本文選題：家庭血壓 + 遠(yuǎn)程血壓監(jiān)測��； 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：本研究通過開展隨機(jī)對照臨床試驗(yàn),對比家庭遠(yuǎn)程血壓監(jiān)測方法和傳統(tǒng)血壓管理方法在高血壓患者中應(yīng)用的臨床效果。另外,由于本臨床研究的的研究對象主要集中在我院及下轄社區(qū),為非多中心研究,同時(shí)因樣本量小,以及隨訪時(shí)間短等原因,我們通過收集了近年來已發(fā)表的相關(guān)文獻(xiàn)進(jìn)行系統(tǒng)評價(jià)及Meta分析,以彌補(bǔ)上述臨床試驗(yàn)的不足。本研究共分為兩部分進(jìn)行論述:第一部分基于物聯(lián)網(wǎng)的家庭遠(yuǎn)程血壓監(jiān)測在高血壓患者中初步應(yīng)用的臨床研究目的:探討基于物聯(lián)網(wǎng)的家庭遠(yuǎn)程血壓監(jiān)測方法較傳統(tǒng)高血壓管理方法對高血壓病患者血壓控制、用藥依從性、生活質(zhì)量、藥物治療強(qiáng)度、延續(xù)性等方面的影響。方法:對入選的142名高血壓患者,隨機(jī)分為對照組和干預(yù)組。對照組患者采用傳統(tǒng)的門診血壓管理方法,干預(yù)組采用物聯(lián)網(wǎng)的家庭遠(yuǎn)程血壓管理。通過12個月隨訪,分析比較兩組中患者的血壓控制情況、用藥依從性、生活質(zhì)量等;在干預(yù)“洗脫期”,評價(jià)遠(yuǎn)程血壓干預(yù)的延續(xù)效應(yīng)。結(jié)果:12個月的遠(yuǎn)程干預(yù)結(jié)束時(shí),干預(yù)組患者血壓明顯低于對照組(P0.05),且血壓達(dá)標(biāo)率明顯高于對照組(P0.05);干預(yù)組患者用藥依從性明顯優(yōu)于對照組(P0.05);生活質(zhì)量評分和治療強(qiáng)度兩組間無明顯差異(P0.05);6個月的洗脫期后,干預(yù)組仍表現(xiàn)出較對照組更好的血壓控制及用藥依從性(P0.05)。結(jié)論:與傳統(tǒng)的管理方式相比,基于物聯(lián)網(wǎng)的高血壓的遠(yuǎn)程管理方法能夠更大程度的降低血壓,提高血壓的達(dá)標(biāo)率,增進(jìn)用藥依從性。第二部分家庭遠(yuǎn)程血壓監(jiān)測的臨床效果:一項(xiàng)基于隨機(jī)對照研究的系統(tǒng)評價(jià)及Meta分析目的:進(jìn)一步探討關(guān)于家庭遠(yuǎn)程血壓監(jiān)測的臨床效果及其關(guān)鍵組成部分。方法:通過檢索PubMed、EMBASE和Cochrane等多個數(shù)據(jù)庫,查找相關(guān)期刊論文、會議論文及其他灰色文獻(xiàn)。結(jié)果:經(jīng)過嚴(yán)格的篩選后共納入46篇文獻(xiàn),包含13875例患者。血壓變化:與對照組相比,家庭血壓監(jiān)測組患者收縮壓和舒張壓的下降幅度分別為3.99mmHg和1.99mmHg(P均0.05)。對于動態(tài)血壓變化情況,無論收縮壓(-4.41 mmHg)和舒張壓(-2.33mmHg)家庭遠(yuǎn)程血壓監(jiān)測組均明顯高于對照組(P0.05)。血壓達(dá)標(biāo)率:家庭遠(yuǎn)程血壓監(jiān)測組患者血壓達(dá)標(biāo)率明顯高于對照組。次要指標(biāo):各指標(biāo)均未發(fā)現(xiàn)明顯的組間差異。亞組分析:與對照組相比,在隨訪時(shí)間為6或12月、使用基于電腦的數(shù)據(jù)傳輸方式,或伴有咨詢的額外支持方法的亞組中,遠(yuǎn)程血壓監(jiān)測可以更好的控制血壓。結(jié)論:家庭遠(yuǎn)程血壓監(jiān)測方法較傳統(tǒng)方法能更好的控制血壓;使用合適的干預(yù)工具或者提供積極主動的額外支持,將會有更好的血壓控制效果。
[Abstract]:In this study, a randomized controlled clinical trial was conducted to compare the clinical effects of home remote blood pressure monitoring and traditional blood pressure management in hypertensive patients. In addition, because the subjects of this clinical study are mainly concentrated in our hospital and the community under their jurisdiction, they are non-multicenter studies. At the same time, the sample size is small, and the follow-up time is short, and so on. In order to make up for the deficiency of the above clinical trials, we collected the literature published in recent years for systematic evaluation and meta-analysis. This study is divided into two parts: the first part is the clinical study of the primary application of remote home blood pressure monitoring based on the Internet of things in patients with hypertension objective: to explore the method of remote blood pressure monitoring based on the Internet of things. Traditional hypertension management methods to control the blood pressure of patients with hypertension, Drug compliance, quality of life, drug treatment intensity, continuity and so on. Methods: 142 patients with hypertension were randomly divided into control group and intervention group. The control group adopted the traditional outpatient blood pressure management method, the intervention group adopted the remote blood pressure management based on Internet of things. After 12 months follow-up, the blood pressure control, drug compliance and quality of life of patients in the two groups were analyzed and compared, and the continuation effect of remote blood pressure intervention was evaluated during the "elution period". Results: at the end of 12 months of remote intervention, The blood pressure of the intervention group was significantly lower than that of the control group (P0.05), and the rate of blood pressure reaching the standard was significantly higher than that of the control group (P0.05); the drug compliance of the intervention group was significantly better than that of the control group (P0.05); there was no significant difference between the two groups in quality of life score and treatment intensity (P0.05); after 6 months of elution, there was no significant difference between the two groups. The intervention group still showed better blood pressure control and drug compliance than the control group (P0.05). Conclusion: compared with traditional management, remote management of hypertension based on Internet of things can lower blood pressure, improve blood pressure compliance and improve drug compliance. The second part: clinical effect of home remote blood pressure monitoring: a systematic evaluation and meta-analysis based on randomized controlled study objective: to further explore the clinical effect and key components of household remote blood pressure monitoring. Methods: through searching several databases of PubMedus EMBASE and Cochrane, we searched for related journal papers, conference papers and other grey papers. Results: a total of 46 articles including 13875 patients were included after strict screening. Changes of blood pressure: the decrease of systolic and diastolic blood pressure were 3.99mmHg and 1.99mmHg respectively in the family blood pressure monitoring group compared with the control group (P 0.05). Both systolic blood pressure (-4.41 mmHg) and diastolic blood pressure (-2.33 mmHg) were significantly higher in the ambulatory blood pressure monitoring group than in the control group (P0.05). The blood pressure reached the standard rate in the home remote blood pressure monitoring group was significantly higher than that in the control group. Secondary indicators: no significant differences between groups were found in each index. Subgroup analysis: remote blood pressure monitoring was more effective in controlling blood pressure in groups that were followed up for 6 or 12 months using computer-based data transmission or additional support with counseling. Conclusion: the home remote blood pressure monitoring method can control blood pressure better than the traditional method, and it will have better blood pressure control effect by using appropriate intervention tools or providing active and additional support.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.1

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相關(guān)期刊論文 前1條

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本文編號：2117028