标题：全专团队模式下中西医结合康复对社区2型糖尿病认知功能障碍的效果评价

      作者：周蒨，董萍，陈真，李梅，徐蕾，毛维维，郑羽翔，管佳希，孙永毅，匡晓雯    上海市第一康复医院(同济大学医学院)代谢与肾脏康复科，上海 200090

      卷次： 2020年31卷24期

      【摘要】 目的 探讨全专团队模式下中西医结合康复对社区2型糖尿病(T2DM)患者认知功能障碍的治疗效果。方法 将2017年6月至2018年6月上海市第一康复医院(同济大学医学院)收治的62例T2DM患者采用随机数表法分为对照组和干预组，每组31例。对照组依托社区糖尿病慢病管理平台路径进行规范化管理，在对照组基础上，干预组由中西医结合团队专家提供集体作业疗法(OT)训练、太极拳、针灸等康复治疗方案。干预1年后，比较两组患者血糖控制、认知功能改善及家庭医生服务的利用情况。结果 干预1年后，干预组和对照组患者的FPG[(7.91±1.42) mmol/L、(8.66±1.27) mmol/L]、2 hPG [(9.83±2.9) mmol/L、(11.83±3.01) mmol/L]及HbA1c [(6.90±1.02)%、(7.71±0.94)%]均显著下降，干预组降幅明显大于对照组，差异均有统计学意义(P<0.05)；干预后，干预组和对照组患者的记忆力[(2.96±0.60)分 vs (2.45±0.43)分]、定向力[(8.91±1.46)分 vs (8.34±1.68)分]、注意力和计算力[(4.13±0.42)分 vs(3.67±0.23)分]及总评分[(25.89±1.22)分 vs (23.48±1.43)分]比较，干预组明显高于对照组，差异均有统计学意义(P<0.05)；干预后，干预组和对照组患者的预约门诊率(45.1% vs 31.7%)、签约医生就诊率(64.5% vs 42.7%)、签约服务满意率(19.5% vs 11.6%)比较，干预组明显高于对照组，差异均有统计学意义(P<0.05)。结论 全专团队模式下中西医结合康复可增强T2DM患者血糖控制，并改善认知功能障碍。
      【关键词】 2型糖尿病；全专团队模式；中西医结合；康复治疗；认知功能
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2020）24—3188—04

Effect of integrated Chinese and western medicine rehabilitation under general-specialist team model oncognitive dysfunction of type 2 diabetes mellitus in community.
ZHOU Qian, DONG Ping, CHEN Zhen, LI Mei, XU Lei,MAO Wei-wei, ZHENG Yu-xiang, GUAN Jia-xi, SUN Yong-yi, KUANG Xiao-wen. Department of Metabolism and RenalRehabilitation, Shanghai First Rehabilitation Hospital (Tongji University School of Medicine), Shanghai 200090, CHINA
【Abstract】 Objective To explore the efficacy of integrated Chinese and western medicine rehabilitation undergeneral-specialist team model on cognitive dysfunction of type 2 diabetes mellitus (T2DM) in community. Methods Six-ty-two patients with T2DM who were treated and managed in Shanghai First Rehabilitation Hospital (Tongji UniversitySchool of Medicine) from June 2017 to June 2018 were randomly divided into control group and intervention group byrandom number table. The control group (n=31) was given standardized management relied on the path of community di-abetes management platform. On the basis of the control group, the intervention group was given OT training, Tai Chi,acupuncture and other rehabilitation treatment programs by team experts of integrated Chinese and western medicine.Blood glucose control, cognitive function improvement, and utilization of family doctor services were compared be-tween the two groups at 1 year after the intervention. Results After 1 year of intervention, the blood glucose indexes ofFPG, 2 hPG, and HbA1c in both groups were decreased significantly: FPG, (7.91±1.42) mmol/L vs (8.66±1.27) mmol/L;2 hPG, (9.83±2.91) mmol/L vs (11.83±3.01) mmol/L; HbA1c, (6.90±1.02)% vs (7.71±0.94)%, and the decreases in the inter-vention group were significantly greater than those in the control group (P<0.05). After intervention, MMSE scale scores inthe intervention group were significantly higher than those in the control group (P<0.05): memory, (2.96±0.60) points vs(2.45±0.43) points; orientation, (8.91±1.46) points vs (8.34±1.68) points; attention and computational power, (4.13±0.42) points vs (3.67±0.23) points; total score, (25.89±1.22) points vs (23.48±1.43) points. Compared with the controlgroup, signed doctor visiting rate (64.5% vs 42.7%), appointment rate of outpatient service (45.1% vs 31.7%), and ser-vice satisfaction rate of signed doctor (19.5% vs 11.6%) in the intervention group were significantly higher (P<0.05).Conclusion Integrated Chinese and western medicine rehabilitation under general-specialist team model is helpful toimprove blood glucose control and cognitive dysfunction in patients with T2DM.
      【Key words】 Type 2 diabetes mellitus; General-specialist team model; Integrated Chinese and western medicine;Rehabilitation; Cognitive function