摘要
目的探讨以家庭医生为依托的系统随访及强化教育对轻中度慢性阻塞性肺疾病(COPD)患者的意义。方法将2018年1月至9月在浦东新区金桥社区卫生服务中心治疗与管理的200例轻中度COPD患者,随机分为对照组(100例)、干预组(100例)。对照组按照《慢性阻塞性肺疾病全球倡议》进行规范化管理,干预组在此基础上依托家庭医生进行系统随访、强化教育及肺功能检测随访。随访18个月后,分析2组COPD病情、烟草依赖程度及肺功能变化。结果随访18个月,2组慢性阻塞性肺疾病评估测试(CAT)评分和改良的英国医学委员会量表(mMRC)评分均显著改善,干预组各评分仍明显低于对照组(P<0.05)。随访12、18个月,干预组戒烟成功率较对照组明显升高,而尼古丁依赖检测量表(FTND)评分则显著降低(P<0.05)。随访18个月,两组肺功能指标均有不同程度改善,干预组FVC预计值的百分比(FVC%)pred、第1秒用力呼吸容积(FEV1)、FEV1/用力肺活量(FVC)水平显著高于对照组(P<0.05)。结论以家庭医生为依托的系统随访和强化教育有助于改善轻中度COPD患者呼吸困难症状,降低烟草依赖程度,改善肺功能。
Objective To explore the significance of systematic follow-up and intensive education supported by family doctors for patients with mild and moderate chronic obstructive pulmonary disease(COPD).Methods From January 2018 to September 2018,200 patients with mild and moderate COPD who were treated and managed in Jinqiao community health service center of Pudong new area were randomly divided into thecontrol group andthe intervention group.The control group(n=100)was standardized in accordance with the global initiative for chronic obstructive lung disease(GOLD),and the intervention group(n=100)relied on family physicians for systematic follow-up,intensive education,and follow-up for lung function testing.After a follow-up of 18 months,COPD status,tobacco dependence and lung function in the two groups were compared and analyzed.Results Follow-up for 18 months showed that there was significant improvement in CAT scores and mMRC scores in the two groups,while the scores in the intervention group were still significantly lower than those in the control group(P<0.05).The success rate of smoking cessation in the intervention group was significantly higher than that in the control group during the follow-up period of 12 and 18 months,while FTND score was significantly reduced(P<0.05).During the follow-up for 18 months,the lung function indexes of the two groups were improved to varying degrees,and the levels of FVC%pred,FEV1 and FEV1/FVC in the intervention group were significantly higher than those in the control group(P<0.05).Conclusions Systematic follow-up and intensive education supported by family doctors can help to improve respiratory distress,reduce tobacco dependence,and improve lung function in patients with mild to moderate COPD.
作者
崔凯铭
张蓉
Cui Kaiming;Zhang Rong(Department of General Medicine,Jinqiao Community Health Service Center,Pudong New Area,Shanghai 201206,China)
出处
《山西医药杂志》
CAS
2021年第8期1231-1234,共4页
Shanxi Medical Journal
基金
上海市浦东新区卫生和计划生育委员会卫生计生科研项目(PW2018B-21)。
关键词
肺疾病
慢性阻塞性
随访研究
强化教育
家庭医生
Pulmonary disease,chronic obstructive
Follow-up studies
Intensive education
Family doctor
