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目的:探索建立一个基于医院体检中心的检后服务模式,并将此模式用于常见慢性非传染性疾病的健康管理。方法:将研究人群分为健康管理组和常规体检对照组。对健康管理组在常规体检的基础上,进行疾病风险评估和中医体质测评,检后进行健康管理。统计连续3年完成体检和随访的两组人群管理前后各项体检指标、生活方式、常见慢性疾病高风险比例以及医疗费用的变化。结果:干预后健康管理组人群2型糖尿病、高血压病、中风、冠心病及肺癌、肝癌、胃癌、肠癌、乳腺癌的患病高风险比例显著下降(P<0.05);生活方式(运动及饮食习惯、吸烟、过量饮酒)有明显改善(P<0.05);其中代谢综合症高危人群体重指数、收缩压、舒张压、甘油三酯、总胆固醇、低密度脂蛋白、尿酸显著降低(P<0.05);腰围、空腹血糖的下降和高密度脂蛋白的升高均具有显著性(P<0.01);管理组医疗费用控制比对照组更理想(P<0.05)。结论:以网络为依托,采取中西医结合的方式对体检人群进行检后健康管理,可以有效降低常见慢性病的发病风险,符合费用效果和费用效益原则,可用于医院体检中心检后健康管理。
Objective: To explore a post-examination service model based on the hospital medical examination center and to use this model for the common management of chronic non-communicable diseases. Methods: The study population was divided into health management group and routine physical examination control group. On the basis of routine medical examination, the health management team conducts disease risk assessment and Chinese constitutional physical examination and conducts health check after examination. Statistics for three consecutive years to complete physical examination and follow-up of two groups of people before and after the management of the physical examination indicators, lifestyle, common high risk of chronic diseases and the proportion of changes in medical costs. Results: After the intervention, the risk of type 2 diabetes, hypertension, stroke, coronary heart disease and lung cancer, liver cancer, gastric cancer, intestinal cancer and breast cancer were significantly decreased in the health management group (P <0.05) (P <0.05). The body mass index, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein, and uric acid in high-risk groups with metabolic syndrome were significantly decreased <0.05). The decrease of waist circumference, fasting blood glucose and the increase of high density lipoprotein were all significant (P <0.01). The medical expense control in the management group was better than the control group (P <0.05). Conclusion: Based on the network, adopting the integrated traditional Chinese and western medicine to carry out post-mortem health management of the medical examination population can effectively reduce the risk of common chronic diseases and is in line with the principle of cost-effectiveness and cost-effectiveness and can be used for the post-inspection health management of the medical examination center.