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目的:采用网状Meta分析方法评价16种教育方法联合药物对2型糖尿病患者血糖和糖化血红蛋白的影响。方法:检索中国学术期刊网络出版总库、维普中文科技期刊全文数据库、中国生物医学文献数据库、万方数据期刊论文资源和中国科学引文数据库获取不同教育方法联合药物对2型糖尿病患者血糖和糖化血红蛋白影响的随机对照试验(randomized controlled trial,RCT),按预先制定的纳入与排除标准筛选和纳入,并对纳入RCTs的质量进行质量评价,数据采用ADDIS软件进行分析。结果:最终纳入57篇RCTs,纳入RCTs的方法学质量低,网状Meta分析结果显示,基于餐后2 h血糖统计分析结果,行为转变理论为基础的干预和无线通讯短信教育优于其他教育方法,基于糖化血红蛋白统计分析结果,以问题为基础的教育和授权原理教育模式优于其他教育方法。结论:网状Meta分析结果提示,以降糖药物联合常规健康教育为共同干预措施,以转变理论为基础的干预和以问题为基础的教育较其他14种教育方法相对有效。
OBJECTIVE: To evaluate the effect of 16 educational methods combined with drugs on blood glucose and HbA1c in patients with type 2 diabetes mellitus using reticular meta-analysis. Methods: To search the Chinese Journal of General Network Publishing, VIP Chinese Science and Technology Journals Full-text Database, Chinese Biomedical Literature Database, Wanfang Data Journal Paper Resources and Chinese Science Citation Database to obtain the blood glucose and glycosylated hemoglobin in patients with type 2 diabetes mellitus Randomized controlled trials (RCTs) were screened and included according to pre-established inclusion and exclusion criteria, and the quality of the RCTs included was evaluated. The data were analyzed using the ADDIS software. RESULTS: The final RCTs included 57 RCTs with poor methodology, and the reticular meta-analysis showed that based on the 2-hour postprandial blood glucose statistics analysis, behavioral change theory-based interventions and wireless messaging were superior to other educational methods Based on the results of HbA1c analysis, the educational model based on problem-based education and authorization principle outperformed other education methods. Conclusions: The results of reticular meta-analysis suggest that interventions based on hypoglycemic agents combined with general health education are more effective than the other 14 educational methods based on change-based theory and problem-based education.