【作者】 孙玮；

【导师】 郭红卫； 孙建琴； 陈爱芳；

【作者基本信息】 复旦大学 ， 公共卫生管理， 2010， 硕士

【摘要】 目的通过社区代谢综合征患者症状体征的前后比较,分析本社区营养综合干预的效果,并探索适合上海社区的营养综合干预的管理模式。方法选择本社区25～85岁的代谢综合征(metabolic syndrome, MS)患者199名,分为营养干预组84名和对照组115名。营养综合干预分为前三个月的强化干预和后9个月的一般干预。干预内容包括营养宣教、膳食指导以及定期的体重、血糖、血压等监测；对照组仅进行健康宣教。根据干预前后问卷及体检结果,分析评价本干预措施对代谢综合征患者症状体征的影响以及营养综合干预模式在社区慢性病治疗中的可行性。结果营养干预组经过12个月的综合干预后,根据配对资料的t检验及方差分析得出干预组的各项体检结果与基线情况相比,收缩压、舒张压、体重、腰围、臀围、BMI及腰臀比的改变有统计学意义(P<0.05)；负荷2h后血糖、糖化血红蛋白以及载脂蛋白A、B的改变与对照组相比也有统计学意义。干预组经过12个月的营养干预,对代谢综合征的知识、态度和行为调查与对照组相比也有明显差异。结论倡导健康的生活方式,而不是一味的寻求如何治疗,是目前社区慢性病管理工作的共识。在社区开展适宜各自情况的不同形式的营养综合干预,以更科学的提倡健康的生活方式是提高人群健康水平、提升生活质量、解决医疗费用不断上涨的必由之路。本课题所采取的营养综合干预措施,对改善代谢综合征患者的症状体征具有明显的效果,这一模式简便易行、成本低廉,值得进一步推广更多还原

【Abstract】 Objectives The object is to compare the effect of the comprehensive nutrition intervention on metabolic syndrome (MS) patients’signs and symptoms in community. We also want to explore an appropriate method for intervention, prenvention and control of MS in community of Shanghai, and improve its effect in controlling MS.Methods According to the criteria of MS given by International Diabetes Federal (IDF),199 people of 25 to 85-year-old were divided into nutrition intervention group and control group. There were 84 people in intervention group and 115 people in control group. Nutrition integrated intervention include the first 3 months’ intensive intervention and next 9 months’ general intervention. The main interventions includes nutritional dietary guidance, regular body weight, blood glucose, blood pressure monitoring. The control group only had a health missionaries. According to the results of intervention questionnaires and physical examination before and after we want to analyze and evaluate the intervention’s effect on metabolic syndrome with symptoms, the impact of nutrition intervention model integrated in the community, and the feasibility of the treatment of chronic diseases.Results After 12 months of comprehensive intervention, based on paired t test and variance analysis, there were significant difference of the medical obtained results in the intervention group compared to baseline. SBP, DBP, weight, waist circumference, hip circumference, BMI, and waist-hip ratio were statistically significant changed (P<0.05); OGTT, HbAlC, and apolipoprotein A, B also have statistical significance. And after twelve months intervention, there were significant difference in KAP investigation between the two groups.Conclusion Promote a healthy lifestyle rather than to find a way of treatment, is currently the consensus in chronic disease management. With the accelerated pace of work life, urban people are faced with over-nutrition and nutritional imbalance problems. Therefore, to promote different forms of comprehensive nutrition intervention in communities by the government is the only way to improve the level of people’s health, enhance the life quality and solve the rising medical costs. This topic has taken an integrated nutrition intervention for improving the signs and symptoms of MS patients; it’s also a significant effect, for it is easy, low cost and should be further broadcast.更多还原