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目的了解社区糖尿病管理中Ⅱ型糖尿病患者共病抑郁障碍的发生率及影响因素,并探讨通过社会支持干预对Ⅱ型糖尿病共病抑郁障碍的影响及代谢控制。方法对纳入社区糖尿病分级管理试点的310例Ⅱ型糖尿病患者,通过采用Zung氏抑郁自评量表(SDS)进行测评,选出Ⅱ型糖尿病共病抑郁障碍98例,随机分为治疗组48例,对照组50例,在综合治疗基础上,对治疗组进行为期6个月社会支持干预治疗,治疗前后进行抑郁自评量表及代谢控制水平评估。结果糖尿病患者抑郁障碍患病率为31.6%,高于正常人群;治疗组经社会支持干预治疗6个月后,与治疗前相比抑郁分值降低(P<0.01),抑郁好转率高,与对照组比较差异有统计学意义(P<0.01);血糖控制及代谢指标改善差异有统计学意义(P<0.01)。结论在综合治疗糖尿病患者时,应着重加强患者的心理支持和精神疏导,给患者更多的关怀;同时应努力提高患者对疾病的认识水平及糖尿病防治知识,以社区管理为基础的社会支持可改善抑郁症状及糖代谢。
Objective To investigate the incidence and influencing factors of comorbid depression in type 2 diabetes mellitus (DM) in community diabetes management and to explore the influence of metabolic support and social support intervention on comorbid depression in type 2 diabetes mellitus. Methods A total of 310 type Ⅱ diabetic patients, who were included in the community diabetes management pilot program, were evaluated by Zung’s Self-rating Depression Scale (SDS). 98 cases of type Ⅱ diabetic comorbid depression were selected and randomly divided into treatment group (n = 48) , Control group of 50 cases, on the basis of comprehensive treatment, the treatment group for 6 months social support intervention treatment, before and after treatment for depression self-rating scale and metabolic control level assessment. Results The prevalence of depression in diabetic patients was 31.6%, which was higher than that in normal subjects. After six months of treatment, the depression scores of the patients in treatment group were lower than those before treatment (P <0.01) There was significant difference between the control group and the control group (P <0.01). The difference between the control group and the metabolic index was statistically significant (P <0.01). Conclusion In the comprehensive treatment of diabetic patients, we should focus on strengthening the patient’s psychological support and mental grooming, giving patients more care; the same time, efforts should be made to improve the level of awareness of patients with disease and diabetes prevention and treatment, community-based social support may be Depression symptoms and improve glucose metabolism.