阶段性行为改变对女性 2 型糖尿病患者的影响

摘要

目的 探讨阶段性行为改变模式对促进成年超重、肥胖女性2型糖尿病( DM)合并高血压患者规律运动及代谢指标的影响. 方法 选择2014年1至6月在西安交通大学第一附属医院门诊就医的200例成年超重、肥胖女性2型DM合并高血压患者随机分为试验组100例和对照组100例. 两组均接受常规运动教育,在此基础上试验组运用阶段性行为改变模式进行教育讲座和个体化康复指导. 在入组日及入组后1、3、6个月共4个时间点进行两组之间患者所处的运动改变阶段、运动行为评分、体质量指数( BMI)、血脂、血压、血糖水平的比较. 结果 干预前两组患者所处的运动改变阶段及BMI、血脂、血压、血糖变化比较差异均无统计学意义(均P>0.05). 干预后1、3、6个月,两组患者的行为改变有所改善;具体运动行为(运动频率、运动持续时间)提高;BMI、总胆固醇(TC)、甘油三酯(TG)、血压(DBP、SBP)、糖化血红蛋白(HbAlc)、空腹血糖(FBG)、餐后血糖(PBG)均下降,且试验组较对照组改善明显,差异均有统计学意义( t 值分别为 -30.7581、-14.9125、1.5338、-42.8386、-68.4942、-32.5500、-18.1127、-20.7092,均P<0.05). 结论 阶段性行为改变模式为患者行为改变提供了一个量化的衡量指标,该模式能促进成年超重、肥胖女性2型DM合并高血压患者规律运动并调整代谢指标.%Objective To investigate the influence of phase-behavior-changing-mode on the regulatory exercise and metabolic indices of adult overweight or obese type 2 diabetes mellitus ( DM) women accompanied with hypertension.Methods From January to June in 2014 200 adult outpatients of overweight or obese DM women accompanied with hypertension visiting the First Affiliated Hospital of Xi ' an Jiaotong University were randomly divided into experimental group ( EG, n=100 ) and control group ( CG, n=100 ) , and both groups received general exercise education.In addition, EG received education and individual habilitation guidance in phase-behavior-changing-mode.The stage of behavior changing, score of behavior, body mass index (BMI), lipid, blood pressure and blood glucose were compared at grouping day and 1, 3, 6 months after enrollment.Results No significant difference in the stage of behavior changing, score of behavior, BMI, lipid, blood pressure and blood glucose was observed between two groups before intervention (all P>0.05).After 1, 3 and 6 months, the behavior of patients in both groups were improved, and specific exercise behavior ( frequency and duration) were increased. BMI, TC, TG, DBP, SBP, HbAlc, FBG and PBG were all decreased, and the changes in EG were obvious than those in CG ( t value was-30.7581, -14.9125, 1.5338, -42.8386, -68.4942, -32.5500, -18.1127 and -20.7092, respectively, all P<0.05). Conclusion Phase-behavior-changing-mode provides an index for evaluating behavior changing.The model can benefit the regulatory exercise and metabolism of adult overweight or obese type 2 DM women patients accompanied with hypertension.