社区医师健康教育联合药物治疗类风湿关节炎31例临床观察(1)
【摘 要】目的：探讨社区医师健康教育联合药物治疗对类风湿关节炎患者疗效和生活质量的影响。方法：将62例类风湿关节炎患者随机分为治疗组和对照组，每组31例。对照组口服双氯芬酸钠缓释片、来氟米特、甲氨蝶呤及中成药等药物系统治疗；治疗组在对照组基础上，接受社区医师健康教育及治疗干预。2组疗程均为6个月。观察2组患者治疗前后坚持用药和定期复诊情况，以及抑郁自评量表(SDS)评分和焦虑自评量表(SAS)评分。结果：治疗后，治疗组患者坚持用药和定期复诊率均优于对照组
(P < 0.05)；2组SDS评分、SAS评分较治疗前均有改善(P < 0.05)，且治疗组优于对照组(P < 0.05)。结论：社区医师对类风湿关节炎患者在药物治疗的同时，进行健康教育和治疗干预，能促使患者坚持治疗和定期随诊，并能减轻患者的抑郁和焦虑状态，提高生活质量。
【关键词】 关节炎，类风湿；健康教育；治疗干预；社区医师
Clinical Observation on 31 Cases of Rheumatoid Arthritis Treated by Community Doctors' Health Education Combined with Medication
WANG Xiao-qin，ZHANG Jing，YU Wen-guang
【ABSTRACT】Objective：To explore the effects of community doctors' health education and medication on the curative effect and quality of life of patients with rheumatoid arthritis.Methods：Sixty-two cases with rheumatoid arthritis were randomly divided into a treatment group and a control group，31 cases in each group.The control group was treated with diclofenac sustained release tablets，leflunomide，methotrexate and Chinese patent medicine，and the treatment group，based on the treatment for the control group，was given health education and treatment intervention.The two groups were treated for 6 months，observing their adherence to drugs and regular visits before and after treatment，as well as their self-rating depression scale(SDS)and self-rating anxiety scale(SAS).Results：After treatment，the treatment group were superior to the control group on adherence to drugs and regular visits(P < 0.05)，and the SDS and SAS in the two groups were improved(P < 0.05)，and the treatment group was better than the control group(P < 0.05).Conclusion：Community doctors' health education and treatment intervention for the patients with rheumatoid arthritis can promote them to adhere to treatment and regular visits and reduce their depression and anxiety，improving their quality of life.
【Keywords】 arthritis，rheumatoid；health education；treatment intervention；community doctor
類风湿关节炎(rheumatoid arthritis，RA)是一种严重危害人们健康的常见病、多发病，病情迁延发展，如果延误治疗，致残率较高，对关节康复产生影响，且患者多伴有焦虑和抑郁心理。笔者对RA患者应用药物系统治疗同时，给予社区医师的健康教育和治疗干预，观察患者坚持治疗和定期复诊情况，以及对抑郁和焦虑状态的影响，现总结报告如下。
1 临床资料
1.1 一般资料 选取2017年3月至2018年2月在海阳市第三人民医院就诊的RA患者62例，按照随机数字表法分为治疗组和对照组，每组
31例。治疗组男9例，女22例；年龄21～57岁，平均(37.82±8.91)岁；病程0.5～15年，平均(2.90±1.73)年。对照组男8例，女23例；年龄22～60岁，平均(36.92±9.33)岁；病程0.6～
14年，平均(2.74±1.62)年。2组患者在性别、年龄、病程等方面比较，差异无统计学意义(P > 0.05)，具有可比性。
1.2 诊断标准 按照1987年美国风湿病学会(ACR)制定的RA分类标准[1]。
1.3 纳入标准 ①符合上述诊断标准；②自愿接受系统治疗；③签署知情同意书。, 百拇医药(王晓芹 张静 于文广)
(P < 0.05)；2组SDS评分、SAS评分较治疗前均有改善(P < 0.05)，且治疗组优于对照组(P < 0.05)。结论：社区医师对类风湿关节炎患者在药物治疗的同时，进行健康教育和治疗干预，能促使患者坚持治疗和定期随诊，并能减轻患者的抑郁和焦虑状态，提高生活质量。
【关键词】 关节炎，类风湿；健康教育；治疗干预；社区医师
Clinical Observation on 31 Cases of Rheumatoid Arthritis Treated by Community Doctors' Health Education Combined with Medication
WANG Xiao-qin，ZHANG Jing，YU Wen-guang
【ABSTRACT】Objective：To explore the effects of community doctors' health education and medication on the curative effect and quality of life of patients with rheumatoid arthritis.Methods：Sixty-two cases with rheumatoid arthritis were randomly divided into a treatment group and a control group，31 cases in each group.The control group was treated with diclofenac sustained release tablets，leflunomide，methotrexate and Chinese patent medicine，and the treatment group，based on the treatment for the control group，was given health education and treatment intervention.The two groups were treated for 6 months，observing their adherence to drugs and regular visits before and after treatment，as well as their self-rating depression scale(SDS)and self-rating anxiety scale(SAS).Results：After treatment，the treatment group were superior to the control group on adherence to drugs and regular visits(P < 0.05)，and the SDS and SAS in the two groups were improved(P < 0.05)，and the treatment group was better than the control group(P < 0.05).Conclusion：Community doctors' health education and treatment intervention for the patients with rheumatoid arthritis can promote them to adhere to treatment and regular visits and reduce their depression and anxiety，improving their quality of life.
【Keywords】 arthritis，rheumatoid；health education；treatment intervention；community doctor
類风湿关节炎(rheumatoid arthritis，RA)是一种严重危害人们健康的常见病、多发病，病情迁延发展，如果延误治疗，致残率较高，对关节康复产生影响，且患者多伴有焦虑和抑郁心理。笔者对RA患者应用药物系统治疗同时，给予社区医师的健康教育和治疗干预，观察患者坚持治疗和定期复诊情况，以及对抑郁和焦虑状态的影响，现总结报告如下。
1 临床资料
1.1 一般资料 选取2017年3月至2018年2月在海阳市第三人民医院就诊的RA患者62例，按照随机数字表法分为治疗组和对照组，每组
31例。治疗组男9例，女22例；年龄21～57岁，平均(37.82±8.91)岁；病程0.5～15年，平均(2.90±1.73)年。对照组男8例，女23例；年龄22～60岁，平均(36.92±9.33)岁；病程0.6～
14年，平均(2.74±1.62)年。2组患者在性别、年龄、病程等方面比较，差异无统计学意义(P > 0.05)，具有可比性。
1.2 诊断标准 按照1987年美国风湿病学会(ACR)制定的RA分类标准[1]。
1.3 纳入标准 ①符合上述诊断标准；②自愿接受系统治疗；③签署知情同意书。, 百拇医药(王晓芹 张静 于文广)