管理内容并发放高血压管理手册,按规定的时间随访,采集两组患者的血压达标情况,血压分级情况,不良生活习惯是否减少,以及患者的血糖、血脂、纤维蛋白原、肌酐、尿酸.结果 经过社区全科医师综合管理及规范化药物治疗的观察组患者,血压达标率明显高于对照组,差异有统计学意义(P<0.01),血压分级显著降低.与对照组比较,观察组患者不良生活习惯比例大大减少,差异有统计学意义(P均<0.01).观察组血糖、纤维蛋白原、尿酸、血脂较对照组干预后明显改善,差异有统计学意义(P均<0.01).结论 社区全科医师对高血压患者综合管理及规范化药物治疗是一个合理有效的控制高血压的措施.%Objective To discuss the changes of compliance rate of blood pressure (BP) and BP grading through comprehensive management and standardized medication by general practitioners in communities. Methods The general practitioners took part in this study were given standard training of hypertension comprehensive management and standardized medication. The hypertensive patients (n=892) were chosen from the healthcare center in Huilongguan community of Changping District of Beijing from Jan. 2015 to Sept. 2016, and educated with the content of hypertension comprehensive management and standardized medication. The patients received the education were chosen in observation group (n=502, male 228 and female 274). The patients without the education were chosen in control group (n=390, male 213 and female 177). The observation group was given explanation of comprehensive management content in details and hypertension controlling handbooks, and followed up at set time points. The data about BP controlling, BP grading and decrease of unhealthy living habits were collected, and levels of blood sugar, blood fat, fibrinogen (FIB), creatinine (Cr) and uric acid (UA) were detected in 2 groups.Results The compliance rate of BP was significantly higher (P<0.01), and BP grading was lower in observation group than those in control group. The proportion of patients with unhealthy living habits decreased significantly in observation group compared with control group (all P<0.01). The levels of blood sugar, FIB, UA and blood fat were significantly ameliorated in observation group compared with control group after intervention (all P<0.01).Conclusion The hypertension comprehensive management and standardized medication by general practitioners in communities is a rational and effective measure for controlling hypertension.